北京市老年人Alzheimer病与痴呆家族史关系研究

目的探讨Alzheimer病(AD)和痴呆家族史的关系.方法采用以人群为基础的病例对照研究设计,通过分层分析和Logistic回归分析估计AD与其痴呆家族史之间的联系强度.结果一级亲属有痴呆病史者,患AD危险性显著高于对照人群(OR值为2.82,P<0.01).同时调整年龄和受教育程度后,一级亲属的痴呆家族史仍和AD的发生有显著联系(调整后的OR值为3.517,P<0.01).结论北京市老年人Alzheimer病存在家族聚集性.     

Nutritional Status Is Associated With Clinical Progression in Alzheimer's Disease: The NUDAD Project

ObjectiveIn cognitively normal adults, nutritional parameters are related to cognitive decline and incidence of dementia. Studies on the role of nutrition in predementia stages subjective cognitive decline and mild cognitive impairment, and mild stages of Alzheimer's disease (AD) dementia in a clinical setting are lacking. In the absence of a curative treatment, this evidence is important for targeting nutritional factors to potentially prevent or delay further cognitive decline. Our aim is to investigate associations of nutritional parameters with clinical progression in patients ranging from those who are cognitively normal to those who have AD dementia.DesignLongitudinal.Setting and ParticipantsMemory clinic, 551 patients (219 with subjective cognitive decline, 135 with mild cognitive impairment, and 197 with AD dementia), mean age 64 ± 8 years.MeasurementsWe assessed body mass index, fat-free mass, Mini-Nutritional Assessment, and dietary intake with the Dutch Healthy Diet food frequency questionnaire and the 238-item healthy life in an urban setting (HELIUS) food frequency questionnaire at baseline. Cox proportional hazard models were used to evaluate associations of nutritional parameters with clinical progression. Additional analyses were restricted to patients who were amyloid positive.ResultsWe observed clinical progression in 170 patients (31%) over 2.2 ± 0.9 years. Poorer Mini-Nutritional Assessment score [hazard ratio (95% confidence interval) 1.39 (1.18–1.64)], lower body mass index [1.15 (0.96–1.38)], lower fat-free mass [1.40 (0.93–2.10)], and a less healthy dietary pattern [1.22 (1.01–1.48)] were associated with a higher risk of clinical progression. Similar effect sizes were found in patients who were amyloid positive.Conclusions and ImplicationsPoorer nutritional status and a less healthy dietary pattern are associated with a higher risk of clinical progression. This study provides support for investigating whether improving nutritional status can alter the clinical trajectory of AD.     

Validity of family history for the diagnosis of dementia among siblings of patients with late-onset Alzheimer's disease

We examined 180 siblings of 127 probands with probable or possible Alzheimer's dementia (AD) in a family study of AD. The overall sensitivity of a simple family history questionnaire was 64% and the specificity was 84%. Sensitivity improved 90–100% with minimal decline in specificity when we considered clinic-based vs. Population survey patients. Higher education among informants and the availability of a spouse or a sibling as informant significantly increased sensitivity. Awareness of such factors may improve the yield of the family history in AD using a simple questionnaire. Genet. Epidemiol. 15:215–223, 1998. © 1998 Wiley-Liss, Inc.     

