Lederle F A, Johnson G R, Wilson S E, Chute E P, Littooy F N, Bandyk D, Krupski W C, Barone G W, Acher C W, Ballard D J
Ann Intern Med. 1997 Mar 15;126(6):441-9. doi: 10.7326/0003-4819-126-6-199703150-00004.
Independent risk factors for abdominal aortic aneurysm (AAA) have not been clearly defined in multivariable analyses of large patient populations.
To identify factors that are independently associated with AAA and to determine the prevalence of previously unrecognized AAA in defined demographic and risk groups.
Cross-sectional screening study.
15 Department of Veterans Affairs medical centers.
73451 veterans who were 50 to 79 years of age and had no history of AAA.
The results of ultrasonographic screening for AAA and a prescreening questionnaire were analyzed using multiple logistic regression.
An AAA of 4.0 cm or larger was detected in 1031 participants (1.4%). Smoking was the risk factor most strongly associated with AAA; the odds ratio (OR) for AAAs of 4.0 cm or larger compared with normal aortas (infrarenal aortic diameter < 3.0 cm) was 5.57 (95% CI, 4.24 to 7.31). The association between smoking and AAA increased significantly with the number of years of smoking and decreased significantly with the number of years after quitting smoking. The excess prevalence associated with smoking accounted for 78% of all AAAs that were 4.0 cm or larger in the study sample. Female sex (OR, 0.22 [CI, 0.07 to 0.68]), black race (OR, 0.49 [CI, 0.35 to 0.69]), and presence of diabetes (OR, 0.54 [CI, 0.44 to 0.65]) were negatively associated with AAA. A family history of AAA was positively associated with AAA (OR, 1.95 [CI, 1.56 to 2.43]) but was reported by only 5.1% of participants. Other independently associated factors included age, height, coronary artery disease, any atherosclerosis, high cholesterol levels, and hypertension.
Abdominal aortic aneurysm is associated with multiple factors. Smoking was the risk factor most strongly associated with AAA and may be responsible for most clinically important cases of previously undiagnosed AAA.
在对大量患者群体进行的多变量分析中，腹主动脉瘤（AAA）的独立危险因素尚未明确界定。
确定与AAA独立相关的因素，并确定在特定人口统计学和风险群体中先前未被识别的AAA的患病率。
横断面筛查研究。
15家退伍军人事务部医疗中心。
73451名年龄在50至79岁之间且无AAA病史的退伍军人。
使用多元逻辑回归分析AAA超声筛查结果和预筛查问卷。
在1031名参与者（1.4%）中检测到直径4.0 cm或更大的AAA。吸烟是与AAA关联最密切的危险因素；直径4.0 cm或更大的AAA与正常主动脉（肾下主动脉直径<3.0 cm）相比的比值比（OR）为5.57（95%CI，4.24至7.31）。吸烟与AAA之间的关联随吸烟年数显著增加，随戒烟后年数显著降低。与吸烟相关的额外患病率占研究样本中所有直径4.0 cm或更大的AAA的78%。女性（OR，0.22[CI，0.07至0.68]）、黑人种族（OR，0.49[CI，0.35至0.69]）和糖尿病的存在（OR，0.54[CI，0.44至0.65]）与AAA呈负相关。AAA家族史与AAA呈正相关（OR，1.95[CI，1.56至2.43]），但只有5.1%的参与者报告有家族史。其他独立相关因素包括年龄、身高、冠状动脉疾病、任何动脉粥样硬化、高胆固醇水平和高血压。
腹主动脉瘤与多种因素相关。吸烟是与AAA关联最密切的危险因素，可能是大多数先前未诊断出的具有临床重要性的AAA病例的原因。
