Alcohol intemperance and sudden death

Ten years after a health screening examination was offered to 50 year old men 32 of the 2322 participants and 12 of the 454 nonparticipants had died of ischaemic heart disease. Of these, 26 and 11 respectively had suffered sudden death, for which necropsy was performed. Half of the men who had died suddenly had been registered for alcohol intemperance up to 1973, which was four times the prevalence of such registrations in the general population. Registration at both the Swedish Temperance Board and the Bureau of Social Services was associated with an odds ratio of 3.74 for sudden death as compared with not being registered at either. Logistic analysis including the classical risk factors for ischaemic heart disease together with registration for alcohol intemperance and at the Bureau of Social Services showed only the two types of registration and systolic blood pressure to be independent risk factors. On the other hand, there was no overrepresentation of subjects entered in the registers among those surviving a myocardial infarction. For non-fatal myocardial infarction blood pressure and serum triglyceride concentration were significant risk factors and serum cholesterol concentration, smoking, and body mass index probable risk factors; the two types of registration were not independent risk factors. Alcohol intemperance is strongly associated with an increased risk of sudden death after myocardial infarction.     

Risk functions for prediction of cardiovascular disease in elderly Australians: the Dubbo Study

OBJECTIVES: To evaluate a Framingham risk function for coronary heart disease in an elderly Australian cohort and to derive a risk function for cardiovascular disease (CVD) in elderly Australians. DESIGN AND SETTING: Analysis of data from a prospective cohort study (the Dubbo Study) in a semi-urban town (population, 34 000). PARTICIPANTS: 2805 men and women 60 years and older living in the community, first assessed in 1988, and a subcohort of 2102 free of CVD at study entry. MAIN OUTCOME MEASURES: Incidence of CVD (myocardial infarction, coronary death or stroke) over 5 and 10 years. RESULTS: A Framingham risk function assessing "hard" coronary heart disease (ie, myocardial infarction or coronary death) accurately predicted 10-year incidence in men and women aged 60-79 years who were free of prevalent CVD or diabetes at study entry. In a multiple logistic model, CVD incidence was significantly predicted by age, sex, taking antihypertensive medication, blood pressure, smoking, total cholesterol level and diabetes. For a given age and cholesterol level, CVD risk over 5 years was doubled in the presence of antihypertensive medication or diabetes, increased by 50% with cigarette smoking, and halved in women compared with men. CONCLUSIONS: We have derived a simple CVD risk function specifically for elderly Australians that employs risk factors readily accessible to all medical practitioners.     

Survival rates with coronary artery disease for black women compared with black men.

OBJECTIVE--To evaluate the influence of gender on the prognosis of coronary heart disease among black patients. DESIGN--Cohort study based on a consecutive sample from a hospital registry, with a mean follow-up of 4 years. SETTING--An inner-city public hospital in Chicago, Ill. PATIENTS--The study included 1719 consecutive black patients (780 men and 939 women) who had any one of the following events: cardiac catheterization for presumed coronary heart disease, hospitalization for acute myocardial infarction, or coronary artery bypass grafting. RESULTS--Hospital and operative mortality rates following acute myocardial infarction and coronary artery bypass grafting were similar between the two sexes. The relative risks for cardiac death in women vs men were 0.88 (95% confidence interval [CI], 0.60 to 1.28), 0.79 (95% CI, 0.53 to 1.17), and 0.79 (95% CI, 0.34 to 1.85) for coronary artery disease, acute myocardial infarction, and coronary artery bypass grafting, respectively, after adjusting for age, history of diabetes, hypertension, angina pectoris and myocardial infarction, number of diseased vessels, and ejection fraction. Compared with patients of the same sex with normal angiograms, relative risk estimates were 5.0, 10.1, and 6.3 for women and were 1.8, 4.0, and 2.0 for men in the same three groups of patients, respectively. CONCLUSIONS--Survival with coronary artery disease in black women is similar to that observed in black men, but relative to members of the same sex without the disease, the prognosis for women is considerably worse than for men.     