军队老年人阿尔茨海默病危险因素的病例对照研究

目的 探讨军队老年人阿尔茨海默病(AD)的危险因素,初步分析早年电磁暴露与AD的关系。方法 采用病例对照研究。选择解放军总医院近年来确诊的62例军队AD患者为病例组,在同一医院住院治疗的离退休老干部中按照年龄段分层抽样(按1:2比例)选取124例对照。调查方式为电话访谈。结果 单因素分析结果显示,病例组社会活动情况明显少于对照组,早年电磁暴露、体育锻炼情况、负性生活事件、慢性阻塞性肺病病史、既往癌症病史、痴呆家族史在两组间差异有显著性。在调整相关影响因素后,负性生活事件、痴呆家族史、社会活动量的OR值(95％CI)分别为3.27(1.53～6.97)、5.78(1.39～24.10)和0.81(0.72～0.92),早年电磁暴露的OR值(95％CI)为2.49(0.96～6.45),而既往癌症病史和吸烟似与AD呈负相关。结论 负性生活事件、痴呆家族史、社会活动减少是AD的独立危险因素,早年电磁暴露是其可能的危险因素;吸烟和既往癌症病史与AD呈负相关的原因可能与该老年人群的“生存偏性”有关。     

Apolipoprotein E-η4 allele and familial risk in Alzheimer's disease

Recent studies have found an association between presence of apolipoprotein E (APOE) η4 allele and Alzheimer's disease (AD). The present study compared the cumulative risk of primary progressive dementia (PPD) in relatives of AD probands carrying at least one copy of the η4 allele with the relatives of AD probands not carrying η4 and with relatives of non-demented controls. Our aim was to determine whether the familial aggregation of PPD in relatives of AD probands is primarily due to those carrying η4. Seventy-seven neuropathologically diagnosed AD patients were obtained as probands through our Alzheimer's Disease Research Center Brain Bank. AD probands were genotyped for APOE. As a comparison group, 198 non-demented probands were also included. Through family informants, demographic and diagnostic data were collected on 382 first-degree relatives (age ≥ 45 years) of AD probands and 848 relatives of the controls. We found that the cumulative risk of PPD in both relatives of AD probands with and without the η4 allele was significantly higher than that in the relatives of non-demented controls. However, the increased risk in the relatives of AD probands with the η4 allele was marginally, but not significantly, lower than the risk in the relatives of probands without η4. A greater likelihood of death by heart diseases over developing PPD in relatives of AD probands with η4 (3.1-fold increase) was found compared to relatives of probands without η4 (1.7-fold increase), especially prior to age 70, although the difference was not statistically significant. The increased familial risk for PPD in the relatives of AD probands with the APOE-η4 allele relative to controls suggests that familial factors in addition to APOE-η4 are risk factors for AD. Differential censorship from increased mortality of heart diseases may have prevented a higher incidence of PPD among the relatives of probands with η4. © 1996 Wiley-Liss, Inc.     

慢性阻塞性肺病与阿尔茨海默病的病例对照研究

目的探讨老年人阿尔茨海默病（AD）与慢性阻塞性肺病（COPD）的关系。方法采用病例对照研究。选择确诊的77例军队AD病人为病例组，在同一医院住院治疗的离退休老干部中按照年龄段分层抽样（按1：2比例）选取154例非痴呆对照。调查方式为电话访谈。结果单因素分析结果显示病例组社会活动情况明显少于对照组，体育锻炼情况、负性生活事件、既往COPD病史、既往癌症病史、痴呆家族史在两组间有显著性差异。在调整相关影响因素后，COPD病史致AD的OR值（95% CI）为2．122（1．007～4．472），负性生活事件、痴呆家族史、社会活动量减少的OR值分别为2．975（1．371～6．457），4．284（1．047～19．392），1．002（1．001～1．004）。结论COPD病史可能是AD的一个独立危险因素。     

Area-Level Characteristics and Smoking in Women

OBJECTIVES: This study examined whether area-level characteristics are associated with individual smoking behavior among women. METHODS: Analyses included 648 women enrolled as control patients in the Carolina Breast Cancer Study (1993-1996). Smoking and covariate information was obtained from interviews. Area-level characteristics included census block-group education level, poverty, unemployment, car-home ownership, crowding, and, for 431 women, city-level crime rates. RESULTS: In multivariate logistic regression models, no area characteristics were clearly associated with a history of smoking. Among those who had ever smoked, continued smoking was associated with living in low-education areas (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 1.0, 2.9), high-unemployment areas (OR = 1.7, 95% CI = 1.0, 2.8), and high-crime areas (OR = 1.6, 95% CI = 0.8, 3.2). CONCLUSIONS: The present findings are consistent with a growing literature suggesting that area-level social and economic disadvantage influences individual smoking behavior.     

