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四个初级卫生保健单位中吸烟与血脂谱的关系:一项研究

Relationship Between Smoking and Lipid Profile in Four Primary Health Care Units: A Research Study.

作者信息

Sousa Inês R, Miranda Marlene, Gomes Hugo, Figueiredo Adriana, Silva Jessica, Campos Juliana

机构信息

Family Medicine, Unidade de Saúde Familiar Viatodos, Barcelos, PRT.

Family Medicine, Unidade de Saúde Familiar Lígios, Barcelos, PRT.

出版信息

Cureus. 2024 Sep 11;16(9):e69172. doi: 10.7759/cureus.69172. eCollection 2024 Sep.

Abstract

Introduction Smoking is the most preventable cause of cardiovascular disease (CVD). Dyslipidemia is also an important risk factor for CVD. Yet, research has provided contradicting findings regarding the association between smoking and blood lipids. This study aims to assess the relationship between smoking and dyslipidemia, as well as compliance with the previously established treatment target. Materials and methods This was a cross-sectional study. Apparently, healthy users aged 40 or over, were from four primary health care units (PHCU) in Portugal. The inclusion criteria were: age between 40 and 69 and active enrollment in one of the four PHCU. The exclusion criteria were: background of atherosclerotic disease, heart failure, chronic kidney disease, diabetes mellitus, and a history of acute myocardial infarction; no record of lipid profile or triglyceride value of more than 400 mg/dL. Cardiovascular risk levels were determined using the Systematic Coronary Risk Evaluation (SCORE) 2 risk. The low-density lipoprotein cholesterol (LDL-c) target was considered the recommendation by the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) 2019. Results From an initial population of 16,939 patients, 12,076 apparently healthy patients were included. The difference between cholesterol values is statistically significant, with total cholesterol, LDL-c, and triglyceride values tending to be higher in the smoking group and the high-density lipoprotein cholesterol (HDL-c) value tending to be higher in the non-smoking group. Regarding the LDL target, there is also a statistically significant difference between smokers and non-smokers. Discussion Smoking and dyslipidemia are two isolated cardiovascular risk factors. Their association has been questioned. This study demonstrated that there is an association between smoking and the lipid profile, but also with the LDL target. However, there are some biases that must be considered, and which do not allow for generalization. Conclusions This study concludes that smoking negatively influences the lipid profile, with lipids being found less frequently on target. However, more studies are needed in this area, particularly studying other relevant factors such as body mass index.

摘要

引言

吸烟是心血管疾病(CVD)最可预防的病因。血脂异常也是心血管疾病的一个重要危险因素。然而,关于吸烟与血脂之间的关联,研究结果相互矛盾。本研究旨在评估吸烟与血脂异常之间的关系,以及与先前确立的治疗目标的依从性。

材料与方法

这是一项横断面研究。明显健康的40岁及以上使用者来自葡萄牙的四个初级卫生保健单位(PHCU)。纳入标准为:年龄在40至69岁之间且积极登记参加四个PHCU之一。排除标准为:动脉粥样硬化疾病、心力衰竭、慢性肾病、糖尿病病史以及急性心肌梗死病史;无血脂谱记录或甘油三酯值超过400mg/dL。使用系统性冠状动脉风险评估(SCORE)2风险来确定心血管风险水平。低密度脂蛋白胆固醇(LDL-c)目标被视为欧洲心脏病学会/欧洲动脉粥样硬化学会(ESC/EAS)2019年的建议。

结果

从最初的16939名患者群体中,纳入了12076名明显健康的患者。胆固醇值之间的差异具有统计学意义,吸烟组的总胆固醇、LDL-c和甘油三酯值往往更高,而非吸烟组的高密度脂蛋白胆固醇(HDL-c)值往往更高。关于LDL目标,吸烟者和非吸烟者之间也存在统计学显著差异。

讨论

吸烟和血脂异常是两个独立的心血管危险因素。它们之间的关联受到质疑。本研究表明吸烟与血脂谱之间存在关联,而且与LDL目标也有关联。然而,存在一些必须考虑的偏差,不允许进行推广。

结论

本研究得出结论,吸烟对血脂谱有负面影响,血脂达标的情况较少见。然而,该领域需要更多研究,特别是研究其他相关因素,如体重指数。

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