Intrinsic contribution of gender and ethnicity to normal anlde-brachial index values: The Multi-Ethnic Study of Atherosclerosis (MESA)
Intrinsic contribution of gender and ethnicity to normal anlde-brachial index values: The Multi-Ethnic Study of Atherosclerosis (MESA)
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DOI：
10.1016/j.jvs.2006.10.032
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发表时间：
2007-02-01
影响因子：
4.3
通讯作者：
Manolio, Teri A.
中科院分区：
文献类型：
--
作者：
Aboyans, Victor;Criqui, Michael H.;Manolio, Teri A.
目的：几项研究报告了女性和黑人外周动脉疾病（PAD）的较高患病率。这些研究基于踝臂指数（ABI）< 0.90的PAD定义。我们假设，有一个固有的贡献，性别和种族正常的ABI值，独立的生物和社会差异，性别和种族群体之间存在。因此，ABI阈值，无视这些基本的性别相关和种族相关的差异，可能会部分导致报告的患病率differences.Methods：一个横断面研究的一部分，多种族研究动脉粥样硬化（梅萨），多中心的美国人口研究。我们选择了一个ABI明确正常（1.00至1.30）的参与者亚组，并排除了任何主要PAD风险因素（吸烟，糖尿病，血脂异常，高血压）的参与者。在一个线性模型与ABI为因变量，人口，临床，生物学和社会变量被引入为independent factors.Results：在1775名健康参与者，有ABI水平和亚临床心血管疾病（冠状动脉钙化或颈动脉斑块）之间没有关联。男性性别、体重和高教育水平与ABI呈正相关，而黑人、甘油三酯、包年（过去吸烟者）和脉压呈负相关。在充分调整的模型中，女性的ABI值比男性低约0.02，黑人的ABI值比非西班牙裔white.Conclusion：这些数据表明内在的种族和性别差异ABI。这种差异虽然幅度不大，但非常显著，可能扭曲人口对疾病负担的估计。
Objective: Several studies report a higher prevalence of peripheral arterial disease (PAD) in women and among blacks. These studies based their PAD definition on an ankle-brachial index (ABI) < 0.90. We hypothesized that there is an inherent contribution of gender and ethnicity to normal ABI values, independent of biologic and social disparities that exist between gender and ethnic groups. Consequently, an ABI threshold that disregards these fundamental gender-related and ethnicity-related differences could partly contribute to reported prevalence differences.Methods: A cross-sectional study was designed as part of the Multi-Ethnic Study of Atherosclerosis (MESA), a multicenter United States population study. We selected a subgroup of participants with unequivocally normal ABIs (1.00 to 1.30), and additionally excluded participants with any major PAD risk factor (smoking, diabetes, dyslipidemia, hypertension). In a linear model with ABI as the dependent variable, demographic, clinical, biologic, and social variables were introduced as independent factors.Results: Among 1775 healthy participants, there was no association between ABI level and subclinical cardiovascular disease (coronary calcium or carotid plaque). Male gender, weight, and high education level were positively correlated with ABI, whereas black race, triglycerides, pack-years (in past smokers), and pulse pressure were negatively correlated. In the fully adjusted model, women had about 0.02 lower ABI values than men, and blacks showed ABI values about 0.02 lower than non-Hispanic whites.Conclusion: These data suggest intrinsic ethnic and gender differences in ABI. Such differences, although small in magnitude, are highly significant and can distort population estimates of disease burden.