Differential Associations of 6 Adiposity Indices With Dementia in Older Adults: The MIND-China Study

ObjectivesThe cross-sectional association between late-life obesity and dementia is often explained by the obesity paradox. We assessed the potential differential associations of various adiposity indices with dementia and subtypes of dementia in rural Chinese older adults.DesignA population-based cross-sectional study.Setting and ParticipantsA total of 5277 participants (age ≥60 years; 57.23% female) who were living in rural communities and were examined in March–September 2018 for MIND-China.MethodsWe used weight, height, and waist circumference (WC) to calculate 6 adiposity indices: body mass index (BMI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI), A Body Shape Index (ABSI), body roundness index (BRI), and Conicity Index (ConI). Dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were clinically diagnosed following the international criteria. Data were analyzed with logistic regression models.ResultsOf the 5277 participants, 303 were diagnosed with dementia, including 193 with AD and 99 with VaD. The multivariable-adjusted odds ratio (95% CI) of dementia associated with the highest (vs lowest) quintile of adiposity index was 2.32 (1.40–3.85) for WWI, 1.56 (1.03–2.36) for ABSI, and 1.40 (0.92–2.11) for ConI. Similarly, higher levels of these 3 adiposity indices were significantly associated with an increased likelihood of AD, whereas a higher BMI was associated with a decreased likelihood of AD. None of the 6 examined adiposity indices was significantly associated with VaD when adjusting for multiple confounders.Conclusions and ImplicationsThe adiposity index WWI is linearly associated with the likelihood of dementia and AD. An increased WWI may be a clinical marker for the dementia syndrome and Alzheimer's dementia.     

Risk factors for smoking among school adolescents in Greece

Objective We conducted this study among school adolescents to identify factors, which influence schoolchildren to smoke. Methods We carried out a cross‐sectional study in a sample of 924 students of all classes (ages 12–18 years old) in 15 public high schools in a semi‐urban area in Crete, Greece, using a questionnaire. The questionnaire comprised of 46 questions covering children's lifestyle habits regarding daily activities and leisure time, frequency of risk‐taking behaviour, knowledge about the hazards and long‐term consequences of smoking. Results 23.9% of participants were experimental smokers and 18.6% were current smokers. 11.4% of the total population was daily smokers. There was a significant increase in the prevalence of experimental and current smokers with school grades, while peaks in last grades were observed. Boys started smoking earlier than girls, mean (standard error) age 13.4 (2.3) years vs. 14.1 (2.3) years, P = 0.01. Stepwise logistic regression analysis showed a positive relationship between current smoking and having brother or sister smoking [odds ratio (95% confidence interval) 2.7 (1.7–4.4) and 1.8 (1.1–3.3) respectively], having more than three friends who were smokers [2.6 (2–3.4)] and last school grade [1.4 (1.2–1.7)]. Students appeared to be informed about long‐term smoking hazards and had negative views on children who smoke especially in the lower grades. Conclusions Prevention programmes should be imposed early in elementary schools while cessation policies should target at all grades, in particular at critical grades depending on population‐specific characteristics.     