早发ST段抬高型急性心梗患者临床特点分析

目的分析早发ST段抬高型急性心梗（STEMI）患者的传统危险因素分布以及血生化指标及冠状动脉造影结果特点。方法收集自2009年1月-2010年3月STEMI临床资料,比较早发STEMI患者（男性〈55岁,女性〈65岁）和非早发的STEMI患者（男性〉55岁,女性〉65岁）的传统危险因素、血生化代谢指标及冠脉造影结果的差异,并进行统计学分析。结果早发STEMI组与非早发组比较具有以下临床特点：吸烟（56.8%∶38.0%,P〈0.05）和代谢综合征（55.6%∶33.0%,P〈0.05）的比率较高。早发STEMI组的体重指数（BMI）显著高于非早发组[（25.94±3.15）∶（24.75±3.66）P〈0.05]。早发组以冠脉单支病变为主（58.0%∶31.0%,P〈0.05）,以前降支受累为主,而非早发组以三支病变为主（21.0%∶44.0%,P〈0.05）。针对早发STEMI危险因素的Logistic多元回归分析发现代谢综合征和吸烟是早发STEMI的独立危险因素,代谢综合征和吸烟的OR值分别是2.54和2.82。结论吸烟和代谢综合征在早发STEMI的发生、发展过程中起重要作用,对于存在代谢异常的青中年患者进行减肥和戒烟具有尤其重要的预防心血管事件的意义。     

Smoking and diabetes in Chinese men

Smoking is a major cardiovascular risk factor and cause of death. Diabetes mellitus is also associated with an increased mortality and morbidity. Evidence concerning whether smoking increases the incidence of diabetes remains conflicting. Glycaemic status and smoking habits were analysed in 3718 Chinese subjects in order to assess the possible association between smoking and risk of diabetes in the Chinese population. The World Health Organisation 1998 criteria were used for the diagnosis of glucose intolerance. Smoking was defined as current cigarette smoking or ex-smoking without regard to daily consumption. The smoking habits of the studied subjects were correlated with glycaemic status. There were 3003 (80.8%) women and 715 (19.2%) men. The mean age (SD) was 38.4 (12.8) years (median 35.0, range 12-88 years). Of the 3718 subjects, 786 (21.1%) had diabetes, 708 (19.1%) had impaired glucose tolerance, and 2224 (59.8%) had normal results. Of the 3003 women, only 87 (2.9%) were smokers. The female smokers were younger, heavier, and had higher alcohol consumption than non-smokers. The prevalence of diabetes was similar between female smokers and non-smokers after adjustment for age, body mass index, family history of diabetes, and alcohol. Of the 715 men, 175 (24.5%) were smokers. The male smokers were younger, had lower blood pressure, and higher alcohol consumption. After adjustment for age, body mass index, family history of diabetes and alcohol, the male smokers had lower blood pressure, higher one hour plasma glucose, and more diabetes. Using logistic regression analysis (stepwise forward) with age, body mass index, alcohol, smoking, and family history of diabetes as independent variables to predict the risk of having diabetes, age and body mass index are independently associated with diabetes in both men and women. In addition, smoking is independently associated with the risk of diabetes in men, the odds ratio (95% confidence interval, CI) being 1.705 (1.106 to 2.630). Family history of diabetes is independently associated with the risk of diabetes in women, and the odds ratio (95% CI) is 1.643 (1.314, to 2.053). In conclusion, it was found that smoking is independently associated with diabetes after adjustment for age, body mass index, alcohol, and family history of diabetes in Hong Kong Chinese men, the odds ratio being 1.7. The prevalence of smoking in Hong Kong Chinese women is low and its association with diabetes is inconclusive.     

Differences in prognostic factors and outcomes between women and men undergoing coronary artery stenting

CONTEXT: Women with coronary artery disease (CAD) are believed to have a higher risk for adverse outcomes than men after conventional coronary interventions. The increasing use of coronary stenting has improved the outcome of patients undergoing coronary interventions, but little is known about the nature of outcomes in men vs women after this procedure. OBJECTIVE: To examine whether there are sex-based differences in prognostic factors and in early and late outcomes among CAD patients undergoing coronary stent placement. DESIGN, SETTING, AND PATIENTS: Inception cohort study, at 2 tertiary referral institutions in Germany. Consecutive series of 1001 women and 3263 men with symptomatic CAD who were treated with stenting between May 1992 and December 1998. Patients who underwent stenting in the setting of acute myocardial infarction were excluded. MAIN OUTCOME MEASURE: The combined event rates of death and nonfatal myocardial infarction, assessed at 30 days and 1 year after stenting and compared by sex. RESULTS: Compared with men, women undergoing coronary stenting were significantly older (mean age, 69 vs 63 years) and more likely to present with diabetes, arterial hypertension, or hypercholesterolemia. Women had less extensive CAD, a less frequent history of myocardial infarction and better preserved left ventricular function than men. Women presented an excess risk of death or nonfatal myocardial infarction only during the early period after stenting: the 30-day combined event rate of death or myocardial infarction was 3.1% in women and 1.8% in men (P =.02) and the multivariate-adjusted hazard ratio (HR) for women was 2.02 (95% confidence interval [CI], 1.27-3.19). At 1 year, the outcome was similar for both women and men (combined event rate for women, 6.0%, and for men, 5.8% (P =.77); multivariate-adjusted HR for women, 1.06 [95% CI, 0.75-1.48]). There was a sex difference in the prognostic value of baseline characteristics: the strongest prognostic factors were diabetes in women and age in men. CONCLUSIONS: The results of this study indicate that 1-year outcomes of women with CAD undergoing coronary artery stenting are similar to those of men. Despite the similarity in outcomes, there are several sex-specific differences in baseline characteristics, clinical course after the intervention, and relative weight of prognostic factors. JAMA. 2000;284:1799-1805.     

