Freedman D S, Gruchow H W, Manley J C, Anderson A J, Sobocinski K A, Barboriak J J
Division of Biostatistics and Clinical Epidemiology, Medical College of Wisconsin, Milwaukee 53226.
Am J Cardiol. 1988 Aug 1;62(4):214-9. doi: 10.1016/0002-9149(88)90214-7.
Although the leading cause of death among black men in the United States is coronary artery disease (CAD), risk factors have not been well documented in black populations. Therefore, possible racial differences in the relation of several characteristics to the extent of CAD were assessed in 4,722 white and 169 black men who underwent arteriography. Associations between an occlusion score (ranging from 0 to 300), reflecting the severity of CAD, and levels of total and high-density lipoprotein (HDL) cholesterol, triglycerides, cigarette smoking, alcohol intake, relative weight, systemic hypertension and diabetes mellitus were examined. Most risk factors were significantly related to the extent of CAD in both races, but lipid levels showed stronger associations with CAD among blacks: correlations between CAD and total cholesterol were 0.16 (whites) vs 0.29 (blacks) and associations with HDL cholesterol were -0.22 (whites) vs -0.49 (blacks). In addition, at adverse levels of certain risk factors, blacks had more extensive CAD than did whites: mean occlusion scores were 148 (whites) and 238 (blacks) at HDL cholesterol levels less than 30 mg/dl. As assessed by multiple linear regression, however, only triglyceride levels were differentially related to CAD between whites (beta = 0) and blacks (beta = 0.47), p less than 0.01 for racial contrast. These results document the importance of risk factors in black men and indicate black/white differences in the relation of triglycerides to CAD.
尽管在美国黑人男性中，主要死因是冠状动脉疾病（CAD），但黑人人群中的风险因素尚未得到充分记录。因此，在4722名白人和169名接受血管造影的黑人男性中，评估了几种特征与CAD程度之间可能存在的种族差异。研究了反映CAD严重程度的闭塞评分（范围为0至300）与总胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯水平、吸烟、饮酒、相对体重、系统性高血压和糖尿病之间的关联。大多数风险因素在两个种族中均与CAD程度显著相关，但脂质水平在黑人中与CAD的关联更强：CAD与总胆固醇的相关性在白人中为0.16，在黑人中为0.29；与HDL胆固醇的关联在白人中为-0.22，在黑人中为-0.49。此外，在某些风险因素处于不利水平时，黑人的CAD比白人更广泛：在HDL胆固醇水平低于30mg/dl时，平均闭塞评分白人是148，黑人是238。然而，通过多元线性回归评估，只有甘油三酯水平在白人与黑人之间与CAD的关系存在差异（白人的β=0，黑人的β=0.47），种族对比的p值小于0.01。这些结果证明了风险因素在黑人男性中的重要性，并表明甘油三酯与CAD关系中的黑白差异。
