Food intake patterns and 25-year mortality from coronary heart disease: Cross-cultural correlations in the Seven Countries Study

In the Seven Countries Study, associations between the intake of food-groups and 25-year mortality from coronary heart disease (CHD, defined as sudden coronary death or fatal myocardial infarction) were investigated. Baseline surveys were carried out between 1958 and 1964. A number of individual characteristics were measured in 12,763 middle-aged men belonging to 16 cohorts in seven countries (USA, Finland, The Netherlands, Italy, former Yugoslavia, Greece and Japan). Dietary information was collected in sub-samples using the weighed record method. Vital status of all participants was verified at regular intervals during 25 years of follow-up and the underlying cause of death was adjudicated. Eighteen different food-groups and combinations were considered for comparison among cohorts. Large differences in food-group consumption were seen, with high consumption of dairy products in Northern Europe, meat in the USA, vegetables, legumes, fish, and wine in Southern Europe, and cereals, soy products, and fish in Japan. Population death rates from CHD showed large differences, ranging from 268 per 1000 in East Finland to 25 per 1000 in Crete, Greece. Animal food-groups were directly correlated, and vegetable food-groups (except potatoes) as well as fish and alcohol were inversely correlated with CHD mortality. Univariate analysis showed significant positive correlation coefficients for butter (R = 0.887), meat (R = 0.645), pastries (R = 0.752), and milk (R = 0.600) consumption, and significant negative correlation coefficients for legumes (R = –0.822), oils (R = –0.571), and alcohol (R = –0.609) consumption. Combined vegetable foods (excluding alcohol) were inversely correlated (R = –0.519), whereas combined animal foods (excluding fish) were directly correlated (R = 0.798) with CHD death rates. Multivariate stepwise analysis selected butter, lard+margarine and meat as significant predictors and produced an R² of 0.922. These findings were confirmed by factor analysis. These cross-cultural analyses are consistent with the hypothesis that dietary patterns are important determinants of differences in population CHD death rates, and confirm the opposite effects on apparent risk of animal and vegetable foods.     

Change in Type A behaviour among medical students: a 4-year longitudinal study

Medical students were administered a measure of Type A behaviour at first-year orientation (n = 178), and about 9 months into their first (n = 169), second (n = 122), third (n = 73), and fourth (n = 86) years. Type A behaviour decreased over the course of the first year and from the start of the first year to the second year; however, no differences were found between the first (at 9 months) and second years. From the first (at 9 months) year and from the combined preclinical years to the third year, however, Type A behaviour increased. Type A behaviour peaked during the fourth year and was significantly higher than the level in the first year (at 9 months). Also, Type A behaviour was higher during the clinical years relative to the first year (at 9 months). The results were interpreted in the context of the developmental stresses experienced by students during each year. The relative ranking of the Type A scores was reasonably stable (test-retest) during an interval of 3 years 8 months.     

高血压和冠心病与2型糖尿病继发脑梗塞关系的研究

为探讨高血压和冠心病与2型糖尿病继发脑梗塞的关系,应用1:1配对病例对照研究方法,采用条件Logistic回归模型进行分析。结果表明,高血压可以增加2型糖尿病继发脑梗塞的危险性,冠心病史和房颤与2型糖尿病继发脑梗塞有关。提示高血压和冠心病及房颤是2型糖尿病继发脑梗塞的危险因素。应注意控制血压,积极治疗冠心病及房颤,以预防2型糖尿病继发脑梗塞发生。     

Determinants of nutrition knowledge in young and middle-aged Belgian women and the association with their dietary behaviour

The present study investigated the role of socio-demographic and lifestyle determinants on the nutrition knowledge of Belgian women and the association between their knowledge and dietary behaviour. A total of 803 women, aged 18–39 years, were included in a cross-sectional study and completed a general and nutrition knowledge questionnaire and a 2-day food record. Their height and weight were measured under standardised conditions. Linear regression models showed independent significant associations between the following determinants and the women's nutrition knowledge (in order of importance): educational level, age, kind of occupation, smoking behaviour, and work status. Inconsistent or no associations were found for body mass index, physical activity, living situation, and whether or not they had children. The investigated determinants accounted for 13–14.5% of variance in total nutrition knowledge. A rise in nutrition knowledge was associated with a significant rise in consumption of vegetables and fruit, but no differences were seen for other dietary indicators. Most important determinants of the women's nutrition knowledge were educational level, age and their kind of occupation. Women who had better knowledge of nutrition also exhibited better dietary behaviour, thus underlying the importance of nutrition education for improving dietary behaviour.     

