曲阜市农村居民临界高压危险因素研究

目的 探索临界高血压发生的危险因素,为开展高血压的一级预防提供依据。方法 对２４０例临界高血压１：１病例对照调查资料进行多因素条件Ｌｏｇｉｓｔｉｃ回归分析。结果 定α＝０．０５水平,运算结果最终进入回归方程的因素有５个,高血压家族史（ＯＲ＝４．２１）、体重指数（ＯＲ＝５．１６）、饮食嗜碱（ＯＲ＝３．０８）、经常饮酒（ＯＲ＝２．５７）、经常进行体育锻炼（ＯＲ＝０．４２）。结论 高血压家族史、超重、饮     

鼻咽癌危险因素的病例对照研究

选择１９９２年１０月１日至１９９３年１０月１日间１０４例新诊鼻咽癌病例，并随机选择对照，１∶１配对。调查居住史、职业史、烹调史等。多因素条件Ｌｏｇｉｓｔｉｔ回归分析的结果表明：梅菜（ＯＲ＝１．８１，Ｐ＝０．０４５），陈皮梅（ＯＲ＝２．９５１，Ｐ＝０．０４３），室内做饭（Ｐ＝０．００４，且＞３５年，ＯＲ＝１．９５６），无烟囱的炉子（Ｐ＝０．００４，且＞１０年，ＯＲ＝２．６８８）为鼻咽癌发病的危险因素。而葡萄（ＯＲ＝０．３１２３，Ｐ＜０．００１）则有保护作用。遗传因素的ＯＲ值最大，提示可能是鼻咽癌发病的主要因素。     

20个妇幼项目县孕产妇死亡危险因素分析

７省２０个妇幼项目县对孕产妇死亡危险因素的１：１病例对照研究结果表明：单因素配对分析发现其中与孕产妇死亡有显著性意义的因素为计划外妊娠（ＯＲ＝２．３）、生活在大家庭（ＯＲ＝１．４）、想生男孩（ＯＲ＝２．８）、无产前检查史（ＯＲ＝２．９）、非住院分娩（ＯＲ＝１．７）、产后大出血（ＯＲ＝２．５）、孕产妇有一定文化程度（ＯＲ＝０．７）和孕产妇本人有经济收入（ＯＲ＝０．４）等。多因素Ｌｏｇｉｓｔｉｃ回归分析发现与孕产妇死亡有关的危险因素有计划外妊娠、想生男孩、非住院分娩、产后大出血、未消毒接生、孕期合并症等。并且发现孕产妇有一定文化程度、孕产妇有独立经济收入、孕产妇有一定保健知识对减少孕产妇死亡有一定保护作用。     

饮食与胃癌关系的病例对照研究

目的探讨鱼露摄入及饮食、生活习惯与胃癌发生的关系。方法１９９４年５月～１９９５年７月，在胃癌高发区福建省长乐、福清两市，进行以人群为基础１２配对的病例对照研究。共调查２７２对。结果危险状态的单因素检验提示，过量摄入鱼露（ＯＲ＝２．５７）、腌制蔬菜（ＯＲ＝１．４１）、腌制海产品（ＯＲ＝１．５７），少吃新鲜蔬菜（ＯＲ＝１．９５）、柑桔类水果（ＯＲ＝１．４１）、其他水平（ＯＲ＝１．３１）、绿茶（ＯＲ＝１．７２），以及暴露于霉粮（ＯＲ＝２．３２）、三餐不定时（ＯＲ＝５．４７）、家族肿瘤史（ＯＲ＝３．２７）等与胃癌的发生存在显著性正关联。未发现吸烟、饮酒、盐摄入量、使用冰箱等与胃癌间的联系。危险状态的条件Ｌｏｇｉｓｔｉｃ回归分析，入选最佳子集的因素为鱼露、腌制海产品、三餐不定时和家族肿瘤史。４个因素的综合归因危险度为７５．４９％。结论过量摄入鱼露、腌制食品、霉粮，及三餐不定时、家族肿瘤史等可能是当地胃癌高发的危险因素。而新鲜蔬菜、水果，绿茶等可能具有保护作用。     

