Kekäläinen P, Sarlund H, Pyörälä K, Laakso M
Department of Medicine, Kuopio University Hospital, Finland.
Atherosclerosis. 1996 Jun;123(1-2):203-13. doi: 10.1016/0021-9150(96)05808-x.
The aim of this study was to compare the effect of family history of non-insulin dependent diabetes mellitus (NIDDM) and coronary heart disease (CHD) as risk factors for CHD morbidity and mortality. Altogether, 394 siblings of NIDDM probands and non-diabetic probands, with and without CHD, were followed for 8 years with respect to CHD events in a prospective population-based study. The baseline study was conducted from 1983 to 1985. Age- and sex-adjusted cumulative occurrence of CHD events was higher in the siblings of the probands with CHD and with NIDDM (13.1%; P = 0.037) and in the siblings of the probands with CHD and without NIDDM (15.4%; P = 0.054), compared with the siblings of the probands without NIDDM and without CHD (4.8%). The incidence of fatal CHD events tended to be higher in a group with a family history of NIDDM and CHD, but the trend was not statistically significant. In univariate logistic regression analyses, a family history of CHD was positively associated with cumulative occurrence of CHD events (odds ratio 2.53, P = 0.009), whereas a family history of NIDDM had no significant association (odds ratio 1.39, P = 0.312). After adjustment for age, sex, family history of NIDDM and major cardiovascular risk factors, the association between family history of CHD and cumulative occurrence of CHD events remained significant (odds ratio 2.25, P = 0.048). In conclusion, the present study indicates that a family history of CHD is a stronger predictor of future CHD events than a family history of NIDDM.
本研究的目的是比较非胰岛素依赖型糖尿病(NIDDM)家族史和冠心病(CHD)家族史作为冠心病发病和死亡风险因素的作用。在一项基于人群的前瞻性研究中,对394名NIDDM先证者和非糖尿病先证者的兄弟姐妹进行了为期8年的随访,观察冠心病事件的发生情况,这些兄弟姐妹有或没有冠心病。基线研究于1983年至1985年进行。与无NIDDM且无CHD的先证者的兄弟姐妹(4.8%)相比,有CHD且有NIDDM的先证者的兄弟姐妹中,经年龄和性别调整后的冠心病事件累积发生率更高(13.1%;P = 0.037),有CHD但无NIDDM的先证者的兄弟姐妹中该发生率也更高(15.4%;P = 0.054)。有NIDDM和CHD家族史的组中,致命性冠心病事件的发生率有升高趋势,但该趋势无统计学意义。在单因素逻辑回归分析中,CHD家族史与冠心病事件的累积发生率呈正相关(比值比2.53,P = 0.009),而NIDDM家族史无显著相关性(比值比1.39,P = 0.312)。在对年龄、性别NIDDM家族史和主要心血管危险因素进行调整后,CHD家族史与冠心病事件累积发生率之间的关联仍然显著(比值比2.25,P = 0.048)。总之,本研究表明,CHD家族史比NIDDM家族史更能预测未来的冠心病事件。