代谢综合征与心脑血管病关系的前瞻性研究

目的探讨我国人群中代谢综合征(MS)与心脑血管疾病发生的关系。方法于1983-1984年在北京市和广州市35～59岁的男女性城市和农村人群中进行心脑血管病危险因素基线调查,并对研究对象进行随访至2005年底,登记并核实心脑血管病事件(包括冠心病事件和脑卒中事件)的发生情况及各种原因的死亡。根据中华医学会糖尿病分会推荐的标准确定基线时研究对象是否罹患MS。结果共纳入研究对象9 434人,其中男性4 621人,女性4 813人,男女性MS患病率分别为4.2%和5.2%。在平均19年的随访期间,研究对象共发生心脑血管病事件786例(男性488例,女性298例)。在调整多种危险因素后,男女性MS者发生心脑血管病事件、冠心病事件、总脑卒中事件和缺血性脑卒中事件的风险明显高于非MS者(P值均<0.05),MS者发生出血性脑卒中的相对危险也高于非MS者(男性:RR=1.48,95%CI:0.71～3.09,女性:RR=2.54,95%CI:1.15～5.60),但在男性中差异未达到显著性水平(P=0.297)。结论 MS者发生心脑血管病的风险明显增加,但MS与出血性脑卒中的关系值得进一步研究。     

2型糖尿病合并冠心病患者调脂治疗达标情况分析

目的了解2型糖尿病（T2DM）合并冠心病（CHD）患者调脂治疗的达标情况。方法对6个月内接受过调脂治疗的161例合并CHD的T2DM患者进行血脂检测,并以2007年《中国2型糖尿病防治指南》为标准分析其达标情况。结果 LDL-C、HDL-C和TG水平分别为（2.71±0.67）、（1.15±0.43）和（2.06±0.87）mmol/L,经t检验,HDL-C水平达标（P〉0.05）,LDL-C和TG水平未达标（P均〈0.05）。LDL-C、HDL-C和TG的达标率分别为33.5%、65.2%和46.6%。结论 T2DM合并CHD患者调脂治疗达标率较低,需进一步提高患者对调脂治疗的依从性和医生应用调脂药物的水平。     

A型性格冠心病患者健康教育干预及随访研究

目的研究健康教育干预对于A型性格冠心病（CHD）患者生活质量和1年主要心脏不良事件（MACE）的影响。方法选择281例冠心病患者为研究对象;应用A型行为类型量表分为A型性格和B型性格。将162例A型性格CHD患者分为健康教育干预组和对照组,每组各81人。8周后评价健康教育对于患者身体功能、角色功能、情绪功能、社会功能及总体生活质量的影响,分析健康教育干预与A型性格CHD患者发生MACE的关系。结果281例CHD组中A型性格162人（57．7％）。健康教育干预8周后,干预组和对照组身体功能、角色功能、情绪功能、社会功能、总体生活质量评分差异均有统计学意义（P〈0．001）。随访1年,干预组和对照组分别有21例（25．9％）和28例（34．6％）发生MACE,差异无统计学意义（P〉0．05）。结论临床上要重视患者性格类型的评估和干预,从而真正做到对CHD患者的综合、全面的治疗。     

高校教师生活方式与健康状况的调查研究

目的了解不同生活方式对健康状况的影响，为教师保健提供依据。方法对2000名高校教师进行生活方式问卷调查及相关实验室检查。根据教师生活方式不同分组，对各组的健康状况进行对比分析。结果高脂饮食组与非高脂饮食组比较，吸烟、饮酒者与非吸烟、饮酒者比较，经常参加运动、注意劳逸结合者与不运动、长期精神紧张者比较，发生高血糖、高血压、血脂异常、脂肪肝、冠心病的危险增加，差异均有统计学意义（P〈0．01）。结论生活方式对于慢性代谢性和心脑血管疾病的发生、发展有着显著的影响。     

Investigating IGF-II and IGF2R serum markers as predictors of body weight loss following an 8-week acute weight loss intervention: PREVIEW sub-study

