Familial study of chronic lymphocytic leukemia: aggregation of different malignant processes in families with individuals affected with chronic lymphocytic leukemia

There has been evidence that familial factors play a certain role in some cases of chronic lymphocytic leukemia. It is possible in one or more family members to observe chronic lymphocytic leukemia alone, other malignant disorders or combination of both of them. THE AIM: of our study was to analyze the association of family history of malignances with the onset of chronic lymphocytic leukemia. PATIENTS AND METHODS: We conducted a case-control study through direct inquiry of the families of 126 patients with chronic lymphocytic leukemia. The control group consisted of 124 patients with benignant disorders. For statistic data processing we used Fisher's exact test in 2x2 table and Kaplan-Meier survival analyses. RESULTS: 35.71% of the investigated individuals had first degree relatives with malignant disorders, while in the control group their percentage was 17.7%. Significant correlation between positive family history of malignancy and the onset of chronic lymphocytic leukemia was found (P = 0.0016). The risk of development of chronic lymphocytic leukemia in individuals with family history of malignant disorders was 1.69 times higher than in individuals with negative family history RR = 1.697, 95% C.I. [1.177; 2.448]. There was no significant difference in the general survival between groups with positive and negative family history of malignancy. Stomach cancer was particularly often diagnosed in families with individuals affected with chronic lymphocytic leukemia. Other lymphoproliferative disorders were also registered in 3.9% of the families from the control group. CONCLUSION: Our data show that there is a high risk of getting chronic lymphocytic leukemia in close relatives of affected individuals with malignant disorders. There was no data for greater aggressiveness of chronic lymphocytic leukemia in patients with positive family history of malignancy.     

厦门市同安区儿童哮喘患病情况调查分析

目的 调查2012-2013年厦门市同安区0~14 岁儿童哮喘患病情况及哮喘发病的危险因素, 为今后儿童哮喘的防治工作提供科学依据。方法 通过多阶段分层随机整群抽样方法, 采用2010年第三次全国儿童哮喘流行病学调查问卷, 调查厦门市同安区10 168名0~14岁儿童哮喘患病情况;其次采用1∶1病例对照研究方法和Logistic 回归分析法对哮喘患儿的发病危险因素进行研究。结果 在调查的10 168人中, 哮喘患儿428人, 总患病率为4.21%。男性患病率(5.88%)高于女性(2.28%)(P＜0.001)。哮喘患儿中, 首次发病以3岁内居多占74.76%;发作诱因最常见的为呼吸道感染占85.61%;发作先兆最常见的为打喷嚏占95.20%;经常发作强度以轻度最常见占68.25%;发作类型以突然发作最多占78.50%;好发季节为换季占50.60%;好发时间为夜间和清晨占71.45%。通过对428例哮喘患儿及428例非哮喘儿童的病例对照研究并且经Logistic 回归分析显示, 哮喘发病的独立危险因素包括:个人过敏史、过敏性鼻炎、家族过敏史、家族哮喘史(P＜0.001)。结论 厦门市同安区0~14岁儿童哮喘患病率高于10年前厦门市区哮喘发病率。男性哮喘患病率高于女性。个人过敏史、过敏性鼻炎、家族哮喘史及家族过敏史是该地区儿童哮喘发病的独立危险因素。     

Chronic fatigue,abuse-related traumatization,and psychiatric disorders in a community-based sample

The relationship between sexual and physical abuse history and negative health effects has been well-documented in medical facility samples. Few studies have examined the role of abuse history and its relationship with chronic fatigue and psychiatric disorders in a diverse, randomly selected community-based sample. The present study compared rates of different types of abuse events in individuals with chronic fatigue and non-symptomatic controls. Relationships between specific types of abuse and psychiatric disorders commonly associated with chronic fatigue were also explored. A stratified random sample of 18,675 adults residing in ethnically and socioeconomically diverse neighborhoods in Chicago first completed a telephone screening questionnaire. A control group and a group of individuals with chronic fatigue symptomatology were identified and administered a semi-structured psychiatric interview assessing DSM-IV Axis I psychiatric disorders and a sexual and physical abuse history questionnaire. Controlling for sociodemographic differences, fatigue outcome was significantly predicted by childhood sexual abuse and the total number of different childhood abuse events. Within the chronic fatigue group, diagnosis of posttraumatic stress disorder (PTSD) was significantly predicted by childhood sexual abuse, childhood death threat, the total number of childhood abuse events, and lifetime abuse events. Sexual abuse during adolescence or adulthood significantly predicted other anxiety disorders among individuals with chronic fatigue. These findings suggest that a history of abuse, particularly during childhood, may play a role in the development and perpetuation of a wide range of disorders involving chronic fatigue. Among individuals with chronic fatigue, PTSD and other anxiety disorders appear to demonstrate the strongest association with abuse history. The implications of these findings are discussed.     

Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study

ABSTRACT: BACKGROUND: Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood. METHODS: We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4--16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21--35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. RESULTS: At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. CONCLUSION: Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.     

中国人群慢性阻塞肺病相关危险因素的Meta分析

目的 探讨影响中国人群慢性阻塞肺病相关危险因素的Meta分析。 方法 收集2000-2015年我国公开发表的关于中国人群慢性阻塞肺病相关危险因素的研究文献资料共14篇。应用RevMan 5.0软件进行Meta分析。 结果 吸烟、有被动吸烟史、BMI、职业粉尘或化学品暴露、家族呼吸道疾病史、儿童时期呼吸道疾病史、受教育程度、使用煤及柴草燃料及厨房通风情况与慢性阻塞肺病OR值之间存在关联,且均为危险因素。根据其OR估计值的大小,吸烟3.08(95％CI:2.26,4.21)、使用煤及柴草燃料3.10(95％CI:1.77,3.71)、家族呼吸道疾病史3.42(95％CI:2.76,3.98)与慢性阻塞肺病OR值呈较强的关联强度, 被动吸烟1.46(95％CI:1.15,1.98)、职业粉尘或化学品暴露1.57(95％CI:1.17,2.45)、厨房通风情况1.28(95％CI:1.82,2.43)与慢性阻塞肺病OR值呈较弱关联, 其他因素均呈中等强度关联。男性、高龄与慢性阻塞肺病OR值无相关。采用固定效应模型和随机效应模型分别计算慢性阻塞肺病发病危险因素的OR合并值及95%CI,结果两种模型分析结果基本相似。 结论 吸烟、有被动吸烟史、BMI、职业粉尘或化学品暴露、家族呼吸道疾病史、儿童时期呼吸道疾病史、受教育程度、使用煤及柴草燃料及厨房通风情况是影响中国人群慢性阻塞肺病发病的危险因素。     

Risk of preterm delivery and hypertensive disorders of pregnancy in relation to maternal co-morbid mood and migraine disorders during pregnancy

We evaluated the risks of preterm delivery and hypertensive disorders of pregnancy among pregnant women with mood and migraine disorders, using a cohort study of 3432 pregnant women. Maternal pre-pregnancy or early pregnancy (<20 weeks gestation) mood disorder and pre-pregnancy migraine diagnoses were ascertained from interview and medical record review. We fitted generalised linear models to derive risk ratios (RR) and 95% confidence intervals (CI) of preterm delivery and hypertensive disorders of pregnancy for women with isolated mood, isolated migraine and co-morbid mood-migraine disorders, respectively. Reported RR were adjusted for maternal age, race/ethnicity, marital status, parity, smoking status, chronic hypertension or pre-existing diabetes mellitus, and pre-pregnancy body mass index. Women without mood or migraine disorders were defined as the reference group. The risks for preterm delivery and hypertensive disorders of pregnancy were more consistently elevated among women with co-morbid mood-migraine disorders than among women with isolated mood or migraine disorder. Women with co-morbid disorders were almost twice as likely to deliver preterm (adjusted RR=1.87, 95% CI 1.05, 3.34) compared with the reference group. There was no clear evidence of increased risks of preterm delivery and its subtypes with isolated migraine disorder. Women with mood disorder had elevated risks of pre-eclampsia (adjusted RR=3.57, 95% CI 1.83, 6.99). Our results suggest an association between isolated migraine disorder and pregnancy-induced hypertension (adjusted RR=1.42, 95% CI 1.00, 2.01). This is the first study examining perinatal outcomes in women with co-morbid mood-migraine disorders. Pregnant women with a history of migraine may benefit from screening for depression during prenatal care and vigilant monitoring, especially for women with co-morbid mood and migraine disorders.     