云南省陇川县男性青年吸毒危险因素分析

目的　探索边境地区男性青年吸毒的危险因素。方法　断面调查基础上建立回顾性队列,观察期为１９９１ 年１ 月１ 日至１９９４ 年８ 月１ 日。被调查对象人口学和行为方面资料采用匿名方法收集。危险因素的确定采用单因素和多因素分析方法。结果　每年新吸毒者发生率在１９９１ ～１９９３ 年间逐年上升。根据多因素分析,吸毒的危险因素包括：未婚、离婚或分居或丧偶（ Ｏ Ｒ＝ ８ ．９） 、被朋友或他人鼓励尝试毒品（ Ｏ Ｒ＝ ８ ．８） ,吸烟（ Ｏ Ｒ＝ ２ ．４） ,属景颇族（ Ｏ Ｒ＝ １ ．８） 以及１９９１ 年家庭成员中有人吸毒（ Ｏ Ｒ＝ １ ．５） 。至少上学７ 年是吸毒的保护因素（ Ｏ Ｒ＝ ０ ．６） 。几个主要危险因素的人群归因危险度分别是：被朋友或他人鼓励尝试吸毒为７０ ．８ ％ ,吸烟５０ ％ ,属景颇族为２４ ％ 。结论　采取社区干预来改变人们对吸烟及吸毒的看法,可能会大幅度降低新吸毒者发生率。为此,建议尽快开展社区干预项目。     

2型糖尿病患者不同时期危险因素的比较研究

调查２００对按１：１配对的２型糖尿病和对照在少儿阶段和成年阶段的饮食等暴露情况,条件Ｌｏｇｉｓｔｉｃ回归分析的结果表明,少儿阶段的危险因素有：油炸食物（Ｂｉ＝２．４９５,Ｂｓ－０．９３３,ＯＲ－１２．１２２）,甜食（Ｂｉ＝２．３６９,Ｂｓ＝０．９１３,ＯＲ＝１０．６８７）,饥饿（Ｂｉ＝１．０６５,Ｂｓ＝０．８２５,ＯＲ＝２．９０１）,腮腺炎病史（Ｂｉ＝２．２３０,Ｂｓ＝０．７０１,ＯＲ＝９．３００     

Ⅱ型糖尿病多发性家庭的发病危险因素探讨

目的探讨影响Ⅱ型糖尿病（ＮＩＤＤＭ）多发性家庭中家庭成员发病的危险因素。方法 以ＮＩＤＤＭ多发性家庭中的同胞为基础,进行成组病例对照研究。其中病例组２２５例,对照组１９４ 例。结果单因素ｌｏｇｉｓｔｉｃ回归提示,ＮＩＤＤＭ多发性家庭中女性患病率高于男性（ＯＲ＝１． ６３７）;多 个饮食因素与ＮＩＤＤＭ发病有关,其中包括:吃甜食（ＯＲ＝１． ７０６）、吃食用糖（ｏＲ一２。 ２０３）、吃高脂 肪肉类（与不吃肉相比ＯＲ＝１３． １２５）、食肉量大（每周大于两斤与少于半斤相比ＯＲ＝２． ７２８）、食新 鲜蔬菜少（每天半斤左右与一斤以上相比ＯＲ＝１． ６８７）、口味嗜咸（ＯＲ＝１． ８６７）、食量大（每天大于 ５００ ｇ与少于２５０ｇ相比ＯＲ＝２． ６３２）;与ＮＩＤＤＭ发病有关的生活习惯是:冬季午睡（ＯＲ＝ １．７８７）、夏季午睡（ＯＲ＝１． ５２４）;另外,腰臀比（ＯＲ＝１． ７２４）;高血压（ＯＲ已１． ８６７）;精神刺激史 （ＯＲ＝１． ５９３）及文化程度（低与高相比ＯＲ＝２． ５３８）也与ＮＩＤＤＭ发病有关。多因素ｌｏｇｉｓｔｉｃ回归显 示:性别因素（ＯＲ＝３． ３３５）,吃食用糖（Ｏ...     

