Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Selangor, Malaysia.
Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor, Malaysia.
BMC Cardiovasc Disord. 2022 Feb 23;22(1):70. doi: 10.1186/s12872-021-02447-y.
Coronary artery disease (CAD) is one of the major causes of morbidity and mortality worldwide. Early identification of the cardiovascular risk factors (CRF) among youths assists in determining the high-risk group to develop CAD in later life. In view of the modernised lifestyle, both urban and rural residing youths are thought to be equally exposed to various CRF. This study aimed to describe the common CRF including obesity, dyslipidaemia, hypertension, smoking and family history of hypercholesterolaemia and premature CAD in youths residing in urban and rural areas in Malaysia.
We recruited 942 Malaysian subjects aged 15-24 years old [(males = 257, and urban = 555 vs. rural = 387, (mean age ± SD = 20.5 ± 2.1 years)] from the community health screening programmes organised in both rural and urban regions throughout Malaysia. Medical history and standardised anthropometric measurements were recorded. Laboratory investigations were obtained for fasting serum lipid profiles and plasma glucose levels.
A total of 43.7% from the total study population was either obese or overweight. Youths in the rural were more overweight and obese (49.4% vs. 42.7%, p < 0.044) and have higher family history of hypercholesterolaemia (16.3% vs. 11.3%, p < 0.036) than youths in the urban areas. Low-density lipoprotein (LDL-c) (2.8 vs. 2.7 mmol/L) and total cholesterol (TC) (4.7 vs. 4.5 mmol/L) were significantly higher in urban compared to rural youths (p < 0.019 and p < 0.012). Overall, more youth in this study has CRF rather than not (Has ≥ 1 CRF = 69.9%). Significantly more rural youths have at least one CRF compared to urban youths (rural = 74.2% vs. urban = 66.8%, p = 0.016).
In conclusion, our study showed that a large number of youths had at least one or more CRF. Rural youths have significantly higher BMI with higher family history of hypercholesterolaemia compared to urban youths. However, urban youths have higher LDL-c and TC levels. Other coronary risk factors are not significantly different between urban and rural youths. Rural youths have more CRF compared to urban youths. A larger longitudinal study focusing on this population is important to better understand the effect of the area of residence on CRF in youth.
冠心病（CAD）是全球发病率和死亡率的主要原因之一。在年轻人中早期识别心血管危险因素（CRF）有助于确定以后生活中发生 CAD 的高危人群。鉴于现代生活方式，城市和农村地区的年轻人都被认为同样容易受到各种 CRF 的影响。本研究旨在描述包括肥胖、血脂异常、高血压、吸烟以及家族性高胆固醇血症和早发性 CAD 在内的常见 CRF，这些 CRF 存在于马来西亚城乡年轻人中。
我们招募了 942 名年龄在 15-24 岁的马来西亚受试者（男性 257 名，城市 555 名，农村 387 名，（平均年龄±标准差为 20.5±2.1 岁）），他们来自马来西亚城乡各地的社区健康筛查计划。记录了他们的病史和标准化的人体测量学数据。进行了空腹血清血脂谱和血糖水平的实验室检查。
研究人群中共有 43.7%的人超重或肥胖。农村地区的年轻人超重和肥胖的比例更高（49.4%比 42.7%，p<0.044），且家族性高胆固醇血症的比例更高（16.3%比 11.3%，p<0.036）。与农村年轻人相比，城市年轻人的低密度脂蛋白胆固醇（LDL-c）（2.8 比 2.7mmol/L）和总胆固醇（TC）（4.7 比 4.5mmol/L）更高（p<0.019 和 p<0.012）。总的来说，本研究中患有 CRF 的年轻人多于不患有 CRF 的年轻人（有≥1 项 CRF 者=69.9%）。与城市年轻人相比，农村年轻人中至少有一项 CRF 的比例明显更高（农村年轻人为 74.2%，城市年轻人为 66.8%，p=0.016）。
总之，我们的研究表明，大量年轻人至少有一种或多种 CRF。与城市年轻人相比，农村年轻人的 BMI 更高，且家族性高胆固醇血症的比例更高。然而，城市年轻人的 LDL-c 和 TC 水平更高。城乡年轻人之间的其他冠心病危险因素没有显著差异。与城市年轻人相比，农村年轻人的 CRF 更多。对这一人群进行更大规模的纵向研究，有助于更好地了解居住地区对年轻人 CRF 的影响。