School performance and alcohol use problems in early adulthood: a longitudinal study

There is inconsistent evidence about the association between school performance and subsequent use of alcohol and alcohol problems in adolescents and young adults. This study examines whether school performance at 14 years is associated with drinking problems in early adulthood; and whether this association is explained by family and individual factors in childhood and adolescence. Data were from a 21-year follow-up of 3,478 Australian young adults from birth to the age of 21 years when data on use of alcohol were collected. Child school performance (CSP) was assessed at 14 years via self- and maternal report. Alcohol consumption at 21 years was measured via self-report, and alcohol abuse and dependence were assessed by the computerized version of Composite International Diagnostic Interview (CIDI-Auto). Potential confounding factors were prospectively measured between the child’s birth and age of 14 years. School performance at 14 years predicted young adults’ alcohol consumption and alcohol use disorders (AUDs). After controlling for confounding, children who had lower school performance had increased risk of drinking more than two glasses of alcohol per day in early adulthood (odds ratio = 1.7; 95% confidence interval: 1.1–2.6). There was a similar pattern of association between CSP and young adults’ alcohol abuse and dependence (AUD) measured by CIDI-Auto. Level of academic performance in high school children predicts their drinking problems as young adults, independently of a selected group of individual and family confounders. Exploration of the pathway linking school performance and alcohol problems in young people may help identify opportunities for preventive interventions.     

青少年童年期反复身体和情感虐待经历及其相关因素研究

目的描述童年期反复发生的重度身体虐待、中度身体虐待和情感虐待行为的报告率，分析青少年及其父母的人口统计学特征与3种反复虐待行为的关系。方法5453名初一，初二和高一、高二年级学生自愿参加无记名的问卷调查，回顾小学阶段经历的由父母或其他监护人实施的9项重度身体虐待，8项中度身体虐待和7项情感虐待行为，5141人提供了完整的问卷。以在小学年龄阶段，3种共24项虐待类型中至少1项虐待行为平均1a发生3次以上，界定为有该种童年期反复虐待经历。结果童年期反复重度身体虐待报告率为8．0％，从0．2％（把头按在水下）到6．6％（用脚踢）；童年期反复中度身体虐待报告率为18．6％，从0．4％（强迫吃难吃的东西）到9．7％（用手或棍棒打臀部）；童年期反复情感虐待报告率为14．4％，从0．8％（用恶鬼等恐吓）到11．8％（责骂）。多因素非条件logistic回归分析表明，在城市上学的农村户籍是3种童年期反复虐待行为的保护因素．女性是反复重度和中度身体虐待的保护因素，独生子女是中度身体虐待和情感虐待的保护因素；单亲家庭是重度和中度身体虐待的危险因素，父亲长期在外工作或打工是童年期反复重度身体虐待和情感虐待的危险因素，年龄大，继母为童年期反复情感虐待的危险因素。结论童年期反复身体和情感虐待行为较为常见，与青少年以及父母的人口统计特征存在关联。     

Family history as a predictor of asthma risk

Asthma, one of the most important chronic diseases of children, disproportionately affects minority and low-income children. Many environmental risk factors for asthma have been identified, including animal, mite, and other allergens; cigarette smoke; and air pollutants. Genetics also play an important causative role, as indicated by familial aggregation and the identification of candidate genes and chromosomal regions linked to asthma risk. Using a positive family history of asthma to identify children at increased risk could provide a basis for targeted prevention efforts, aimed at reducing exposure to environmental risk factors.To assess the predictive value of family history as an indicator of risk for childhood asthma, we reviewed population-based studies that evaluated family history of asthma and atopic disease in children with asthma.Our search identified 33 studies from all geographic regions of the world for review. The studies varied in definitions of positive family history and asthma phenotype and used study populations with asthma prevalence ranging from 2% to 26%. Nevertheless, family history of asthma in one or more first-degree relatives was consistently identified as a risk factor for asthma. In ten studies, sensitivity and predictive value of a positive family history of asthma could be calculated: sensitivity ranged from 4% to 43%, positive predictive value from 11% to 37%, and negative predictive value from 86% to 97%.Although a positive family history predicts an increased risk of asthma, it identifies a minority of children at risk. Positive family history may have utility in targeting some individual prevention efforts, but the low positive predictive value limits its value as a means to direct environmental remediation efforts.     

