Pathological and Epidemiological Study of Coronary Atherosclerosis in Autopsy Subjects of Hisayama Town

目得：本研究的目的是调查男性和女性冠状动脉粥样硬化的危险因素，分别使用日本普通人群的尸检对象，并检查冠状动脉粥样硬化的病理评估的有效性。久山县40岁以上的居民中有233例，他们在1988年接受了集体体检，到1996年死亡时进行了尸检，进行了研究。将心外膜冠状动脉分为14段，并对每段最狭窄的部位进行组织学检查。对14例标本进行冠状动脉粥样硬化的整体评估，通过描述动脉粥样硬化病变和测量狭窄率，并分为6级。分析的危险因素包括年龄、收缩压和舒张压、血清总胆固醇、HDL-胆固醇、血红蛋白A1 C、吸烟和饮酒习惯、体重指数和腰臀比。结果：男性冠状动脉粥样硬化程度与年龄、收缩压、血清总胆固醇、血红蛋白A_1c相关，女性冠状动脉粥样硬化程度与年龄、收缩压、腰臀比相关。2)男性和女性的风险因素略有不同，特别是在代谢方面。

PURPOSE : The aims of this study were to investigate risk factors for coronary atherosclerosis in men and women, respectively, using autopsy subjects of Japanese general population, and to examine the validity of pathological assessments for coronary atherosclerosis.METHODS : Two hundred and thirty three cases in Hisayama residents over 40 years of age, who underwent a mass medical examination in 1988 and an autopsy at death by 1996, were subjected to the study. Epicardial coronary arteries were divided into 14 segments and the most narrowed site in each segment was sectioned for histological examinations. The coronary atherosclerosis was globally assessed by characterizing the atherosclerotic lesion and measuring the stenotic ratio in the 14 specimens, and graded into 6 grades. Risk factors analyzed were age, systolic and diastolic blood pressures, serum total cholesterol, HDL-cholesterol, hemoglobin A1C, smoking and drinking habits, body mass index and waist to hip ratio. Multiple regression analysis was used for statistical analysis.RESULTS : There were significant correlations between the grade of coronary atherosclerosis and age, systolic blood pressure, serum total cholesterol and hemoglobin A_1c in men, and age, systolic blood pressure and waist to hip ratio in women.CONCLUSIONS : 1) The global assessment based on pathological examination is useful to investigate risk factors for coronary atherosclerosis. 2) The risk factors are slightly different between men and women, especially in metabolic aspects.