BackgroundWeight reduction is effective in preventing T2D however, weight reduction and maintenance is difficult to achieve on a population scale. Serum insulin-like growth factor II (IGF-II) and IGF-II receptor (IGF2R) have been associated with diabetic status and body weight in prior studies and, in addition, IGF-II has been indicated as predictive of future weight change. We measured these serum markers in participants with obesity/overweight and prediabetes from the New Zealand arm of the PREVIEW lifestyle intervention randomised trial before and after an 8-week low energy diet (LED).MethodsTotal IGF-II (n = 223) and soluble IGF2R (n = 151) were measured using commercial ELISA kits on fasted serum samples taken prior to an 8-week LED and also from participants completing the LED.ResultsIGF-II levels were not correlated with baseline body weight although mean levels did significantly decrease following the LED. Change in IGF-II serum level was correlated to fasting glucose change (p = 0.04) but not to weight change. Baseline serum IGF2R was correlated with BMI (p = 0.007) and was significantly higher in Māori compared to European Caucasian participants independent of body weight (p = 0.0016). Following LED, IGF2R change was positively associated with weight change (p = 0.02) when corrected for ethnicity. Pre-LED levels of these serum markers were not predictive of the magnitude of weight loss over the 8 weeks.ConclusionNeither marker was useful in predicting magnitude of short-term weight loss. IGF2R is positively associated with BMI and is higher in Māori compared to European Caucasian individuals.     

苏州市成年人睡眠状况与冠心病发病风险的前瞻性关联研究

目的 探讨苏州市成年人睡眠状况与冠心病发病的关联。方法 使用中国慢性病前瞻性研究苏州市吴中区项目点53 269例30~79岁调查对象的基线和随访信息,剔除基线调查时自报患有冠心病、脑卒中、癌症的研究对象后,最终纳入分析51 929例研究对象。采用Cox比例风险回归模型分析各睡眠因素（打鼾症状、失眠症状、每日睡眠时长、午睡情况）、健康睡眠评分（0~3分）与冠心病发病风险的关联。结果 研究对象中位随访时间为11.12年,随访期间共诊断冠心病1 304例。调整潜在混杂因素后,与没有相应睡眠症状者相比,有时打鼾（HR=1.20,95%CI：1.04~1.38）、经常打鼾（HR=1.17,95%CI：1.02~1.33）、有失眠障碍（HR=1.41,95%CI：1.12~1.78）、日间功能障碍（HR=1.56,95%CI：1.20~2.03）、常年午睡（HR=1.37,95%CI：1.19~1.59）均与冠心病发病风险增加相关。与健康睡眠评分为0~1分（睡眠最不健康）者相比,健康睡眠评分3分（睡眠最健康）者冠心病发病风险降低26%（HR=0.74,95%CI：0.63~0.87）。分层分析结果显示,健康睡眠评分3分与冠心病发病风险的关联在低体力活动水平亚组中更明显（交互作用P<0.05）。结论 打鼾、失眠障碍、日间功能障碍、常年午睡均与冠心病发病风险增加相关,遵循健康的睡眠模式也许可以降低成年人冠心病发病风险。     

同型半胱氨酸与冠心病合并2型糖尿病患者心功能的相关性分析

目的研究同型半胱氨酸(HCY)与冠心病合并糖尿病患者心功能的关系。方法选取92例冠心病合并2型糖尿病患者测定HCY、脑钠肽(BNP),行超声心动图测定左心室射血分数(LVEF),按照美国纽约心脏病学会(NYHA)心功能分级标准分为心力衰竭(HF)组(63例)和无HF组(29例)。HF组又分为3个亚组:HFⅡ级组、HFⅢ级组、HFⅣ级组。结果 HF组患者HCY(19.5±8.0)μmol/L,显著高于无HF组(12.6±4.1)μmol/L,差异具有统计学意义(P<0.01)。HF组患者随心功能NYHA分级的增加,HCY水平逐步增高。HCY水平与心功能分级之间呈正相关(r=0.49,P<0.01),在控制年龄、性别变量后,HCY水平与心功能分级仍呈正相关(r=0.46,P<0.01)。HCY水平与LVEF呈负相关(r=﹣0.30,P<0.05)。HCY水平与BNP水平呈正相关(r=0.39,P<0.01)。结论冠心病合并2型糖尿病患者随心功能恶化,HCY水平逐渐增高。     

The relationships between indicators of physical activity, indicators of sedentary behaviour and adiposity in French adults: the FLVS II study