山东省40岁及以上居民慢性阻塞性肺疾病患病情况及危险因素分析

目的 了解山东省≥40岁居民慢性阻塞性肺疾病患病率及危险因素,为制定防控策略提供依据。方法 2015年7月—2016年2月,采用分层整群随机抽样的方法在山东省抽取3 600名≥40岁居民进行问卷调查、体格检查及肺功能检查。采用复杂抽样加权估算慢阻肺的患病率,并应用多因素logistic回归模型分析患病的危险因素。结果 本次调查项目全部完成且质控合格的共3 317人,慢阻肺患病471人,经复杂加权后山东省≥40岁居民慢阻肺患病率为13.391%,男性患病率为20.200%,女性为6.632%,男性高于女性（χ2 = 95.359,P＜0.001）,40～49岁、50～59岁、60～69岁、≥70岁年龄组的患病率分别为6.549%、10.837%、19.991%、23.632%,随年龄的增长患病率增高（χ2 = -12.018,P＜0.001）;多因素logistic回归分析显示,性别（OR = 2.416,95%CI = 1.639～3.561）、年龄（OR = 3.749,95%CI = 1.883～7.467）、有慢性支气管炎（简称慢支）等慢性呼吸系统疾病家族史（OR = 1.444,95%CI = 1.127～1.849）、儿童时期严重肺部感染史（OR = 3.183,95%CI = 1.414～7.168）、吸烟（OR = 2.207,95%CI = 1.805～2.698）、做饭时不通风（OR = 1.361,95%CI = 1.021～1.814）等是慢阻肺患病的危险因素。结论 山东省≥40岁居民慢阻肺患病率较高,应从各项危险因素入手,特别是男性、高龄、有慢性呼吸系统疾病家族史、吸烟、儿童时期严重肺部感染史、室内空气污染等方面,加强对慢阻肺的防控。     

Respiratory history during infancy and childhood, and respiratory conditions in adulthood

The aim of this paper was to study respiratory disorders in infancy and childhood as a risk factor for respiratory conditions in adulthood. During the first part of the survey 15,247 adolescents in the Bordeaux area (average age: 16.5 years, boys = 46.6%) filled in a self-administered questionnaire concerning their respiratory history during infancy and childhood, their present symptoms and their smoking habits. Each subject with chronic cough (n = 538) was then matched with two controls (n = 1094) and the parents of these subjects and of their controls were sent a complementary questionnaire. During the second part, 1807 adults (average age: 39.3 years; men = 49.7%) working at Bordeaux University filled in a self-administered questionnaire about their present respiratory symptoms, smoking habits and respiratory symptoms during adolescence. Spirometry was performed in 172 adolescents and 1665 adults. The results of the first part showed a very significant relationship in adolescents between respiratory history during infancy and childhood and current chronic cough even in non-smokers, non-wheezers and non-asthmatics. The second part showed a very significant relationship in adults between respiratory symptoms during adolescence and present respiratory symptoms on the one hand, and a lower pulmonary function on the other, taking wheezing, smoking and asthma into account. In common with many similar studies, we conclude that respiratory disorders in young children may predispose to later disease, and that consequently it might be important to determine appropriate measures to prevent respiratory illness in childhood.     

学龄期儿童偏头痛影响因素的临床研究

目的探讨学龄期儿童偏头痛的影响因素,为采取预防措施提供依据。方法36例儿童偏头痛病例均详细询问病史和进行一系列理化检查,排除了上呼吸道感、中枢神经系统等器质性疾病引起的头痛,并排除了眼、耳鼻喉科疾病。收集了全部偏头痛儿童的病史、生活饮食习惯、心理因素、家庭环境因素等,并进行非条件logistic多元回归分析。结果按α=0.05水平入选logistic回归模型的因素有过度疲劳、睡眠不足、心理因素、使用电脑或看电视过久、头痛家族史、环境因素,均有统计学意义。结论针对影响儿童偏头痛的主要因素,临床采取心理治疗、养成良好的学习生活习惯等措施,有助于缓解儿童偏头痛的症状。     

Una revisión sobre los factores de riesgo en la infancia para la esquizofrenia y los trastornos mentales graves del adulto