年轻急性心肌梗死患者的临床特征

为探讨年轻患者急性心肌梗死 (AMI)的临床及冠状动脉特点 ,对 40岁以下男性 2 7例和绝经前女性 2 4例 ,共 5 1例急性心肌梗死 (AMI)患者的病史、动脉硬化相关危险因素、冠状动脉造影及预后进行分析。结果显示 ,女性组危险因素平均 2 .3个 ,按发生率高低分别为 :阳性家族史 1 9例 (79.2 % ) ,高胆固醇血症 1 2例 (5 0 .0 % ) ,高血压 1 0例 (4 1 .7% ) ,糖尿病 8例 (3 3 .3 % ) ,吸烟史 1例 (4 .2 % )。男性组危险因素平均 3 .1个 ,按发生率高低分别为 :吸烟史2 6例 (96.3 % ) ,高胆固醇血症 1 9例 (70 .4% ) ,阳性家族史 1 7例 (63 .0 % ) ,高血压 1 4例 (5 1 .9% ) ,糖尿病 7例(2 5 .9% )。冠状动脉造影结果显示 ,男性以单支病变为主 ,共 1 4例 ,占 5 1 .9% ,女性以多支病变为主 ,共 1 4例 ,占5 8.3 %。提示冠状动脉粥样硬化仍然是年轻男性和绝经前女性心肌梗死的主要原因 ,多个危险因素是年轻患者共同的特点 ,危险因素中女性以阳性家族史为首 ,男性则以吸烟史为首。     

Elevated glycated haemoglobin in non-diabetic patients is associated with an increased mortality in myocardial infarction.

Diabetes is associated with increased mortality following acute myocardial infarction compared to the general population. Elevated glycated haemoglobin (HbA1c) in diabetic patients is also associated with increased mortality following acute myocardial infarction, while mild elevation in HbA1c are associated with impaired glucose tolerance. The aim of this study was to determine the influence of HbA1c on outcome of acute myocardial infarction in 253 non-diabetic patients, 46 of whom died in one year. In univariate analysis, risk factors for death included smoking, glucose, cholesterol and HbA1c. In logistic regression analysis HbA1c was an independent risk factor for death. Over one-third of the fatality group had an HbA1c in the highest quartile, compared to one-fifth of the surviving group (p = 0.02). Elevated HbA1c is a risk marker for short-term mortality following acute myocardial infarction in non-diabetic subjects.     

Smoking and myocardial infarction: secondary prevention

This prospective study examines the question ''Is it too late to stop smoking cigarettes once you have had a myocardial infarction?'' One hundred and nineteen cigarette smokers (90 men, 29 women) who survived their first myocardial infarction for one month were followed for five years or until their death if earlier. The age corrected mortality rate of men who continued to smoke cigarettes was 2.2 times the age corrected mortality rate of those who stopped smoking after their infarct. The women who continued to smoke had 2.4 times the age corrected mortality of those who stopped smoking. The age and sex corrected mortality rates for the combined group of men and women show that those who stopped smoking after their infarction have 55% of the mortality of those who continued to smoke (P less than 0.05). These results suggest that smoking is not merely a ''risk factor'' for myocardial infarction but is also a causal factor whose effects can be avoided by both men and women after an initial myocardial infarction.     