Psychosocial work factors and dementia

Aims: To evaluate the association between psychosocial workplace factors and dementia in a case-control study. Methods: Patients with dementia (aged 55–99 years) were recruited from 23 general practices in the city of Frankfurt-on-Main and surrounding area in 1998–2000. Of these, 108 were suffering from possible Alzheimer''s disease, 59 from possible vascular dementia, and 28 from secondary or unclassified dementia. A total of 229 control subjects (aged 60–94 years) was recruited from the same study region: 122 population controls and 107 dementia-free ambulatory patients. A detailed job history was elicited in a structured personal interview (next-of-kin interviews of cases). Psychosocial work exposure was assigned to cases and control subjects by linking lifetime job histories with a Finnish job-exposure matrix. Data were analysed using logistic regression, to control for age, region, sex, dementia in parents, education, smoking, and the psychosocial network at age 30. Results: There were decreased odds ratios for high challenge at work, high control possibilities at work, and high social demands at work. High risks for error at work revealed a significant positive association with the diagnosis of dementia. Restriction of the analysis to cases with possible Alzheimer''s disease or to cases with possible vascular dementia led to similar results. Conclusions: These results support a role for psychosocial work factors in the aetiology of dementia. As an alternative explanation, people might have chosen jobs with poor work factors due to preclinical dementia, which becomes clinically manifest decades later.     

Cigarette smoking and the risk of natural menopause

We reviewed published studies on the association of age at natural menopause and cigarette smoking. All demonstrated an earlier median or mean age of menopause among smokers; for current smokers vs noncurrent smokers the difference ranged from 0.8 to 1.7 years. For studies that presented suitable data, we computed prevalence odds ratios of menopause for current smokers vs never-smokers, current smokers vs noncurrent smokers, and former smokers vs never-smokers. The Mantel-Haenzel summary odds ratios and 95% confidence intervals for these contrasts were: 1.9 (1.7-2.2), 1.7 (1.5-1.9), and 1.3 (1.0-1.7). Studies that presented data on amount of cigarettes smoked per day demonstrated "dose-response" trends when analyzed using the Mantel-Haenszel extension. The consistency of results across studies, the persistence of the effect when age and other covariates were considered, and the dose-response relation all support the hypothesis that smoking increases the risk of early menopause.     

Risk factors in clinically diagnosed presenile dementia of the Alzheimer type: a case-control study in northern England.

STUDY OBJECTIVE--To investigate the relationship between presenile dementia of the Alzheimer type (PDAT) and family history, medical history, cigarette smoking, and exposure to aluminum. DESIGN--A case-control study in which 109 cases of clinically diagnosed PDAT and 109 controls matched for age and sex were compared for exposure to the risk factors. Odds ratios (ORs) were calculated using McNemar's test. SETTING--The northern health region of England. PATIENTS--Cases comprised those under 65 years diagnosed as having dementia by specialist services, who met clinical algorithm criteria for Alzheimer's disease (AD). Cases were confirmed at interview. MAIN RESULTS--Comparing cases with controls, (ORs) significantly greater than unity were obtained when there was a first degree relative with dementia (OR 2.5, 95% confidence interval 1.05, 6.56), any relative with dementia (OR 2.1, 95% CI 1.01, 4.55), and any relative aged less than 65 with dementia (OR 8.0, 95% CI 1.07, 348). Exposure to moderate levels of cigarette smoking (cumulative) was not significant; nor was exposure to aluminum in drinking water, diet, and medicinal sources. CONCLUSION--In this study of modest statistical power, a family history of dementia was confirmed as a risk factor in PDAT. No significant relationship between exposure to aluminium in water supplies, tea, and antacids was found. What is important, however, is the bioavailability of all dietary aluminium, determined by the concentrations of dissolved silicon in water: this requires further investigation.     

Risk factors for coronary heart disease in two similar Indian population groups, one residing in India, and the other in Sydney, Australia

