Knight T, Smith Z, Lockton J A, Sahota P, Bedford A, Toop M, Kernohan E, Baker M R
University of Bradford, Clinical Epidemiology Research Unit.
J Epidemiol Community Health. 1993 Apr;47(2):89-95. doi: 10.1136/jech.47.2.89.
To assess and compare the prevalence of established risk markers for ischaemic heart disease in a sample of Asian and non-Asian men and to relate these observations to preventive strategies.
Two factories in the textile industry in Bradford, West Yorkshire, UK. Subjects--288 male manual workers aged 20 to 65 years.
Cross sectional study within one occupational/social class stratum.
Age, body mass index, plasma lipids, fibrinogen and serum insulin values, blood pressure, smoking habits, alcohol consumption, and exercise routines were recorded. Plasma total cholesterol concentrations were significantly lower in Asian than non-Asian men (5.3 mmol/l v 5.8 mmol/l respectively, p < 0.0001), as were low density lipoprotein cholesterol concentrations (3.4 mmol/l v 3.7 mmol/l, p = 0.0150), and high density lipoprotein (HDL) cholesterol (1.1 mmol/l v 1.3 mmol/l, p < 0.0001). Hypercholesterolaemia (concentration > 6.5mM) was present in nearly one quarter of non-Asians but less than one eighth of Asian men. Triglyceride values were not significantly higher in Asians. Smoking rates were high in non-Asians (43.8%) and only slightly lower in Asians (39.1%). Asian smokers smoked fewer cigarettes per day on average (9.3 v 16.1, p = 0.0001). Almost a quarter of non-Asian men (23.1%) and 26.6% of Asian men had raised blood pressure. Systolic pressures were higher in non-Asian men (138.3 mmHg v 133.0 mmHg, p = 0.0070), but diastolic pressures showed no ethnic differences. Diabetes was more prevalent in Asian men (10.9% v 4.4% p < 0.05), who also showed higher serum insulin concentrations after glucose loading (22.3 mU/l v 10.2 mU/l, p < 0.0001). Plasma fibrinogen values were higher in non-Asian men (2.9 g/l v 2.6 g/l, p < 0.0001) and these were associated with smoking. Nearly all non-Asians (92.5%) consumed alcohol at some time whereas 62.5% of Asians habitually abstained from alcohol consumption. Among the drinkers, non-Asian men consumed on average, 23.9 units per week and Asian men 18.4 units per week (p = 0.083). The mean body mass index for Asian men was 24.5 kg/m2 which was not significantly different to the mean in non-Asian men (25.2 kg/m2). The frequency of exercise in leisure time was low in both groups with 44.4% of non-Asian and 21.1% of Asian men taking moderate exercise weekly, and even fewer, regular strenuous exercise (16.3% and 8.6% respectively).
The plasma cholesterol and fibrinogen concentrations, prevalence of hypertension, smoking habits, alcohol intakes, and infrequency of exercise in leisure time in these non-Asian men in Bradford were consistent with an increased risk of heart disease. The pattern of risk markers was clearly different in Asian men. Only their lower HDL cholesterol concentrations, marginally higher triglyceride values, higher prevalence of diabetes, and very low frequency of exercise in leisure time would be consistent with a higher risk of heart disease compared with non-Asians. The implications of these observations for heart disease preventive strategies are discussed.
评估并比较亚洲和非亚洲男性样本中缺血性心脏病既定风险标志物的患病率，并将这些观察结果与预防策略相关联。
英国西约克郡布拉德福德的两家纺织厂。研究对象为288名年龄在20至65岁之间的男性体力劳动者。
在一个职业/社会阶层内进行横断面研究。
记录年龄、体重指数、血脂、纤维蛋白原和血清胰岛素值、血压、吸烟习惯、饮酒量和运动习惯。亚洲男性的血浆总胆固醇浓度显著低于非亚洲男性（分别为5.3 mmol/l和5.8 mmol/l，p<0.0001），低密度脂蛋白胆固醇浓度也较低（3.4 mmol/l对3.7 mmol/l，p = 0.0150），高密度脂蛋白（HDL）胆固醇浓度也较低（1.1 mmol/l对1.3 mmol/l，p<0.0001）。高胆固醇血症（浓度>6.5 mM）在近四分之一的非亚洲男性中存在，但在亚洲男性中不到八分之一。亚洲人的甘油三酯值没有显著更高。非亚洲人的吸烟率较高（43.8%），亚洲人略低（39.1%）。亚洲吸烟者平均每天吸烟较少（9.3支对16.1支，p = 0.0001）。近四分之一的非亚洲男性（23.1%）和26.6%的亚洲男性血压升高。非亚洲男性的收缩压较高（138.3 mmHg对133.0 mmHg，p = 0.0070），但舒张压没有种族差异。糖尿病在亚洲男性中更普遍（10.9%对4.4%，p<0.05），亚洲男性在葡萄糖负荷后血清胰岛素浓度也更高（22.3 mU/l对10.2 mU/l，p<0.0001）。非亚洲男性的血浆纤维蛋白原值较高（2.9 g/l对2.6 g/l，p<0.0001），且与吸烟有关。几乎所有非亚洲人（92.5%）有时饮酒，而62.5%的亚洲人习惯性戒酒。在饮酒者中，非亚洲男性平均每周饮酒23.9单位，亚洲男性为18.4单位（p = 0.083）。亚洲男性的平均体重指数为24.5 kg/m²，与非亚洲男性的平均值（25.2 kg/m²）无显著差异。两组的休闲时间运动频率都很低，44.4%的非亚洲男性和21.1%的亚洲男性每周进行适度运动，进行定期剧烈运动的人更少（分别为16.3%和8.6%）。
布拉德福德这些非亚洲男性的血浆胆固醇和纤维蛋白原浓度、高血压患病率、吸烟习惯、饮酒量以及休闲时间运动频率低与心脏病风险增加一致。亚洲男性的风险标志物模式明显不同。与非亚洲男性相比，只有他们较低的HDL胆固醇浓度、略高的甘油三酯值、较高的糖尿病患病率以及极低的休闲时间运动频率与较高的心脏病风险一致。讨论了这些观察结果对心脏病预防策略的影响。