AimTo provide scientific evidence, usinga literature review on psychosocial risk factors in mental health, that a high exposure to psychosocial stress situations in childhood increases the risk of mental disorders in adulthood,.DesignA literature review up to December 2011 in the electronic databases fromMedline, Universitat de Barcelona, and the Universitat Autonoma de Barcelona. The keywords used were: childhood, prenatal, vulnerability, risk, abuse, neglect, child mental disorder, schizophrenia, and prevention.Inclusion criteria for the studies reviewed: 1) designed to investigate childhood risk factors; 2) Comparative studies with persons without risk factors; 3) Studies with sufficient statistical significance; 4) Studies with “n” participants equal to o more than 30 persons.ResultsThere are a group of easily identifiable mental health risk factors in childhood that can help in the prevention of mental disorders in the adulthood. They can be grouped into four categories: A) Pregnancy, birth and perinatal problems; B) Poor interpersonal relations with parents; C) Adverse life events in the first two years of life; D) Cognitive deficits in primary school, and social isolation during school years.ConclusionsThere are life events that may increase the possibilities of suffering some kind of Psychopathology. It is necessary to consider those events as Risk Factors for Mental Health. The accumulation of these Risk Factors increases vulnerability to Mental Disorders.     

Predictor factors for childhood obesity in a Spanish case-control study

OBJECTIVE: The aim of this study was to identify and characterize factors associated with childhood obesity risk related to lifestyle and perinatal life influences (dietary pattern, physical activity, family history of obesity, breast-feeding, sedentary behavior, and birth weight) in a case-control study design. METHODS: Cases were 185 obese (body mass index >97th percentile) children and adolescents (6-18 y old) from the Navarra region of Spain and control subjects were matched by sex and age. Anthropometric data were collected, and a personal interview about lifestyle parameters (dietary patterns, physical activity, family history of obesity, breast-feeding and sedentary behaviors) was performed with each participant. Conditional logistic regression was used to identify predictive factors of obesity. RESULTS: Leisure time physical activity proved to be a protector factor against obesity (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.92-0.96), whereas family history of obesity (OR 4.18, 95% CI 2.20-8.62), watching television (OR 2.02, 95% CI 1.09-3.77), and sugar-sweetened beverage consumption (OR 1.74, 95% CI 1.05-2.89) were associated with a higher obesity risk. CONCLUSION: Our results suggest that leisure time physical activity, family history of obesity, watching television, and sugar-sweetened beverage consumption are important predictive variables for childhood obesity, whereas other factors including breast-feeding, birth weight, and time spent sleeping did not appear to play an important role in the development of childhood obesity.     

Risk factors for asthma in adults in Pelotas, Rio Grande do Sul State, Brazil

Asthma incidence and mortality rates have increased in recent years. The present cross-sectional survey aimed to measure asthma prevalence and risk factors in a random sample of 1,968 individuals (20-69 years of age) in Pelotas, Rio Grande do Sul State, Brazil. Overall prevalence of "current asthma symptoms" was 6%, varying according to diagnostic criteria. Associated risk factors in the crude analyses were: female gender, age 60-69 years, non-white skin color, low education, low family income, family history of atopy and asthma, personal history of atopic disease, smoking, low body mass index, and minor psychiatric disorders. In the multivariate analysis the following risk factors remained associated with "current asthma symptoms": mother and father with asthma history, minor psychiatric disorders, age 60-69 years, household income less than 1.01 minimum wage, history of atopic disease, and female gender. The results highlight the variation in asthma prevalence according to diagnostic criteria and confirm the importance of genetic, social, and lifestyle factors.     

儿童支气管哮喘的危险因素分析

对长沙地区141例儿童支气管哮喘采用1:1配比的病例对照研究,分析形成儿童哮喘的危险因素。结果表明其危险因素有家族遗传史(OR=44.44);母亲孕期食用致敏食物(OR=22.52)以及孕期过敏史(OR=7.11);儿童过敏性疾病(OR=9.27)以及婴幼儿期呼吸系疾病(OR=7.71);儿童个性(OR=8.01)和居住环境(OR=9.08)。而该病的发病年龄与个人过敏史、家族哮喘史,母亲孕期过敏史和家庭居住环境等有关。说明儿童哮喘是由遗传与环境因素协同作用形成的多因子遗传性疾病。     