OBJECTIVE: To identify the prevalence of coronary risk factors among South Asian Indians in Australia and India. DESIGN: Cross-sectional intercountry comparison. SUBJECTS: Healthy volunteers aged 23-75 y recruited from the Indian community in Sydney Australia (n=125), and their nominated relatives in India, (n=125). RESULTS: The two groups were of similar background with over 90% of the group in India being siblings, parents or relatives of the group in Australia. There was no difference in the populations between India and Australia with regard to mean age (40+/-11.5 vs 39+/-10.3 y), body mass index (BMI) (25+/-3.3 vs 25+/-3.5 kg/m(2)), lipoprotein (a) (178 vs 202 mg/l), total cholesterol (5.3+/-1.3 vs 5.3+/-1.2 mmol/l) or triglyceride (1.7+/-0.8 vs 1.7+/-0.8 mmol/l). The group in India had higher insulin (median values) (139 vs 83 pmol/l, P=0.0001), waist-to-hip ratio (WHR) (0.88+/-0.08 vs 0.85+/-0.09, P=0.01), exercise time (23.7+/-32.7 vs 17.2+/-23.2 h/week, P=0.07), lower waist (83+/-10.0 vs 85+/-11.1 cm, P=0.05) and high-density lipoprotein (0.9+/-0.3 vs 1.1+/-0.6 mmol/l, P=0.02). Women in India had lower BMI (22.7+/-2.9 vs 25.3+/-4.2 kg/m(2), P<0.001), higher insulin (182 vs 90 pmol/l, P<0.001), WHR (0.86+/-0.08 vs 0.77+/-0.06, P<0.001)) and prevalence of abdominal obesity (% WHR >0.8, 73 vs 23%, P<0.001; odds of waist >90 cm=2.3, P<0.05). Men in India had the same BMI, lower waist (85.5+/-8.8 vs 92.9+/-7.2 cm, P<0.001) and WHR (0.89+/-0.09 vs 0.93+/-0.05, P<0.01) but higher insulin (137 vs 76 pmol/l). CONCLUSION: The group in Australia (especially women) have a more favourable disease risk profile than those in India. The fact that the groups are of such similar background and partly related, make it unlikely that changes due to migration have a strong genetic bias. In contrast to other studies, the absence here of excessive weight gain on migration may be a key factor in disease risk prevention.     

50岁以下女性冠心病的临床和冠状动脉造影特点

目的 探讨50岁以下女性冠心病患者的危险因素、临床和冠状动脉造影特点.方法 连续入选2000年4月至2008年6月行冠状动脉造影的50岁以下女性患者126例,回顾性分析女性冠心病患者的危险因素、临床及冠状动脉病变特点.结果 同期行冠状动脉造影6395例,50岁以下女性患者126例,占1.97%,其中冠心病患者44例(冠心病组),平均年龄(46.8 ±3.6)岁;非冠心病患者82例(非冠心病组),平均年龄(45.4±4.3)岁.两组合并原发性高血压[77.3%(34/44)比26.8%(22/82)]、糖尿病[34.1%(15/44)比4.9%(4/82)]、高脂血症[43.2%(19/44)比7.3%(6/82)]、冠心病家族史[43.2%(19144)比7.3%(6,82)]及冠心病危险因素家族史[52.3%(23/44)比12.2%(10/82)]比较差异有统计学意义(P<0.01).冠心病患者以急性冠脉综合征为主[占88.6%(39/44)],冠状动脉病变以单支病变多见[占50.0%(22/44)],左前降支是最易累及的血管,病变钙化程度较轻,病变类型以局限性和节段性为主.结论 原发性高血压、高脂血症、糖尿病、冠心病家族史及冠心病危险因素家族史为50岁以下女性冠心病的重要危险因素.有典型心绞痛症状伴有多重危险因素者,患冠心病的可能性增大.     

Antecedentes familiares de primer grado como factor de riesgo en el cáncer colorrectal

ObjectiveTo evaluate the association between first-degree family history and colorectal cancer (CRC).MethodWe analyzed data from 2857 controls and 1360 CRC cases, collected in the MCC-Spain project. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) of association with the family history of CRC was estimated by non-conditional logistic regression.ResultsFirst-degree relatives doubled the risk of CRC (OR: 2.19; 95% CI: 1.80–2.66), increasing in those with two or more (OR: 4.22; 95% CI: 2.29–7.78) and in those whose relatives were diagnosed before 50 years (OR: 3.24; 95% CI: 1.52–6.91). Regarding the association of the family history with the location, no significant differences were observed between colon and rectum, but there were in the relation of these with the age of diagnosis, having more relatives those diagnosed before 50 years (OR: 4.79; 95% CI: 2.65–8.65).ConclusionsFirst-degree relatives of CRC increase the chances of developing this tumor, they also increase when the relative is diagnosed at an early age. Therefore, it must be a target population on which to carry out prevention measures.     