膀胱癌危险因素交叉配比病例对照研究

对１１２例膀胱癌病例进行与非肿瘤对照和胃癌对照交叉配比病例对照研究，结果相对于胃癌、膀胱癌的特异危险因素为危险职业作业史（ＯＲ＝２．０７）、泌尿道病史（ＯＲ＝２．８３）、憋尿（ＯＲ＝２．８７）、常服解热镇痛药（ＯＲ＝２．６７）；较特异危险因素为吸烟（ＯＲ＝２．７５）和食用糖精（≥１５次／年，ＯＲ＝４．００）；一般因素为精神创伤（ＯＲ＝２．１１）。遗传易感性似乎不明显。     

中学生腰背痛的流行病学调查

用统一的调查表及体检资料，对成都市某中学１５５８名学生进行腰背痛流行病学调查。结果：５５．１％的学生有腰背痛病史，现患率为４２．８％，患病率随年级增大而增高。腰背痛学生中，１７．２％因腰背疼痛影响上学或活动，６．６％因腰背痛就医。腰背痛的相关危险因素有腰伤史（ＯＲ＝２．７５）、坐位时间≥１０ｈ（ＯＲ＝１．６０）、坐姿不正确（ＯＲ＝１．５６）、体质指数≥２２（ＯＲ＝１．４５）以及睡眠用枕头≥２个（ＯＲ＝１．３２）。     

新疆和田地区维吾尔族老年高血压病患者血脂、空腹血糖、空腹胰岛素、性激素水平的病例对照研究

目的 探讨维吾尔族老年高血压病患者血脂、空腹血糖、性激素水平及高血压病的联系及其发病特点。方法 对新疆和田地区１０５例维吾尔族老年高血压病进行１：１配对病例对照研究。结果 维吾尔族老年高血压病患者同时存在高密度脂蛋白胆固醇水平降低是造成老年高血压病并发症的必然因素（ｏｄｄｓ ｒａｔｉｏ，ＯＲ＝５．６２１４）。空腹血糖和空腹胰岛素水平升高是维吾尔族老年高血压病的危险因素（ＯＲ＝２．４４７４和ＯＲ＝２     

CYP1A1和GSTM1基因多态与肺癌发病关系的病例-对照研究

目的 探讨肺癌易感性标记物CYP1A1及GSTM1基因多态以及吸烟等其他环境暴露因素与肺癌发生的关系。方法 采用病例-对照研究的方法，收集原发性肺癌病例91例以及非肺部疾患的住院病例(对照)91例，所有的研究对象均采静脉血进行DNA抽提，并用PCR方法检测CYP1A1以及GSTM1基因多态，同时调查研究对象吸烟等其他环境暴露因素。应用Logistic回归分析方法进行单因素和多因素的分析。结果 无论是单因素分析还是多因素分析均未显示出CYP1A1和GSTM1基因多态与肺癌发病的关联。多因素分析结果表明：化程度的OR为0．63(95％CI：0．45～0．86)，吸烟量的OR为1．56(95％CI：1．14～2．14)，无抽油烟机的OR为3．77(95％CI：1．48～9．56)，食用动物油的OR为1．67(95％CI：1.25～2．24)，常吃胡萝卜的OR为0．47(95％CI：0．22～0．98)，饮酒的OR为6．58(95％CI：1.53～28．30)，家族肺癌史的OR为3．75(95％CI：1．64～8．58)。结论 CYP1A1和GSTM1基因多态与肺癌发病无明显的关联，吸烟、饮酒、食用动物油、家族肺癌吏以及无抽油烟机是肺癌的危险因素，而高化程度和常吃胡萝卜与降低肺癌风险有关。     

肺癌危险因素配对分配中对照人群选择的探讨

目的 探讨肺 危险因素配对分析中人群对照的选择方法,为开展肺癌危险因素监测 提供依据。方法 利用《常见恶性肿瘤发病、死亡及危险因素监测方法研究》课题中北京、天津、上海、重庆４市城区的调查资料,运用条件ｌｏｇｉｓｔｉｃ回归分析方法对３组１：１邻居,１：１正常人,１：２正常人匹配病例对照资料进行分析。结果 ３组资料肺癌主要危险因素的ＯＲ值一致,食物因素等的结果有一定差异;邻居对照和正常人对照因素暴露率     

