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癌症与心血管毒性的关联:基于 1999-2018 年 NHANES 的全国性横断面研究。

Association Between Cancer and Cardiovascular Toxicity: A Nationwide Cross-Sectional Study on NHANES 1999-2018.

机构信息

Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

出版信息

Cardiovasc Toxicol. 2024 Apr;24(4):351-364. doi: 10.1007/s12012-024-09845-6. Epub 2024 Mar 11.

Abstract

There is a dearth of evidence pertaining to the relationship of cardiovascular disease (CVD) and its subtype with adjudicated cancer, thereby limiting our understanding of the heightened risk of CVD resulting from long-term complications of cancer and its therapies. The aim of this study was to quantify the risks of CVD and its subtypes in adult cancer survivors compared with cancer-free controls in a nationwide cross-sectional study on Continuous National Health and Nutrition Examination Survey (NHANES). We included 44,442 participants ranging in age from 20 to 85 years. Cancer and CVD diagnoses were ascertained via the household questionnaires. The association of cancer status with the risk of CVD and CVD subtype was examined using weighted logistic regression. Stratification analyses were also performed by age, sex, race, marital status, income status, educational level, and hyperlipidemia. The Wald test was used to calculate P-value for interaction. A total of 4178 participants have cancer, while 4829 participants had CVD, respectively. In the multivariable-adjusted model, the cancer was consistently linked to an elevated risk of CVD. Stratification analyses showed that stronger association between cancer status and CVD risk was found in younger adults, non-white, and participants living without a spouse or partner, and without hyperlipidemia. Our study confirmed that cancer participants were strongly linked to living with CVD, independent of traditional cardiovascular risk factors, especially in younger adults, non-white, and participants living without a spouse or partner, and without hyperlipidemia. There exists a pressing requirement to establish effective strategies for the prevention of CVD within this population characterized by a heightened risk.

摘要

关于心血管疾病(CVD)及其亚型与已确诊癌症之间的关系,证据匮乏,这限制了我们对癌症及其治疗长期并发症导致 CVD 风险增加的理解。本研究旨在通过全国性的横断面研究——连续国家健康和营养检查调查(NHANES),量化成年癌症幸存者与无癌症对照者 CVD 及其亚型的风险。我们纳入了年龄在 20 至 85 岁之间的 44442 名参与者。癌症和 CVD 的诊断是通过家庭问卷确定的。使用加权逻辑回归检验癌症状况与 CVD 和 CVD 亚型风险之间的关联。还按年龄、性别、种族、婚姻状况、收入状况、教育水平和高血脂症进行了分层分析。使用 Wald 检验计算交互作用的 P 值。共有 4178 名参与者患有癌症,4829 名参与者患有 CVD。在多变量调整模型中,癌症与 CVD 风险升高一致相关。分层分析表明,癌症状况与 CVD 风险之间的关联在年轻成年人、非白人以及没有配偶或伴侣、没有高血脂症的参与者中更强。我们的研究证实,癌症患者与 CVD 的发生密切相关,独立于传统心血管危险因素,尤其是在年轻成年人、非白人以及没有配偶或伴侣、没有高血脂症的参与者中。对于具有更高风险的人群,迫切需要制定有效的 CVD 预防策略。

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