Do Patients Retain their Family Physicians after Long-Term Care Entry? A Retrospective Cohort Study

ObjectiveOlder adults value and benefit from the long-standing relationship they have with their family physicians. This dynamic has not been researched in a long-term care (LTC, ie, nursing home) setting. We sought to determine the proportion of LTC residents who retain their community family physician within the first 180 days of LTC, and the resident, physician, and LTC home factors that may influence retention.DesignPopulation-based retrospective cohort study.Setting and ParticipantsIndividuals from Ontario, Canada, aged 60 years or older who were newly admitted to a LTC home between April 1, 2014 and March 31, 2017.MethodsResidents were indexed upon LTC admission, and their data was linked across ICES databases. Residents were matched to their rostered family physician, and physician retention was defined as having at least 1 visit by their matched physician within 0 to 90 days and 90 to 180 days of LTC admission.ResultsOut of 50,089 LTC residents, 12.1% retained their family physicians post-LTC admission. Resident factors associated with reduced odds of retention included physical impairment [odds ratio OR (95% confidence interval, CI) = 0.59 (0.42‒0.83)], cognitive impairment [0.39 (0.33‒0.47)], and a dementia diagnosis [0.80 (0.74‒0.86)]. Physician factors associated with lower retention included a greater distance from the LTC home to the family physician's clinic [30+ kilometers 0.41 (0.35‒0.48)], having a physician who is female [0.90 (0.83‒0.98)], an international medical graduate [0.89 (0.81‒0.97)] or someone who practices in a capitation-based Family Health Organization [0.86 (0.78‒0.95)]. Factors associated with greater odds of retention were residing in a rural LTC home [2.23 (1.78‒2.79)], having a rural family physician [1.70 (1.52‒1.90)], or a family physician who has billed LTC fee codes in the past year [2.64 (2.45‒2.85)].Conclusions and ImplicationsFew LTC residents retained their family physician post-LTC admission, underscoring this healthcare transition as a breakdown point in relational continuity. Factors that influenced retention included resident health, LTC home geography, and family physician demographics and practice patterns.     

Association of incident lung cancer with family history of female reproductive cancers: the Iowa Women's Health Study

A number of studies have documented the familial aggregation of lung cancer; there is at least one report that female reproductive cancers are also increased in these families. To determine if the risk exists for all reproductive cancer sites, we conducted a nested case-control study of lung cancer incidence in a cohort of 41,837 women ages 55-69 years. Women were recruited by mail and asked to provide information on education, occupation, smoking habits, physical activity, and family history of specific cancer sites among female relatives. Four year follow-up for cancer incidence was conducted using a state-wide tumor registry. Compared to random controls (n = 1900), cases (n = 152) were more likely to have reported at baseline a sister affected with cancer of the uterus [crude odds ratio (OR) = 3.4, 95% Cl = 1.7-7.0, P less than 0.01], cervix (OR = 3.2, 95% Cl 1.2-8.6, P less than 0.05), or cancer at any site (OR = 1.6, 95% Cl 1.1-2.4, P less than 0.05). A family history of an affected mother with a female reproductive cancer was also more common among the cases, but not statistically significant. Cases were less educated, more likely to work in a technical/industrial setting, less physically active, more likely to smoke, and to smoke for a longer period of time than the controls (all P less than 0.01). These differences reduced the magnitude of the family history risk indicators; only the combined category of reproductive cancer at all sites among sisters remained statistically significant. Additional family studies should be done to assess environmental factors in the relatives of the cases and controls to disentangle the influence of shared genes and shared environmental factors in these associations.     