Smoking and other risk factors for lung cancer in Xuanwei, China

In Xuanwei County, Yunnan Province, lung cancer mortality rates are among the highest in China in both males and females. Previous studies have shown a strong association of lung cancer mortality with indoor air pollution from 'smoky' coal combustion. In the present case-control study, 110 newly-diagnosed lung cancer patients and 426 controls were matched with respect to age, sex, occupation (all subjects were farmers), and village of residence (which provided matching with respect to fuel use). This design allowed assessment of known and suspected lung cancer risk factors other than those mentioned above. Data from males and females were analysed by conditional logistic regression. In females who do not smoke, the presence of lung cancer was statistically significantly associated with chronic bronchitis (odds ratio [OR] = 7.37, 95% confidence interval [Cl]: 2.40-22.66) and family history of lung cancer (OR 4.18, 95% Cl: 1.61-10.85). Females' results also suggested an association of lung cancer with duration of cooking food (OR 1.00, 9.18 and 14.70), but not with passive smoking (OR 0.77, 95% Cl: 0.30-1.96). In males, lung cancer was significantly associated with chronic bronchitis (OR 7.32, 95% Cl: 2.66-20.18), family history of lung cancer (OR 3.79, 95% Cl: 1.70-8.42), and personal history of cooking food (OR 3.36, 95% Cl: 1.27-8.88). In males a dose-response relationship of lung cancer with smoking index (years of smoking*amount of smoking) was shown by risks of 1.00, 2.61, 2.17 and 4.70.     

Association between asbestos exposure,cigarette smoking,myeloperoxidase (MPO) genotypes,and lung cancer risk

BACKGROUND: As observed in tobacco-associated carcinogenesis, genetic factors such as the polymorphic metabolic/oxidative enzyme myeloperoxidase (MPO) could modulate individual susceptibility to asbestos-associated carcinogenesis. METHODS: RFLP-PCR analysis identified the MPO genotypes in 375 Caucasian lung cancer cases and 378 matched controls. An epidemiological interview elicited detailed information regarding smoking history and occupational history and exposures. RESULTS: Asbestos exposure was associated with a significantly elevated risk estimate (OR = 1.45; 95% CI 1.04-2.02). On stratified analysis, we found the MPO genotypes modified the effect of asbestos exposure on lung cancer risk. Specifically, G/G carriers who were exposed to asbestos had an odds ratio (OR) of 1.72 (95% CI; 1.09-2.66), while A-allele carriers (G/A + A/A) exposed to asbestos exhibited a reduced OR of 0.89 (95% CI; 0.56-1.44). The OR was further reduced to 0.73 (0.49-1.06) for A-allele carriers not exposed to asbestos. A similar trend was observed for the joint effects between the MPO genotypes and pack-years smoking. Next, all three risk factors (MPO genotypes, asbestos exposure, and smoking) were analyzed simultaneously for joint effects. Heavy smokers with the G/G genotype and a history of asbestos exposure demonstrated a statistically significant elevated risk estimate (OR = 2.19; 95% CI 1.16-4.11), while the A-allele carriers with the same exposure profile were at a lower risk for lung cancer (OR = 1.18; 95% CI 0.58-2.38). The A-allele genotypes demonstrated similar protective effects for the other three exposure profiles. CONCLUSIONS: For a similar level of exposure to established carcinogens, individuals with the MPO A-allele genotypes appear to have a reduced risk of lung cancer.     