Increasing habitual physical activity and decreasing sedentary behaviour have both been identified as targets for the prevention of unhealthy weight gain and obesity. To improve health monitoring in the context of nutrition-related disease prevention, there is a need to better define relevant indicators of sedentary behaviour. The aim of this study was to investigate the relationships between indicators of physical activity, indicators of sedentary behaviour and body fat in French adults. We analysed cross-sectional data from a community-based survey in northern France (213 men, age: 44±5 years; 192 women, age: 42±4 years; mean±SD). Physical activity and sedentary behaviour during the past year were assessed using the Modifiable Activity Questionnaire. Indicators of physical activity were leisure-time and occupational physical activity, indicators of sedentary behaviour during leisure were reading and “screen viewing” (including time spent watching television/video, playing video games, and using a computer). Body-fat percentage was assessed using bio-impedance analysis. In univariate analysis (Spearman rank correlations), reading and screen viewing were not significantly correlated; reading was positively associated with leisure-time physical activity in women and negatively associated with occupational physical activity in men. In multivariate analyses (stepforward regression models) stratified by gender and educational level, independent predictors of percent body fat included, in women, screen viewing (positive association), occupational physical activity (positive association) and leisure-time activity (negative association), but not reading; in men, only reading was associated with percent body fat, with a negative relationship in those with a high educational level. Relationships between indicators of sedentary lifestyle and body fat differ according to gender and type of sedentary pasttime. The data emphasise that sedentary lifestyle represents a complex set of behaviours and that various sedentary behviours may have distinct effects with regard to health outcomes. These results point out the need to assess selected indicators of sedentary behaviour when considering health monitoring in public health nutrition.     

高校教师生活方式与健康状况的调查研究

目的了解不同生活方式对健康状况的影响,为教师保健提供依据。方法对2000名高校教师进行生活方式问卷调查及相关实验室检查。根据教师生活方式不同分组,对各组的健康状况进行对比分析。结果高脂饮食组与非高脂饮食组比较,吸烟、饮酒者与非吸烟、饮酒者比较,经常参加运动、注意劳逸结合者与不运动、长期精神紧张者比较,发生高血糖、高血压、血脂异常、脂肪肝、冠心病的危险增加,差异均有统计学意义(P<0.01)。结论生活方式对于慢性代谢性和心脑血管疾病的发生、发展有着显著的影响。     

Reliability and validity of the Norwegian translation of the Seattle Angina Questionnaire following myocardial infarction

The aim of this study was to validate the Norwegian version of the Seattle Angina Questionnaire (SAQ), a self-administered 19-item questionnaire designed to assess health-related quality of life in patients with chest pain or coronary artery disease. In 885 patients with prior myocardial infarction (MI), we abstracted clinical data from the patients medical records. Two to three years after the MI, we mailed a self-administered questionnaire including the SAQ, the Short Form 36 (SF-36), and questions about current medication, to the 548 patients still alive. The response rate was 74%. Internal consistency reliability of the SAQ, assessed with Cronbachs , ranged 0.75–0.92. Test–retest reliability, tested with an intraclass correlation coefficient, ranged 0.29–0.84. The pattern of association between similar and dissimilar scales of the SAQ and SF-36 mainly supported the construct validity of the SAQ. Four of the five SAQ scales discriminated between patients with different medication regimens as a proxy for severity of angina pectoris. We conclude that the Norwegian version of the SAQ showed acceptable reliability and cross-sectional validity following MI, with properties in line with the original US version.     

CETP TaqIB genotype modifies the association between alcohol and coronary heart disease: The INTERGENE case-control study

Alcohol consumption at moderate levels has been associated with decreased risk of coronary heart disease (CHD). However, the cardio-protective effect of alcohol may be restricted to subjects with a particular genotype of the cholesteryl ester transfer protein (CETP) polymorphism. There is evidence for this from one study in men, but the finding has not been confirmed since. The present study specifically re-examines the potential modification of the association between alcohol consumption and CHD by the CETP TaqIB (rs708272) polymorphism in a sample including both men and women. The INTERGENE case-control study consists of 618 patients with CHD and 2921 control subjects, of whom 19% were homozygous for the CETP TaqIB B2 allele. Alcohol consumption was categorized into sex-specific tertiles of ethanol intake, with non-drinkers constituting a separate category. Logistic regression was used to determine the association between CHD with genotype, ethanol intake, and their interaction. Participants with intermediate ethanol intake (2nd tertile) had lower risk of CHD than those with low ethanol intake (odds ratio [OR] = 0.65; 95% confidence interval [CI] 0.50–0.85). The strongest protective association was seen in the CETP TaqIB B2 homozygotes for intermediate vs. low ethanol intake (odds ratio OR = 0.21; 95% CI 0.10–0.44). The interaction between ethanol intake and genotype was statistically significant (p = 0.008), and of similar size in men and women though significant only in men (p = 0.01). The effect modification could not be explained by differences in lifestyle, socioeconomics, or alcohol-related biological variables such as HDL–cholesterol. Our study is the first to replicate previous findings of an effect modification in men. It gives only suggestive results for women, possibly due to the small number of female cases (n = 165). The prevented fraction for the favorable combination of genotype and alcohol consumption is about 6%, a value suggesting that the cardio-protective effect of moderate alcohol consumption applies only to a small segment of the general population.