Why is diabetes mellitus a stronger risk factor for fatal ischemic heart disease in women than in men? The Rancho Bernardo Study

We report here the 14-year sex-specific effect of non-insulin-dependent diabetes mellitus on the risk of fatal ischemic heart disease in a geographically defined population of men and women aged 40 through 79 years. There were 207 men and 127 women who had diabetes at baseline based on medical history or fasting hyperglycemia. They were compared with 2137 adults who had fasting euglycemia and a negative personal and family history of diabetes. The relative hazard of ischemic heart disease death in diabetics vs nondiabetics was 1.8 in men and 3.3 in women, after adjusting for age, and 1.9 and 3.3, respectively, after adjusting for age, systolic blood pressure, cholesterol, body mass index, and cigarette smoking using the Cox regression model. The sex difference in the independent contribution of diabetes to fatal heart disease was largely explained by the persistently more favorable survival rate of women (than men) without diabetes.     

Marriage is associated with a lower risk of ischaemic heart disease in men

Comparison between subjects who were identified from a register of cases of myocardial infarction and a random sample of the same community showed that in the Lower Hunter region of New South Wales men who currently are not married are at higher risk of acute myocardial infarction or of sudden coronary death than are married men of the same age. While there are indications that unmarried men have a life-style that is different from that of currently married men, their increased risk of ischaemic heart disease is greater than can be accounted for by differences in factors such as age, the previous history of heart disease, their alcohol and tobacco consumption and various socioeconomic factors.     

急性心肌梗死患者28例院内死亡特点分析

目的:探讨住院急性心肌梗死患者的死亡特征构成,探讨降低急性心肌梗死病死率的措施。方法:回顾分析28例住院期间死亡的急性心肌梗死患者的性别、年龄、发病诱因、危险因素、并存疾病、梗死部位、发病至死亡时间、致死原因等资料。结果:因急性心肌梗死致死的住院患者中,男性20例(71.4%),女性8例(28.6%);28例患者心血管病危险因素及并存疾病中,高血压病16例(57.1%),吸烟者18例(64.3%),血脂代谢异常者18例(64.3%);最常见的梗死部位为广泛前壁共16例(57.1%);主要死亡原因中,致命性心律失常11例(39.3%),泵衰竭10例(35.7%)。结论:因急性心肌梗死致死的患者中,男性明显多于女性;28例患者均有心血管病危险因素及并存疾病;最常见的梗死部位以广泛前壁多见;恶性心律失常及泵衰竭是致急性心肌梗死患者院内死亡的主要原因;日常生活对危险因素积极干预是预防急性心肌梗死发生的有效措施,在发病时间窗内及时再灌注治疗是挽救生命的重点。     

女性非ST段抬高急性冠脉综合症患者临床特点和冠状动脉病变特点分析

目的探讨女性非ST段抬高急性冠脉综合症患者的临床特点和冠状动脉病变特点,为临床积极治疗提供参考。方法选择310例在我院经临床资料、冠状动脉造影确诊的女性NSTEACS患者为研究组,同期在我院经冠状动脉造影确诊的男性NSTEACS患者370例为对照组。分别对其临床特点和冠状动脉病变的支数、部位、狭窄类型及程度进行比较。结果⑴与男性相比,女性NSTEACS患者临床表现类型以急性心肌梗死更多见,典型的心绞痛症状和心电图缺血性表现较少,住院期间心功能不全发生率高于男性,吸烟史少、糖尿病史多,血脂异常以TG升高和HDL-C降低更为突出。低血红蛋白血症、高尿酸血症、高同型半胱氨酸血症和社会心理因素对女性的影响也较男性更为明显。而家族史、高血压病史与男性相比无明显差别。⑵与男性相比,女性NSTEACS患者冠状动脉单支病变明显低,而以多支病变明显,侧枝循环形成高于男性;受累血管以前降支最为常见,但两组相比无显著性差异,其次为右冠状动脉,与男性相比有显著性差异;病变血管的狭窄类型女性组以B、C型病变为多,但无统计学差异;病变血管的狭窄程度以gensini积分计算,女性组以中度升高比率为主,且明显高于男性。结论女性非ST段抬高急性冠脉综合症的临床表现类型以急性心肌梗死更多见,临床症状不如男性典型,TG升高和HDL-C降低更为突出,高尿酸血症、高同型半胱氨酸血症等新的危险因素在其发病中发挥了更重要的作用。女性冠脉病变以多支病变为多,侧枝循环形成高于男性。狭窄程度较男性重。     

Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913

In a prospective study of risk factors for ischaemic heart disease 792 54 year old men selected by year of birth (1913) and residence in Gothenburg agreed to attend for questioning and a battery of anthropometric and other measurements in 1967. Thirteen years later these baseline findings were reviewed in relation to the numbers of men who had subsequently suffered a stroke, ischaemic heart disease, or death from all causes. Neither quintiles nor deciles of initial indices of obesity (body mass index, sum of three skinfold thickness measurements, waist or hip circumference) showed a significant correlation with any of the three end points studied. Statistically significant associations were, however, found between the waist to hip circumference ratio and the occurrence of stroke (p = 0.002) and ischaemic heart disease (p = 0.04). When the confounding effect of body mass index or the sum of three skinfold thicknesses was accounted for the waist to hip circumference ratio was significantly associated with all three end points. This ratio, however, was not an independent long term predictor of these end points when smoking, systolic blood pressure, and serum cholesterol concentration were taken into account. These results indicate that in middle aged men the distribution of fat deposits may be a better predictor of cardiovascular disease and death than the degree of adiposity.     

Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease

Context  Calcium deposits in coronary and extracoronary arterial beds may indicate the extent of atherosclerosis. However, the incremental predictive value of vascular calcification, beyond traditional coronary risk factors, is not clearly established. Objective  To evaluate risk factors for aortic arch calcification and its long-term association with cardiovascular diseases in a population-based sample. Design and Setting  Cohort study conducted at a health maintenance organization in northern California. Participants  A total of 60,393 women and 55,916 men, aged 30 to 89 years at baseline who attended multiphasic health checkups between 1964 and 1973 and for whom incidence of hospitalizations and/or mortality data were ascertained using discharge diagnosis codes and death records through December 31, 1997 (median follow-up, 28 years). Main Outcome Measure  Hospitalization for or death due to coronary heart disease, ischemic stroke, hemorrhagic stroke, or peripheral vascular disease, as associated with aortic arch calcification found on chest radiograph at checkup from 1964-1973. Results  Aortic arch calcification was present in 1.9% of men and 2.6% of women. It was independently associated with older age, no college education, current smoking, and hypertension in both sexes, but it was inversely related to body mass index and family history of myocardial infarction. In women, aortic arch calcification was also associated with black race and elevated serum cholesterol level. After adjustment for age, educational attainment, race/ethnicity, cigarette smoking, alcohol consumption, body mass index, serum cholesterol level, hypertension, diabetes, and family history of myocardial infarction, aortic arch calcification was associated with an increased risk of coronary heart disease (in men, relative risk [RR], 1.27; 95% confidence interval [CI], 1.11-1.45; in women, RR, 1.22; 95% CI, 1.07-1.38). Among women, it was also independently associated with a 1.46-fold increased risk of ischemic stroke (95% CI, 1.28-1.67). Conclusion  In our population-based cohort, aortic arch calcification was independently related to coronary heart disease risk in both sexes as well as to ischemic stroke risk in women.      

Association between oral contraceptives and myocardial infarction. A review

Analysis of the association between oral contraceptive use and the development of myocardial infarction in women less than 50 years of age shows that cigarette smoking is the most important factor in increasing the likelihood of myocardial infarction. This effect is independent of oral contraceptive use but oral contraceptive use also appears to be a risk factor; however, their use in the absence of other predisposing factors appears to have only a small effect on increasing the risk of dying from myocardial infarction. This small increase is of the same order of magnitude as the increased risk of death from thromboembolic disease. Oral contraceptive users more than 30 years of age who have other factors that increase the likelihood of myocardial infarction appear to have a substantially higher death rate.     

Prognosis after first myocardial infarction. Comparison of Q-wave and non-Q-wave myocardial infarction in the Framingham Heart Study.