成都市区中学生自杀未遂的现况调查

目的：探讨中学生自杀未遂的出现率及其相关因素。方法：采用多级整群抽样法，从成都市区中学中抽取重点中学2所，普通中学1所，职业中学2所，共1393名中学生，用自编调查问卷、Beck抑郁问卷、青少年生活事件量表、父母教养方式问卷进行调查。筛选出自杀未遂者后再调查其原因及方式。采用SPSS8．0软件进行统计分析。结果：1393名青春期中学生中，曾有自杀未遂者36例（2．6％），男女之比1:2. 遂者中33．3％为反复自杀未遂。中学阶段自杀未遂原因以家庭矛盾居多（34．4％），方式以过量服药或服毒居多（50．0％）。青春期自杀未遂危险因素有可疑幻听、吸烟、受同伴欺侮、想成为异性、父母再婚、女性、父亲的拒绝、否认、过度保护、生活事件等。保护因素有家庭和睦。结论：自杀未遂在中学生中并不罕见，临床医生与教育工作者应认识其危险因素并积极干预。     

Alcohol consumption,family history of hematolymphoproliferative cancer,and the risk of non-Hodgkin's lymphoma in men

PURPOSE: To investigate the association between alcohol consumption and the risk of non-Hodgkin's lymphoma (NHL) and to examine whether the association is modified by a family history of hematolymphoproliferative cancer (HLPC). METHODS: Data on white men from two population-based case-control studies of NHL conducted in Iowa/Minnesota and Kansas were pooled for this analysis. Information on alcohol consumption, family history of HLPC, and other factors was obtained by interviewing 792 cases and 2193 controls or, if deceased, their next-of-kin. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: There was no clear association between NHL and the use of alcohol, beer, hard liquor, or wine. The relationship, however, may differ according to a family history of HLPC. Alcohol use was not associated with the risk of NHL in men without a family history of HLPC (ORs = 0.8 and 0.9 for men consuming alcohol < or = median and > median, respectively), the presence of a family history in the absence of alcohol use was associated with a slightly increased risk (OR = 1.4; 95% CI 0.8-2.5), whereas risks of NHL among men with a positive family history were 2.1 (CI 1.0-4.7) for men consuming alcohol < or = median (13.7 g/day) and 2.8 (1.3-5.9) for men consuming alcohol greater than median. CONCLUSIONS: The present data found no clear association between alcohol consumption and the risk of NHL among men without a family history of HLPC, whereas alcohol intake was associated an elevated risk in men with a positive family history. The finding of effect modification of the alcohol-NHL association by a family history of HLPC is novel and requires confirmation.     

Chronic renal failure in North Central Province of Sri Lanka: an environmentally induced disease

This study was conducted to determine the aetiology of chronic renal failure (CRF) in the North Central Province of Sri Lanka. Patients (n=183) with CRF of unknown aetiology were compared with controls (n=200) who had no evidence of chronic renal dysfunction. Exposure to possible risk factors were determined by an interviewer-administered questionnaire. Being a farmer (P<0.001), using pesticides (P<0.001), drinking well water (P<0.001), a family history of renal dysfunction (P=0.001), use of ayurvedic treatment (P<0.001) and a history of snake bite (P<0.001) were risk factors for CRF of unknown aetiology. Using logistic regression analysis, a family history of chronic renal disease, taking ayurvedic treatment and history of snake bite were found to be significant predictors for CRF of unknown aetiology. There is evidence to support an environmental aetiology to CRF in Sri Lanka.     

糖尿病家族史、饮食及肥胖与糖尿病交互作用

目的探讨糖尿病家族史、饮食及肥胖与糖尿病的交互作用。方法选取对湖南省长沙市望城县3个村所有≥15岁常住居民1 602人,调查社会人口资料、糖尿病家族史、饮食习惯及身高、体重、腰臀比、血糖值以及体育锻炼等情况,并对因素间的交互作用进行分析。结果望城县农村居民糖尿病年龄标化患病率为5.35%,糖尿病家族史与向心性肥胖、年龄≥45岁、文化程度低及高脂饮食间均存在相加交互作用,其交互作用超额相对危险度(RERI)分别为6.2997、.1803、.500、3.020,向心性肥胖与高脂饮食间存在相加交互作用,RERI为6.642。结论糖尿病家族史、饮食及肥胖间存在相加交互作用。