Twenty-four year mortality in World War II US male veteran twins discordant for cigarette smoking
Twenty-four year mortality in World War II US male veteran twins discordant for cigarette smoking
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DOI：
10.1093/ije/25.3.554
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发表时间：
1996-06-01
影响因子：
7.7
通讯作者：
Page, WF
中科院分区：
文献类型：
--
作者：
Carmelli, D;Page, WF
背景资料。本研究旨在检验体质假说，该假说将吸烟与发病率和死亡率的关联归因于吸烟和/或疾病的遗传易感性。受试者是1917年至1927年出生于美国的二战退伍军人，他们在平均年龄47岁时接受了现在和过去的吸烟习惯调查，获得了1515对不适合终身吸烟的双胞胎男性的24年死亡率随访数据。使用吸烟-不和谐配对的第一个或唯一一个死亡，通过合子、死因、吸烟量和死亡年龄计算24年的相对死亡风险。我们发现，与从未吸烟或戒烟的同卵双胞胎相比，基线时经常吸烟的吸烟者的死亡风险更高(同卵对：相对风险[RR]=2.5；95%可信区间[CI]：1.3-6.1和RR=1.7；95%可信区间：1.2-2.5；异卵对：RR=2.4；95%可信区间：1.4-3.8和RR=2.0；95%可信区间：1.3%CI：1.73.3)。吸烟者死亡风险增加的原因是肺癌(单合子对：RR=5.0；95%CI：2.6-15.0；双合子对：RR=11.0；95%CI：4.3-45.0)或心血管疾病死亡(单合子对：RR=3.9；95%CI：1.9-11.5；双合子对：RR=2.8；95%CI：1.7-4.9)。除了这些发现外，吸烟与全因死亡率的关系在早期/年轻死亡和重度至中度吸烟的患者中更强。目前的研究结果来自规模最大、研究时间最长的吸烟不和谐双胞胎系列，否定了体质假说，即吸烟和过早死亡之间存在显著关联的是遗传或早期共有的家族影响。
Background. This study was undertaken to test the constitutional hypothesis which attributes the association of tobacco smoking with morbidity and mortality to genetic predispositions to smoking and/or disease.Methods. Subjects were World War II veterans, born in the US between 1917 and 1927, and surveyed at mean age 47 for present and past smoking habits, Twenty-four year mortality follow-up data were available for 1515 male twin pairs discordant for lifelong cigarette smoking. Using the first or only death of a smoking-discordant pair, 24-year relative risks of mortality were calculated by zygosity, cause of death, amount smoked, and age at death.Results. We found that active smokers at baseline, regardless of zygosity, had a higher risk of death than their co-twins who had never smoked or quit smoking (monozygotic pairs: relative risk [RR] = 2.5; 95% confidence interval [CI] : 1.3-6.1 and RR = 1.7; 95% CI:1.2-2.5; dizygotic pairs: RR = 2.4; 95% CI : 1.4-3.8 and RR = 2.0; 95% CI : 1.73.3). The elevated risk of death among smokers was due to deaths from lung cancer (monozygotic pairs: RR = 5.0; 95% CI : 2.6-15.0; dizygotic pairs: RR = 11.0; 95% Cl : 4.3-45.0) or deaths from cardiovascular diseases (monozygotic pairs: RR = 3.9; 95% CI : 1.9-11.5; dizygotic pairs: RR = 2.8; 95% CI :1.7-4.9). Apart from these findings the relationship of smoking with all-cause mortality was stronger for earlier/younger deaths and for heavy to moderate smoking.Conclusions. The present results, from the largest and longest-studied series of smoking-discordant twins negate the constitutional hypothesis that genetic or early shared familial influences underlie the significant association between tobacco smoking and premature mortality.