中国非吸烟女性肺癌危险因素的病例-对照研究

目的探讨中国非吸烟女性患肺癌的危险因素。方法应用1∶2配对的病例对照方法,收集2001年9月~2004年2月在北京、上海和成都指定医院经病理诊断确诊的非吸烟女性新发肺癌住院病例157例,按照性别、年龄(±2岁)、不吸烟等配对因素选取医院对照和人群对照。利用统一调查表对调查对象进行面对面问卷调查,收集病例和对照有关危险因素的暴露史等情况。通过单因素分析和多因素条件Logistic回归分析筛选肺癌的主要危险因素。结果单因素分析发现28个暴露因素与非吸烟女性肺癌发生有关。多因素分析发现,被动吸烟指数≥50人年(OR=1·77,95%CI为1·07~2·92)、经常吃动物内脏(OR=1·85,95%CI为1·06~3·22)、职业接触粉尘(OR=2·47,95%CI为1·21~5·03)和工作场所通风不良(OR=4·02,95%CI为1·74~9·29)为非吸烟女性肺癌发生的危险因素;常吃蔬菜(OR=0·26,95%CI为0·12~0·59)、经常服用维生素(OR=0·53,95%CI为0·30~0·93)、结婚后家庭人均月收入≥500元(OR=0·50,95%CI为0·28~0·91)和初次生育年龄在24~30岁之间(OR=0·53,95%CI为0·32~0·90)为非吸烟女性肺癌发生的保护因素。趋势性检验发现,被动吸烟与非吸烟女性发生肺癌的相对危险度之间存在一定剂量反应关系。结论被动吸烟、职业接触粉尘、经常吃动物内脏和工作场所通风不良会增加非吸烟女性患肺癌的危险性。常吃蔬菜和经常服用维生素等因素可以降低非吸烟女性发生肺癌的危险性。     

Genetic variants on 15q25.1, smoking, and lung cancer: an assessment of mediation and interaction

Genome-wide association studies have identified variants on chromosome 15q25.1 that increase the risks of both lung cancer and nicotine dependence and associated smoking behavior. However, there remains debate as to whether the association with lung cancer is direct or is mediated by pathways related to smoking behavior. Here, the authors apply a novel method for mediation analysis, allowing for gene-environment interaction, to a lung cancer case-control study (1992-2004) conducted at Massachusetts General Hospital using 2 single nucleotide polymorphisms, rs8034191 and rs1051730, on 15q25.1. The results are validated using data from 3 other lung cancer studies. Tests for additive interaction (P = 2 × 10(-10) and P = 1 × 10(-9)) and multiplicative interaction (P = 0.01 and P = 0.01) were significant. Pooled analyses yielded a direct-effect odds ratio of 1.26 (95% confidence interval (CI): 1.19, 1.33; P = 2 × 10(-15)) for rs8034191 and an indirect-effect odds ratio of 1.01 (95% CI: 1.00, 1.01; P = 0.09); the proportion of increased risk mediated by smoking was 3.2%. For rs1051730, direct- and indirect-effect odds ratios were 1.26 (95% CI: 1.19, 1.33; P = 1 × 10(-15)) and 1.00 (95% CI: 0.99, 1.01; P = 0.22), respectively, with a proportion mediated of 2.3%. Adjustment for measurement error in smoking behavior allowing up to 75% measurement error increased the proportions mediated to 12.5% and 9.2%, respectively. These analyses indicate that the association of the variants with lung cancer operates primarily through other pathways.     

Cigarette smoking and erectile dysfunction among Chinese men without clinical vascular disease

The authors examined the association between cigarette smoking and risk of erectile dysfunction among 7,684 Chinese men aged 35-74 years without clinical vascular disease. Cigarette smoking and erectile dysfunction were assessed by questionnaire. Vascular risk factors were measured according to standard methods. After adjustment for age, education, alcohol consumption, physical inactivity, diabetes, hypertension, overweight, and hypercholesterolemia, the odds ratio of erectile dysfunction was 1.41 (95% confidence interval (CI): 1.09, 1.81) for cigarette smokers compared with never smokers. There was a statistically significant dose-response relation between cigarette smoking and risk of erectile dysfunction (p(trend) = 0.005). Multivariate-adjusted odds ratios of erectile dysfunction were 1.27 (95% CI: 0.91, 1.77), 1.45 (95% CI: 1.08, 1.95), and 1.65 (95% CI: 1.08, 2.50) for those who smoked 1-10, 11-20, and more than 20 cigarettes per day, respectively, compared with never smokers. The association was stronger in participants with diabetes (odds ratio = 3.29, 95% CI: 1.49, 7.27) than in participants without diabetes (odds ratio = 1.33, 95% CI: 1.03, 1.73). If the association is causal, an estimated 22.7% of erectile dysfunction cases (11.8 million cases) among Chinese men are attributable to cigarette smoking. This 2000-2001 study of Chinese men documented an independent and dose-response relation between cigarette smoking and risk of erectile dysfunction.     

