Less subclinical atherosclerosis in Japanese men in Japan than in white men in the United States in the post-World War II birth cohort
Less subclinical atherosclerosis in Japanese men in Japan than in white men in the United States in the post-World War II birth cohort
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DOI：
10.1093/aje/kwk053
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发表时间：
2007-03-15
影响因子：
5
通讯作者：
Kuller, Lewis H.
中科院分区：
文献类型：
--
作者：
Sekikawa, Akira;Ueshima, Hirotsugu;Kuller, Lewis H.
日本的冠心病发病率和死亡率仍然很低，尽管重大的饮食变化和风险因素的增加本应导致冠心病发病率大幅增加（日本悖论）。考虑到移居美国的日本人患冠心病的人数大幅增加，主要的遗传影响不太可能。对于40-49岁的男性来说，日本和美国的总胆固醇和血压水平在他们的一生中是相似的。作者检验了一种假设，即40-49岁的日本和美国男性的亚临床动脉粥样硬化、冠状动脉钙化和颈动脉内膜-中膜厚度水平相似。2002-2005年，他们对493名随机选择的男性进行了一项基于人群的研究：250名来自日本滋贺草津市，243名来自宾夕法尼亚州阿勒格尼县的白人男性。与白人相比，日本人在许多风险因素上都不太受欢迎。与白人相比，冠状动脉钙评分为>= 10的日本人的患病率为0.52（95%可信区间：0.35,0.76）。日本人的平均内膜-中膜厚度显著低于日本人(0.616 mm（标准误差，0.005）和日本人（0.672 mm（标准误差，0.005），p < 0.01）。在调整了危险因素后，这两种关联仍然显著。这些发现值得进一步调查。
Coronary heart disease incidence and mortality remain very low in Japan despite major dietary changes and increases in risk factors that should have resulted in a substantial increase in coronary heart disease rates (Japanese paradox). Primary genetic effects are unlikely, given the substantial increase in coronary heart disease in Japanese migrating to the United States. For men aged 40-49 years, levels of total cholesterol and blood pressure have been similar in Japan and the United States throughout their lifetimes. The authors tested the hypothesis that levels of subclinical atherosclerosis, coronary artery calcification, and intima-media thickness of the carotid artery in men aged 40-49 years are similar in Japan and the United States. They conducted a population-based study of 493 randomly selected men: 250 in Kusatsu City, Shiga, Japan, and 243 White men in Allegheny County, Pennsylvania, in 2002-2005. Compared with the Whites, the Japanese had a less favorable profile regarding many risk factors. The prevalence ratio for the presence of a coronary calcium score of >= 10 for the Japanese compared with the Whites was 0.52 (95% confidence interval: 0.35, 0.76). Mean intima-media thickness was significantly lower in the Japanese (0.616 mm (standard error, 0.005) vs. 0.672 (standard error, 0.005) mm, p < 0.01). Both associations remained significant after adjusting for risk factors. The findings warrant further investigations.