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在长达61年直至研究对象全部死亡的随访中,预测中年人群心血管疾病和癌症死亡的心血管危险因素。

Cardiovascular Risk Factors Predicting Cardiovascular and Cancer Deaths in a Middle-Aged Population Followed-Up for 61 Years until Extinction.

作者信息

Menotti Alessandro, Puddu Paolo Emilio, Piras Paolo

机构信息

Association for Cardiac Research, 00182 Rome, Italy.

EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions D'ischémie Reperfusion Myocardique, Normandie Université, UNICAEN, 14000 Caen, France.

出版信息

J Cardiovasc Dev Dis. 2024 Aug 5;11(8):240. doi: 10.3390/jcdd11080240.

Abstract

BACKGROUND AND AIM

To study the relationships of cardiovascular risk factors with cancer and cardiovascular mortality in a cohort of middle-aged men followed-up for 61 years.

MATERIALS AND METHODS

A rural cohort of 1611 cancer- and cardiovascular disease-free men aged 40-59 years was examined in 1960 within the Italian Section of the Seven Countries Study, and 28 risk factors measured at baseline were used to predict cancer ( = 459) and cardiovascular deaths ( = 678) that occurred during 61 years of follow-up until the extinction of the cohort with Cox proportional hazard models.

RESULTS

A model with 28 risk factors and cancer deaths as the end-point produced eight statistically significant coefficients for age, smoking habits, mother early death, corneal arcus, xanthelasma and diabetes directly related to events, and arm circumference and healthy diet inversely related. In the corresponding models for major cardiovascular diseases and their subgroups, only the coefficients of age and smoking habits were significant among those found for cancer deaths, to which healthy diet can be added if considering coronary heart disease alone. Following a competing risks analysis by the Fine-Gray method, risk factors significantly common to both conditions were only age, smoking, and xanthelasma.

CONCLUSIONS

A sizeable number of traditional cardiovascular risk factors were not predictors of cancer death in a middle-aged male cohort followed-up until extinction.

摘要

背景与目的

研究一个随访61年的中年男性队列中心血管危险因素与癌症及心血管疾病死亡率之间的关系。

材料与方法

1960年,在七国研究的意大利分部对一个由1611名年龄在40 - 59岁、无癌症和心血管疾病的男性组成的农村队列进行了检查,并使用基线时测量的28个危险因素,通过Cox比例风险模型预测在长达61年的随访期间直至该队列消失时发生的癌症死亡(n = 459)和心血管死亡(n = 678)。

结果

以28个危险因素和癌症死亡为终点的模型产生了8个具有统计学意义的系数,分别为与事件直接相关的年龄、吸烟习惯、母亲早逝、角膜弓、睑黄瘤和糖尿病,以及与事件呈负相关的上臂围和健康饮食。在主要心血管疾病及其亚组的相应模型中,在癌症死亡相关的因素中,只有年龄和吸烟习惯的系数具有统计学意义,如果仅考虑冠心病,则可加上健康饮食。采用Fine - Gray方法进行竞争风险分析后,两种情况显著共有的危险因素只有年龄、吸烟和睑黄瘤。

结论

在一个随访至队列消失的中年男性队列中,相当数量的传统心血管危险因素并非癌症死亡的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/635f/11354922/e2b46b26fe45/jcdd-11-00240-g001.jpg

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