Avoidable causes of adult chronic disease death

这一部分的总体目标是提供一个分析框架，以便在2000年全球疾病负担研究的范围内，评估关于主要人口接触造成的疾病和伤害负担的经验证据。为此，它将审查计算和解释可归因分数的概念问题，从而为比较风险因素暴露造成的疾病和伤害负担提供一个连贯的概念框架。相关的目标是增进对非传染性疾病风险因素的现有认识，特别是通过在一个中等收入发展中国家（墨西哥）进行大型前瞻性研究，增进对主要血液风险因素的认识。具体目标是：1.比较风险评估的概念框架：为比较和解释可归因于特定人群暴露的疾病和伤害负担提供一个明确一致的框架。2.已知风险因素的证据：提供可靠的证据，说明已知风险因素在大量中等收入成年人群中对慢性病的重要性和相互作用。3.识别新的风险因素：调查和量化其他血液相关因素作为过早死亡原因的重要性，包括遗传多态性，许多感染因子的抗体，激素和其他信号分子，龋齿凝血和炎症因子，微量营养素和蛋白质糖基化。实证工作将基于对居住在科约阿坎区的200 000名40岁及以上墨西哥成年人的调查，以及反复的积极道德随访。巢式病例对照研究将作为主要方法。这些目标将主要通过在现有的大型前瞻性研究中增加血液样本的收集和长期储存来实现，这些血液样本将在未来几年内发展出特定疾病的“病例”中回顾性分析某些脂质、抗氧化剂、其他生化物质、抗体和白细胞DNA中的遗传多态性，和单独匹配的“对照组”，他们当时仍然活着，没有这种疾病。

The overall aim of this component is to provide an analytic framework for the assessment of empirical evidence on the burden of disease and injury attributable to major population exposures in the context of global Burden of Disease 2000 Study. It will do so by reviewing the conceptual issues in the calculation and interpretation of attributable fractions thereby providing a coherent conceptual framework for comparing disease and injury burden due to risk factor exposures. Related goals are to advance existing knowledge about risk factors for non-communicable disease, especially to advance knowledge about major blood-based risk factors through a large prospective study in a middle-income developing country (Mexico). The specific aims are: 1. Conceptual framework for comparative risk assessment: To provide a clear and coherent framework for comparing and interpreting the disease and injury burden attributable to specific population exposures. 2. Evidence of known risk factors: To provide reliable evidence on the importance and interactions of known risk factors for chronic diseases in a large, middle-income adult population. 3. Identification of new risk factors: To investigate and quantify the importance of other, blood-related factors as causes of premature death including genetic polymorphism, antibodies to many infective agents, hormones and other signal molecules, carious coagulation and inflammatory factors, micronutrients, and protein glycosylation. The empirical work will be based on a survey of 200,000 Mexican adults aged 40 years and older living in Coyoacan district, and repeated active morality follow-ups. Nested case-control studies will serve as the main methodology. These aims would be achieved chiefly by addition into already existing large prospective studies the collection and long-term storage of blood samples, which would be retrospectively analyzed for certain lipids, antioxidants, other biochemistries, antibodies and genetic polymorphisms in leucocyte DNA in "cases" who develop the particular disease of interest over the next few years, and individually matched "controls" who were then still alive and free of this disease.