OBJECTIVE--To compare the short- and long-term prognosis following a first Q-wave or non-Q-wave myocardial infarction. DESIGN--Cohort study with a mean follow-up period of 5.1 +/- 4.9 years. SETTING--Population-based. PARTICIPANTS--Framingham (Mass) Heart Study subjects with an initial recognized myocardial infarction during a 17-year period were studied, including 227 men and 136 women with a mean age of 67.2 years. Seventy-seven percent of first infarctions were Q-wave infarctions and 23% were non-Q-wave infarctions. MAIN OUTCOME MEASURES--Reinfarction and death from coronary heart disease. RESULTS--During the follow-up period, subjects with non-Q-wave infarctions had a significantly higher rate of reinfarction than subjects in the Q-wave group (P = .02 for the entire follow-up). The 10-year reinfarction rates were 44.8% vs 27.4%. When analyzed separately by age and sex, differences in reinfarction rates were only noted in men and in those under the age of 65 years. There were no differences in coronary heart disease death rates based on Q-wave status, even when examined separately by age and sex. Multivariate analysis revealed a 1.8-fold higher risk of reinfarction in the non-Q-wave group (95% confidence interval, 1.1 to 3.1), and also demonstrated that baseline hypertension was an independent risk factor for predicting reinfarction (relative risk, 1.8; 95% confidence interval, 1.1 to 3.2). There were no differences in the rates of sudden death or all-cause mortality following the two types of myocardial infarction. Additionally, subjects with a first Q-wave infarction had a higher rate of subsequent congestive heart failure, while those with non-Q-wave infarctions had a significantly higher rate of coronary insufficiency (unstable angina with transient ST-T wave abnormalities). CONCLUSIONS--These results confirm and extend findings from prior studies that have identified patients with first non-Q-wave myocardial infarctions as potentially unstable, with greater subsequent morbidity and similar mortality to their counterparts with Q-wave infarctions.     

两性急性心肌梗死住院期间死亡风险的Logistic回归分析

目的 分析影响两性患者急性心肌梗死(AMI)住院期间死亡风险的因素,为今后针对不同性别患者急性心肌梗死的防治提供依据.方法 收集2009年1月1日-2010年12月31日因AMI住我院心内科的689例AMI患者的临床资料,按性别分成两组,其中女性214例,男性475例,分析两性患者AMI的特点并对影响住院期间死亡的因素进行Logistic回归分析.结果 整个AMI人群男女比例为2.22:1,两性患者对比有如下特点:①女性较男性平均发病年龄大约晚10年;②女性接受再灌注治疗比率(41.6％)低于男性(59.2％),P＜0.05;③女性AMI患者合并基础疾病种类较男性多,女性平均为(3.46 ±1.80)种,男性为(2.58±1.78)种,P＜0.05;④女性患者发生严重并发症的发病率较男性高(7.5％与3.4％,P＜0.05),住院期间死亡率(24.8％)也远高于男性(11.6％),P＜0.05;⑤对住院期间死亡风险的Logistic回归分析,得出两性患者住院期间死亡风险的Logistic回归模型:女性为P=e-2.452-2.73 ×TREAT+0.695×HF +3.529×COMP/1+e-2.452-2.73×TREAT+0.695×HF +3.529×COMP,男性为:P=e-5.040+1.892×COPD+2.384×CRF+1.013Xhf+5.326×COMP/1+e5.040+1.892×COPD+2.384×CRF+1.013Xhf+5.326×COMP.结论 女性急性心肌梗死患者发病年龄大,并发症多,死亡率高;本研究得出的两性急性心肌梗死住院期间死亡风险的Logistic回归模型表明,女性患者住院期间接受再灌注治疗可降低住院期间死亡风险,再灌注治疗对男性患者则未能降低死亡风险;男性患者合并慢性阻塞性肺疾病、慢性肾功能不全及并发症住院期间死亡风险显著升高,而在女性患者却无类似影响;不论男女出现并发症如心功能不全、心源性休克、恶性心律失常及机械性并发症,住院期间死亡概率明显升高.     

脂联素、瘦素、血脂、体质量指数和腰臀比与女性冠心病的关系

目的通过检测女性冠心病患者血清脂联素、瘦素水平及血脂、体质量指数(body mass index,BMI)、腰臀比(waist-hip ratio,WHR)等代谢指标,明确这些代谢指标、脂肪激素与女性冠心病的关系。方法女性住院患者114例,其中冠心病患者50例,非冠心病患者64例。分别测量身高、体质量、腰围、臀围并获取BMI和WHR,同时抽取肘静脉血,检测血脂、脂联素和瘦素。结果女性冠心病患者与非冠心病患者在年龄、WHR、总胆固醇、高密度脂蛋白胆固醇和脂联素水平方面比较,有显著性差异(P<0.05)。BMI、甘油三酯、低密度脂蛋白胆固醇和瘦素水平之间无统计学意义(P>0.05)。WHR(OR=0.01)、总胆固醇(OR=3.92)和高密度脂蛋白胆固醇(OR=11.09)是女性冠心病患者的独立危险因素。结论女性冠心病患者的年龄、WHR、总胆固醇、高密度脂蛋白胆固醇和脂联素与非冠心病患者相比有显著性差异,但仅WHR、总胆固醇和高密度脂蛋白胆固醇是女性冠心病患者的独立危险因素。