心血管健康,遗传风险和心脏代谢疾病的变化:来自大型队列研究的证据
Shuaizhou Chen1,2, Jialin Li3,2, Qiuhong Man4
1Department of Epidemiology and Ministry of Education Key Laboratory of Public Health Safety, School of Public Health Fudan University Shanghai China.
Journal of the American Heart Association
|December 20, 2024
概括
改善心血管健康 (CVH) 显著降低心脏代谢疾病 (CMD) 风险,特别是在年轻人和具有高遗传倾向的人群中. 维持或增强CVH对于长期健康和疾病预防至关重要.
科学领域:
- 心血管健康和疾病预防
- 遗传学和心脏代谢风险
- 公共卫生和生活方式干预措施
背景情况:
- 优越的心血管健康 (CVH) 与对心脏代谢性疾病 (CMD) 的敏感性降低有关.
- 在一个人的一生中,CVH在动态上发生变化.
- CVH变化对CMD风险的影响,特别是关于遗传倾向的影响,尚未完全理解.
研究的目的:
- 评估基线CVH,随时间变化的CVH和发展CMDs的风险之间的关联.
- 调查这些关联在不同年龄组和遗传风险概况之间有何差异.
- 量化改善CVH在预防CMD方面的潜在好处.
主要方法:
- 对大规模社区队列的分析 (n=289,069为基线,n=37,702为变化).
- 利用Cox比例危险模型,重复评估生活方式和遗传数据.
- 按年龄 (≤65岁与>65岁) 和遗传风险三分之一 (多基因风险评分) 分层分析.
主要成果:
- 较高的基线CVH与较低的CMD风险相关. 从中等到理想的CVH的改善使CMD风险降低了36% (HR 0.64).
- 从中等到差的CVH恶化增加了44%的CMD风险 (HR 1.44).
- 在年轻人 (≤65岁) 中,CVH变化对CMD风险的影响更大. 改善CVH的高遗传风险个体在缺血性心脏病风险下降了50%.
结论:
- 增强的CVH显著降低了CMD风险,在年轻人群和具有高遗传风险的人群中观察到更大的好处.
- 促进心血管健康的干预措施对于人口层面的CMD预防至关重要.
- 研究结果支持针对性预防策略和医疗保健干预措施,以改善心血管健康.
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