Previous pulmonary diseases and risk of lung cancer in Gansu Province, China

BACKGROUND: Although active smoking is well established as the main cause of lung cancer, there is accumulating evidence that history of prior lung diseases may be an independent risk factor for lung cancer. METHODS: A population-based case-control study in Gansu Province, China identified 886 lung cancer cases (656 male, 230 female) diagnosed between January 1994 and April 1998. A standardized interview collected information on a variety of potential risk factors including a history of physician-diagnosed non-malignant lung diseases (pulmonary tuberculosis, chronic bronchitis/emphysema, asthma, pneumonia), age and year in which each condition was first diagnosed, and any therapy or hospitalization received. RESULTS: Pulmonary tuberculosis (odds ratio [OR] = 2.1, 95% CI : 1.4-3.1) and chronic bronchitis/emphysema (OR = 1.4, 95% CI : 1.1-1.8) were associated with increased risk of lung cancer, after adjustment for active smoking and socioeconomic status. The OR for asthma (OR = 1.4, 95% CI : 0.9-2.1) and pneumonia (OR = 1.5, 95% CI : 1.0-2.3) were also elevated. The risk of lung cancer remained significant for pulmonary tuberculosis and chronic bronchitis/emphysema when analysis was limited to the pathologically confirmed cases and self-responders. CONCLUSIONS: This study provides additional evidence that previous pulmonary tuberculosis and chronic bronchitis/emphysema are causally related to lung cancer, although the precise mechanism is still unclear. The results for asthma and pneumonia, while suggestive of a positive association, did not reach the traditional level of statistical significance and should be interpreted with caution.     

Reevaluation of the confounding effect of cigarette smoking on the relationship between alcohol use and lung cancer risk, with larynx cancer used as a positive control

BACKGROUND: The effect of smoking on lung cancer risk has been well documented, while the effect of alcohol remains controversial. We examined the hypothesis that the apparent association between alcohol intake and lung cancer risk is fully due to the confounding effect of cigarette smoke. METHODS: Our sample of hospitalized patients included 2,953 male and 1,622 female lung cancer cases; 521 male and 159 female larynx cancers cases; and 8,169 male and 4,154 female controls, admitted to participating hospitals between 1981 and 1994. All controls had been diagnosed with non-smoking-related diseases. Larynx cancer was used as a positive control for lung cancer. Relative risks were estimated through odds ratios, adjusted through multiple logistic regression. RESULTS: Although the odds ratios for alcohol had been significantly elevated prior to adjustment for smoking (OR = 2.4, 95% CI = 2.0-2.8), alcohol had no effect on lung cancer following this adjustment (OR = 1.2, 95% CI = 1.0-1.4). By contrast, the effect of alcohol on larynx cancer remained high even after adjustment for smoking (OR = 5.6, 95% CI = 3.7-8.6). CONCLUSION: The often-reported association between alcohol and lung cancer risk can be fully explained by the confounding effect of cigarette use.     

鞍钢工人的肿瘤危险度——肺癌病例-对照研究

对鞍钢男工中６１０例肺癌新发病例及９５９例对照进行了访问调查。经吸烟、其他肺疾患、家族肿瘤史、食用水果等非职业因素调整后，岗位工龄等于或超过１５年的下列工人的肺癌危险度显著增高：冶炼工和轧钢工（ＱＲ＝１．５，９５％ＣＩ＝１．１～２．２），耐火砖厂工（ＯＲ＝２．９，９５％ＣＩ＝１．４～５．９），装卸工（ＯＲ＝２．５，９５％ＣＩ＝１．０～６．１），焦炉工（ＯＲ＝３．４，９５％ＣＩ＝１．４～８．５）。各种粉尘和Ｂ［ａ］Ｐ暴露与肺癌危险性呈显著的剂量－反应关系，但与粉尘的特殊成分未见此种关联。长期暴露于污染物的钢铁工人的肺癌的危险度增加４０％。