Ethnic differences in peripheral arterial disease

描述(由申请人提供)： 先前的人口研究指出，与非西班牙裔白人(Nhw)相比，非洲裔美国人(Afr.Amer)的外周动脉疾病(PAD)发生率更高。AFR-AMER的过量不能用更高水平的标准PAD危险因素来解释，如糖尿病、吸烟、血脂异常和高血压。这个应用程序有两个相关的具体目标。第一个特定的目的是确定与NHW相比，AFR-AME中PAD的患病率是否可以全部或部分地由PAD的不同水平的新的动脉粥样硬化、炎症、血栓和纤溶危险标志物来解释。第二个具体目标是确定在AFR中是否有较高的衬垫速率。AMER可以完全或部分地通过对这些新的风险标记物的不同易感性来解释；也就是说，AFR对这些新的风险标记物中的一个或多个的影响-修饰。阿默。种族问题。一个探索性的具体目标也解决了拉美裔和亚洲人的这两个问题。这两个具体目标都将使用Logistic回归模型来解决。PAD病例(n=127)和年龄和性别匹配的对照组(n=127)将来自一项完整的人群研究，在该研究中，AFR-AMER显示标准PAD危险因素无法解释的PAD显著过剩。十个新的风险标记物将在储存的冷冻血浆上进行测量。这些危险标记物是动脉粥样硬化标记物同型半胱氨酸和脂蛋白抗原；炎症标记物C反应蛋白、纤维蛋白原、白介素6和肿瘤坏死因子α；血栓标记物血管性血友病因子和凝血酶原1-2；以及纤溶标记物纤维蛋白D-二聚体和纤溶酶-抗纤溶酶。第一个具体目标将通过评估当较新的风险标记物被输入包含标准PAD风险因素的Logistic模型时AFR-AMER族裔的风险变化来实现。具体的第二个目标将通过评估AFR-AMER种族和LOGISTIC模型中较新的风险标记物之间的影响-修改的交互作用项来探索。这是首次尝试了解这些新的风险标记物是否可以解释PAD的种族差异。因此，这项申请具有很高的创新性，并解决了原始假设。

DESCRIPTION (provided by applicant): Previous population studies have noted a higher rate of peripheral arterial disease (PAD) in African- Americans (Afr.Amer) compared to non-Hispanic whites (NHW). This excess in Afr-Amer is not explained by higher levels of standard PAD risk factors such as diabetes, cigarette smoking, dyslipidemia, and hypertension. This application has two related specific aims. The first specific aim is to determine if the sharply higher prevalence of PAD in Afr-Amer compared to NHW can be explained in whole or in part by different levels of newer atherogenic, inflammatory, thrombotic, and fibrinolytic risk markers for PAD. The second specific aim is to determine whether the higher PAD rate in Afr. Amer can be explained in whole or in part by differential susceptibility to these newer risk markers; that is, an effect-modification of one or more of these newer risk markers by Afr. Amer. ethnicity. An exploratory specific aim also addresses these two questions in Hispanics and Asians. Both specific aims will be addressed using logistic regression models. PAD cases (n=127) and age and sex-matched controls (n=127) will be drawn from a completed population study in which Afr-Amer showed a significant PAD excess not explained by standard PAD risk factors. Ten newer risk markers will be measured on stored frozen plasma. These risk markers are the atherogenic markers homocysteine and lipoprotein antigen; the inflammatory markers c-reactive protein, fibrinogen, interleukin 6, and tumor necrosis factor alpha; the thrombotic markers von Willebrand factor and prothrombin 1-2; and the fibrinolytic markers fibrin D-dimer and plasmin-anti-plasmin. The first specific aim will be addressed by evaluating the change in the risk for Afr-Amer ethnicity when the newer risk markers are entered into the logistic model containing standard PAD risk factors. The specific second aim will be explored by evaluating interaction terms for effect-modification between Afr-Amer ethnicity and the newer risk markers in the logistic model. This is the first attempt to see if these newer risk markers can explain ethnic differences in PAD. Thus, this application is highly innovative and addresses original hypotheses.