摘要
目的 探讨男性中老年人吸烟状况与颈动脉粥样硬化的剂量-反应关系.方法 从〈广州生物库队列研究--心血管疾病亚队列〉中随机抽取959名≥50岁相对健康的男性中老年人的个人资料与病史、体格检查（包括检测空腹血糖、血脂和血压）及应用彩色多普勒超声测量颈总动脉中-内膜厚度（IMT）及斑块形成.结果 （1）不吸烟者占39.1%、已戒烟者为25.7%和现在吸烟者为35.2%.受检者的平均颈动脉中-内膜厚度为0.78（95%CI：0.77～0.79）mm.其中18.4%受检者单侧或双侧颈动脉中-内膜厚度≥1.0 mm,34.1%的受检者检出颈动脉斑块.（2）在调整年龄、教育、体力活动、体重指数、空腹血糖、甘油三酯、高密度脂蛋白胆固醇、SBP和DBP等混杂因素后,现在吸烟者较从不吸烟者,颈动脉内膜增厚和斑块形成的危险明显增加（OR=1.82,95%CI：1.30～2.55和OR=1.95,95%CI：1.38～2.75,P值均＜0.001）;颈动脉IMT和斑块形成的危险随每日吸烟量（支/日）、吸烟时间（年）和吸烟总量（包·年）的增加而明显增加（趋势检验P值均≤0.01）.结论 广州市中老年男性人群中吸烟显著增加颈动脉粥样硬化的危险,且存在明显的剂量-反应关系.
Objective To examine the dose-response relationship of smoking status with carotid atherosclerosis in 959 relatively healthy Chinese men. Methods 959 older Chinese men were selected from Guangzhou Biobank Cohort Study （GBCS） on cardiovascular disease. Personal histories were collected and fasting plasma glucose and lipids, blood pressure, and common carotid artery intima-median thickness （CCA-IMT） were measured. Results （ 1 ） Composition of the cases：39.1% were non-smokers, 25.7% were former smokers and 35.2% were current smokers. The mean （95% confidence interval） carotid IMT was 0.78 （0.77-0.79） mm. 18.4% of the subjects had carotid IMT equal to or thicker than 1.0 mm while 34.1% had carotid plaque. （2）After adjusting for age, sex,physical activity, body mass index, fasting glucose, triglyceride, high-density lipoprotein cholesterol,systolic and diastolic blood pressure, compared to never smokers, current smokers had significantly increased risk for thicker IMT and carotid plaque [odds ratio （OR） = 1.82, 95% GI： 1.30-2.55 and OR=1.95, 95%CI： 1.38-2.75, respectively, all P＜0.001]. The risk for thicker IMT and carotid plaque increased with the increasing amount （cigarettes/day） and duration of smoking （years） as well with cigarette pack-years （P for trend all ≤0.01 ）. Conclusion An elevated risk with a clear doseresponse relationship was found between cigarette smoking and carotid atherosclerosis. Quitting smoking or reducing the amount of smoking may lower the risk of atherosclerosis, preventing and controlling the occurrence of cardiovascular diseases, and reducing the related cardiovascular mortalities.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2010年第9期983-987,共5页
Chinese Journal of Epidemiology
基金
国家自然科学基金（30518001/CO301070202）
香港研究资助局课题（N-HKU720/05）
