A cohort study on risk factors for carotid atherosclerosis and prediction of cardiovascular risk

我们进行了横断面和前瞻性巢式病例对照研究，以调查颈动脉粥样硬化的危险因素以及颈动脉粥样硬化对心血管疾病风险的预测价值。研究对象为秋田农村地区60-74岁男性234人，茨城农村地区60-74岁男性506人，高知县农村地区60-74岁男性302人，大阪郊区60-74岁男性229人，水田市40-74岁男性3998人，其中1761人在基线调查2 - 6年后再次接受调查。高血压、高胆固醇血症和吸烟是颈动脉粥样硬化的重要危险因素，当考虑到过去调查的值时，这些关联更加明显。炎症因子（即血清高敏c反应）和黏附分子（即血清E选择素）与颈动脉粥样硬化显著相关。血管紧张素基因多态性与颈动脉粥样硬化无相关性。偶发性脑卒中患者颈动脉内膜-中膜厚度往往高于对照组。但病例数有限，未进行多因素分析。综上所述，颈动脉粥样硬化检查是一种很有前途的方法，可以评估动脉粥样硬化，并可能预测日本人中风的风险。

We have conducted cross-sectional and prospective nested-case control studies to investigate risk factors for carotid atherosclerosis and the predictive value of carotid atherosclerosis for the risk of caridiovascular disease. The subjects were 234 men aged 60-74 in Akita rural community, 506 men aged 60-74 in Ibaraki rural community, 302 men aged 60-74 in Kochi rural community, 229 men aged 60-74 in the suburb of Osaka, 3,998men and women aged 40-74 in Suita city of which 1,761 men and women were surveyed again after 2 to 6 years of the baseline survey.Strong risk factors for carotid atherosclerosis were hypertension, hypercholesterolemia and smoking and these association were more evident when the values in the past surveys were taken into account. Inflamatory makers, I.e., serum high-sensitive C-reactive and an adhesion molecle, I.e. serum E selectin were associated significantly with carotid atherosclerosis. Polymorphism of angiotensionogen gene were not associated with carotid atherosclerosis.Incident stroke cases tended to have higher intima-media thickness in carotid arteries than controls. However, the number of cases were limted and the multivariate analysis was not conducted. In conclusion, the examination of carotid atherosclerosis is a promising procedure to evaluate atherosclerosis and maybe to predict the risk of stroke among Japanese.