Coughlin S S, Tefft M C
Department of Biostatistics and Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112.
Epidemiology. 1994 Jul;5(4):449-55. doi: 10.1097/00001648-199407000-00012.
We examined possible risk factors for idiopathic dilated cardiomyopathy in women by comparing newly diagnosed cases (N = 61) ascertained from five Washington DC area hospitals with neighborhood controls (N = 122) identified using a random digit dialing technique. We matched the cases and controls on 5-year age intervals and telephone exchange and analyzed the data using conditional logistic regression methods. We found that idiopathic dilated cardiomyopathy was associated with history of asthma, diabetes mellitus, hypertension, and black race. The association with hypertension was particularly strong among women who were less than 50 years of age [crude relative odds (RO) = 21.0, 95% confidence interval (CI) = 4.6-96.9]. We found a strong inverse association with history of oral contraceptive use (crude RO = 0.3, 95% CI = 0.1-0.7; adjusted RO = 0.1, 95% CI = 0.1-0.5, controlling for other identified risk factors). Only 13.2% (7 of 53) of the cases had a reported history of contraceptive use, as compared with 35.5% (43 of 121) of the controls. The possible protective effect from oral contraceptive use was not explained by race, educational attainment, asthma, diabetes mellitus, or hypertension, and was more pronounced among women who were less than 50 years of age.
我们通过比较从华盛顿特区地区五家医院确诊的新发病例(N = 61)与使用随机数字拨号技术确定的社区对照(N = 122),研究了女性特发性扩张型心肌病的可能风险因素。我们按5年年龄间隔和电话局对病例和对照进行匹配,并使用条件逻辑回归方法分析数据。我们发现,特发性扩张型心肌病与哮喘、糖尿病、高血压病史以及黑人种族有关。高血压与年龄小于50岁的女性之间的关联尤为强烈[粗相对比值(RO)= 21.0,95%置信区间(CI)= 4.6 - 96.9]。我们发现口服避孕药使用史与之存在强烈的负相关(粗RO = 0.3,95% CI = 0.1 - 0.7;调整后RO = 0.1,95% CI = 0.1 - 0.5,控制其他已确定的风险因素)。病例中只有13.2%(53例中的7例)有口服避孕药使用史报告,而对照中有35.5%(121例中的43例)有报告。口服避孕药使用的可能保护作用无法用种族、教育程度、哮喘、糖尿病或高血压来解释,且在年龄小于50岁的女性中更为明显。