与中国多省份队列研究相比,弗雷明汉CHD风险评估工具对中国人口的预测值
Jing Liu1, Yuling Hong, Ralph B D'Agostino
1Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. jingliu0516@yahoo.com.cn
JAMA
|June 3, 2004
概括
重新校准弗雷明汉冠状动脉心脏病 (CHD) 风险函数,提高了它们在中国人群中的准确性. 这种调整使得Framingham模型在全球预测心血管疾病风险方面变得更加有用.
科学领域:
- 心脏病学 心脏病学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 弗雷明汉心脏研究提供了关键的冠心病 (CHD) 风险评估工具.
- 然而,其同质的人口限制了对全球多样化人口的直接应用.
- 这些功能的重新校准可以使它们适应全球本地使用.
研究的目的:
- 为了评估原始和重新校准的弗拉明汉CHD风险函数在大量中国人口中的表现.
- 将它们的表现与来自中国多省队列研究 (CMCS) 的函数进行比较.
主要方法:
- 利用了来自CMCS (1992-2002) 的30121名中国成年人和来自弗雷明汉心脏研究 (1971-1984) 的5251名美国居民的数据.
- 风险因素 (年龄,血压,吸烟,糖尿病,胆固醇) 和"硬"心血管疾病事件 (冠状动脉死亡,心肌梗塞) 的比较.
- 评估的Framingham函数直接,经过重新校准,并与CMCS衍生函数对比.
主要成果:
- 大多数心脏病风险因素的相对风险在中国人和弗雷明汉人群之间是相似的,有显著的例外.
- 原始的弗雷明汉函数在CMCS队列中显著高估了绝对心脏病风险.
- 使用CMCS数据进行重新校准大大提高了Framingham函数预测的准确性.
结论:
- 原始的弗雷明汉CHD风险函数对于中国人口来说是不准确的,高估了风险.
- 再校准增强了中国个人对弗雷明汉模型的有用性.
- 再校准为在数据有限的地区开发本地化CHD风险预测工具提供了可行的策略.
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