民族と外周動脈疾患:サンディエゴの人口調査
Michael H Criqui1, Veronica Vargas, Julie O Denenberg
1Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California, USA. mcriqui@ucsd.edu
Circulation
|October 26, 2005
まとめ
黒人の民族は,他の健康状態を考慮した後でも,周辺動脈疾患 (PAD) の独立したリスク因子です. 黒人におけるより高いPADの発生率は未だに解明されていないため,さらなる調査が必要である.
科学分野:
- 心血管疾患の疫学について
- 血管の健康の格差
背景:
- 以前の研究では,非ヒスパニックの白人 (NHWs) に比べて黒人集団の周辺動脈疾患 (PAD) の割合が高かったことが示唆されています.
- ヒスパニック系およびアジア系の人口におけるPADの流行に関するデータは限られている.
- 黒人におけるPADリスクの増加の根本的な理由は十分に理解されていません.
研究 の 目的:
- 4つの主要な民族集団における民族特有のPADの罹患率を決定する.
- 他の危険因子から独立して,黒人民族とPADリスクの関連性を調査する.
主な方法:
- 人口ベースの研究では,NHW,黒人,ヒスパニック系,アジア系4つの民族から29~91歳の2343人の参加者を評価した.
- PADの罹患率と関連するリスク要因を分析するために,加重ロジスティック回帰モデルが使用されました.
- 分析には,人口統計的要因,糖尿病,高血圧,ボディマス指数が含まれていた.
主要な成果:
- PADの総罹患率は4.4% (104例) でした.
- 黒人個人は,人口統計的要因にかかわらず,NHWと比較してPADの有意に高い罹患率 (OR=2.30) を示しました.
- ヒスパニック系およびアジア系におけるPADの発生率は,NHWsと有意に異なるものではありませんでした.
- 糖尿病,高血圧,ボディマス指数の高い割合が黒人個人に観察されましたが,これらはPADリスクの増加を説明しませんでした.
- 黒人人種と他の危険因子との間に有意な相互作用は見つかりませんでしたが,感受性の増加は示唆されていません.
結論:
- 黒人人種は,PADの有意で独立したリスク因子です.
- 黒人におけるPADリスクの増加は,より高いレベルの糖尿病,高血圧,またはボディマス指数に起因するものではありません.
- 黒人集団におけるPADの原因不明の過剰リスクは,根本的な原因を特定するためのさらなる研究を正当化しています.
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