Cigarette smoking and breast cancer: case-control studies of prevalent and incident cancer in the Canadian National Breast Screening Study

Two case-control studies of Canadian women aged 40-59 years are reported investigating the relation of cigarette smoking with initial visit (prevalent) and subsequent visit (incident) breast cancer detection, respectively, within the Canadian National Breast Screening Study. The analysis of prevalent breast cancer (1982-1985), which involved 254 cases and 762 controls, showed no evidence of an elevated risk for women with a history of cigarette smoking, with odds ratios of 0.9 (95% confidence interval (Cl) 0.6-1.5) and 1.2 (95% Cl 0.8-1.8) in premenopausal and postmenopausal subjects, respectively. Similarly, in the incident breast cancer analysis (1981-1987) based on 317 cases and 951 controls, women with a history of cigarette smoking had odds ratios of 1.2 (95% Cl 0.8-2.0) and 1.2 (95% Cl 0.9-1.7) in the premenopausal and postmenopausal categories, respectively. No evidence of dose response or of elevated risk in ex-smokers or current smokers was found in either study. These results persisted despite adjustment for several important variables. The present data demonstrate no association between smoking and prevalent or incident breast cancer in either menopausal category, contradicting the authors' previous finding of a positive association with premenopausal prevalent disease earlier in this screening study. The relation of smoking and breast cancer remains controversial. Further study is required to determine whether an association truly does not exist or whether smoking might have both protective and harmful effects that are mediated through different pathways, thus accounting for the paradoxical findings in the literature to date.     

Maternal and paternal family history of type 2 diabetes differently influence lipid parameters in young nondiabetic Japanese women

Objectives

We assessed the association of family history of type 2 diabetes (T2D) with parameters used for health checkups in young Japanese women.

Methods

The subjects were 497 nondiabetic women aged 19–39 years. Among them, the mothers of 34 subjects and fathers of 50 had T2D (MD group and PD group, respectively). The subjects were assessed for levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG).

Results

TC and LDL-C level showed a tendency to increase in the MD group compared with subjects without family history of T2D. LDL-C/HDL-C ratio ≥2.14 was found in 32.4 and 18.0 % of subjects in the MD and PD groups, respectively. When adjusted for differences in age, body mass index, smoking status, and drinking habits, the MD group was found to have a higher risk of abnormal TC and LDL-C levels than the PD group. LDL-C/HDL-C ratio was independently associated with maternal family history but not with paternal family history (odds ratio 3.44 [99 % confidence interval 1.11–10.6] and 1.21 [0.38–3.89], respectively). There was no association between TG/HDL-C ratio and family history type of T2D.

Conclusions

Maternal family history of T2D had a more pronounced effect on the lipid parameters generally evaluated during health checkups than did paternal family history of T2D. Therefore, we recommend systematic screening for early detection and appropriate healthcare guidance for Japanese women, particularly those with maternal family history of T2D.     

阿尔茨海默病与家族史病例对照研究

目的：探讨家族史和阿尔茨海默病（AD）的关系。方法：采用以人群为基础的病例对照研究设计，病例组为127例临床诊断为AD的病例，并以1；2配对，以年龄、性别、受教育 程度为匹配条件的254名非痴可者作为对照，通过单因素分析和条件logistc回归分析，估计AD与家族史之间的联系强度。结果：一级亲属有痴呆病史或重性精神病史者，患AD危险性显著高于对照人群（OR值分别为6．25和8．33，P＜0．01）。调整混杂因子的影响后，一级亲属的痴呆家族史和AD的发生仍有显著联系（调整后OR＝2．07，P＝0．018）。结论：AD可能存在家族史聚集性。