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社区样本中冠心病家族史的验证及其与成年后代风险因素的关联:博加卢萨心脏研究

Verification of parental history of coronary artery disease and associations with adult offspring risk factors in a community sample: the Bogalusa Heart Study.

作者信息

Greenlund K J, Valdez R, Bao W, Wattigney W A, Srinivasan S R, Berenson G S

机构信息

Tulane Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112-2824, USA.

出版信息

Am J Med Sci. 1997 Apr;313(4):220-7. doi: 10.1097/00000441-199704000-00005.

Abstract

Positive parental history of coronary artery disease (CAD) (myocardial infarction, angina, angioplasty, bypass surgery) reported by 371 of 1,930 black and white adults aged 18 to 31 years in 1988 to 1991 in the Bogalusa Heart Study was verified by interviewing parents or next-of-kin. Error rates in reporting information concerning parental CAD and risk factors in offspring with a positive and negative parental history of CAD were examined. The 371 subjects who reported a positive parental history represented 304 families. Parental CAD could not be verified in 43 (14.1%) instances, and false-positive reports occurred in 45 (14.8%) cases. Among 216 families with confirmed CAD histories, the father had CAD in 175 (81.0%) cases and the mother in 70 (32.4%) cases. Both parents had CAD in 29 (13.4%) families. Of the parents with CAD, 46% of the fathers and 25% of the mothers died. The mean age at clinical onset of CAD was 51 years. Offspring with a confirmed positive parental history (n = 271) had significantly higher (P < 0.05) adjusted serum total and low-density lipoprotein cholesterol, plasma insulin and glucose, body mass index, and triceps and subscapular skinfolds than subjects with a negative parental history (n = 1,253). Those with an unconfirmed positive parental history (n = 51) had higher mean plasma insulin and serum high-density lipoprotein levels than those with a negative parental history; low-density lipoprotein levels were similar. Family history of CAD remains a useful indicator for screening adults at risk of developing CAD. An unverified family history may underestimate the importance of particular risk factors in epidemiologic studies.

摘要

在1988年至1991年进行的博加卢萨心脏研究中,对1930名年龄在18至31岁的黑人和白人成年人进行了调查,其中371人报告有冠状动脉疾病(CAD)(心肌梗死、心绞痛、血管成形术、搭桥手术)的阳性家族史,通过与父母或近亲面谈进行了核实。研究了报告父母CAD信息以及CAD阳性和阴性家族史后代中危险因素的错误率。报告有阳性家族史的371名受试者代表304个家庭。在43例(14.1%)中无法核实父母的CAD,45例(14.8%)出现假阳性报告。在216个有确诊CAD病史的家庭中,父亲患有CAD的有175例(81.0%),母亲患有CAD的有70例(32.4%)。父母双方都患有CAD的家庭有29个(13.4%)。在患有CAD的父母中,46%的父亲和25%的母亲已经去世。CAD临床发病的平均年龄为51岁。有确诊阳性家族史的后代(n = 271)调整后的血清总胆固醇和低密度脂蛋白胆固醇、血浆胰岛素和葡萄糖、体重指数以及肱三头肌和肩胛下皮褶厚度显著高于阴性家族史的受试者(n = 1253)(P < 0.05)。有未确诊阳性家族史的受试者(n = 51)的平均血浆胰岛素和血清高密度脂蛋白水平高于阴性家族史的受试者;低密度脂蛋白水平相似。CAD家族史仍然是筛查有患CAD风险成年人的有用指标。未经核实的家族史可能会低估流行病学研究中特定危险因素的重要性。

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