Family history is a major determinant of subclinical peripheral arterial disease in young adults.
Family history is a major determinant of subclinical peripheral arterial disease in young adults.
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家族史是年轻人亚临床外周动脉疾病的主要决定因素。
DOI：
10.1016/j.jvs.2003.07.011
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发表时间：
2004
影响因子：
4.3
通讯作者：
Cohen,Jonathan
中科院分区：
文献类型：
--
作者：
Valentine,RJames;Guerra,Rudy;Stephan,Phillip;Scoggins,Eva;Clagett,GPatrick;Cohen,Jonathan
心血管疾病在早发性外周动脉闭塞性疾病（早发性PAD）的年轻人的一级亲属中很普遍，但尚不清楚遗传影响是否与其他风险因素无关，其中最普遍的是吸烟。本研究旨在确定家族史和吸烟对早发PAD患者兄弟姐妹隐匿性PAD发生的相对贡献。方法对50例早发PAD患者（发病≤49岁）无症状兄弟姐妹（男25例，女25例）进行颈动脉、腹部和下肢多普勒超声扫描，确定隐匿性PAD的患病率。30名兄弟姐妹（60%）是活跃的吸烟者，20名从未吸烟。双功超声扫描显示20名无症状的兄弟姐妹（40%）、20名重度吸烟者（40%）和2名不吸烟的对照组（4%）的动脉病变升高，导致42名受影响者和108名未受影响者。正如预期的那样，吸烟者比不吸烟者更容易发生动脉病变（比值比[OR]，11.19; 95%可信区间[CI]，4.1-30.7; P < .0001）。有早发PAD家族史的个体发生动脉病变的可能性几乎是无心血管疾病家族史者的3倍（OR，2.76; 95%CI，1.3-5.8; P = .006）。分层和多变量Logistic回归分析表明吸烟和家族史之间没有相互作用，表明简单的添加剂对PAD. CONCLUSIONSSFamily历史是一个主要的决定因素，隐匿性PAD在年轻人，至少是标准的动脉粥样硬化危险因素一样重要。高比例的重度吸烟者即使无症状也有明显可检测的病变。吸烟和家族史可增加过早PAD的风险。
BACKGROUNDCardiovascular disease is prevalent in first-degree relatives of young adults with premature-onset peripheral arterial occlusive disease (premature PAD), but it is not known whether the genetic influence is independent of other risk factors, the most prevalent of which is smoking. This study was performed to determine the relative contributions of family history and smoking to the development of occult PAD in siblings of patients with premature PAD.METHODSThe prevalence of occult PAD was determined with carotid, abdominal, and lower extremity duplex ultrasound scanning in 50 asymptomatic siblings (25 men, 25 women) of patients with premature PAD (onset ≤49 years). Thirty of the siblings (60%) were active smokers, and 20 had never smoked. Age-matched and sex-matched reference groups included 50 asymptomatic heavy smokers (>20 cigarettes/day) and 50 nonsmokers.RESULTSDuplex ultrasound scans demonstrated raised arterial lesions in 20 asymptomatic siblings (40%), 20 heavy smokers (40%), and 2 nonsmoking control subjects (4%), resulting in 42 affected and 108 unaffected subjects. As expected, smokers were far more likely to have arterial lesions than were nonsmokers (odds ratio [OR], 11.19; 95% confidence interval [CI], 4.1-30.7; P < .0001). Individuals with a family history of premature PAD were almost three times more likely to have arterial lesions than those with no family history of cardiovascular disease (OR, 2.76; 95% CI, 1.3-5.8; P = .006). Stratified and multivariable logistic regression indicated no interaction between smoking and family history, indicating simple additive effects on PAD.CONCLUSIONSFamily history is a major determinant of occult PAD in young adults, and is at least as important as standard atherosclerotic risk factors. A high proportion of heavy smokers have clearly detectable lesions even though asymptomatic. Smoking and family history act additively to increase the risk for premature PAD.