Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA
Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA
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DOI：
10.1182/blood-2016-07-727719
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发表时间：
2017-02-09
期刊：
影响因子：
20.3
通讯作者：
Carnethon, Mercedes R.
中科院分区：
文献类型：
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作者：
Liem, Robert I.;Chan, Cheeling;Carnethon, Mercedes R.
尽管人们担心镰状细胞性状（SCT）与劳累性猝死有关，但镰状细胞性状（SCT）对心肺健康种族差异的影响尚不清楚。我们在年轻人冠状动脉风险发展 (CARDIA) 研究中评估了 1995 名非裔美国人（56% 为女性，18-30 岁）25 年来 SCT 状态与健康状况和高血压、糖尿病和代谢综合征风险的横断面和纵向变化之间的关系。总体而言，CARDIA 中 SCT 的患病率为 6.8% (136/1995)，在 25 年的时间里，所有参与者中分别有 46% (738/1590)、18% (288/1631) 和 40% (645/1,611) 患上高血压、糖尿病和代谢综合征。与未接受 SCT 的参与者相比，接受 SCT 的参与者具有相似的横截面健康基线测量值，包括运动持续时间（535 秒与 540 秒；P = .62）、任务的估计代谢当量（MET；11.6 与 11.7；P = .80）、最大心率（174 与 175 次/分钟；P = .41）以及 2 分钟恢复时的心率（44 与 43）节拍/分钟；P = .28)。在我们的二次分析中，在调整性别、基线年龄、体重指数、体能和体力活动后，SCT 状态与体能的纵向变化既不存在关联，也不与高血压、糖尿病或代谢综合征的发生相关。在这项针对年轻非裔美国成年人的纵向研究中，SCT 与健康状况下降无关，这表明 SCT 携带者因劳累而猝死的风险增加不太可能与健康状况有关。 SCT 状态也不是发生高血压、糖尿病或代谢综合征的独立危险因素。
The contribution of sickle cell trait (SCT) to racial disarities in cardiopulmonary fitness is not known, despite concerns that SCT is associated with exertion-related sudden death. We evaluated the association of SCT status with cross-sectional and longitudinal changes in fitness and risk for hypertension, diabetes, and metabolic syndrome over the course of 25 years among 1995 African Americans (56% women, 18-30 years old) in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Overall, the prevalence of SCT was 6.8% (136/1995) in CARDIA, and over the course of 25 years, 46% (738/1590), 18% (288/1631), and 40% (645/1,611) of all participants developed hypertension, diabetes, and metabolic syndrome, respectively. Compared with participants without SCT, participants with SCT had similar baseline measures of fitness in cross-section, including exercise duration (535 vs 540 seconds; P = .62), estimated metabolic equivalent of tasks (METs; 11.6 vs 11.7; P = .80), maximum heart rate (174 vs 175 beats/min; P = .41), and heart rate at 2 minutes recovery (44 vs 43 beats/min; P = .28). In our secondary analysis, there was neither an association of SCT status with longitudinal changes in fitness nor an association with development of hypertension, diabetes, or metabolic syndrome after adjustment for sex, baseline age, body mass index, fitness, and physical activity. SCT is not associated with reduced fitness in this longitudinal study of young African American adults, suggesting the increased risk for exertion-related sudden death in SCT carriers is unlikely related to fitness. SCT status also is not an independent risk factor for developing hypertension, diabetes, or metabolic syndrome.