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首页> 外文期刊>Annals of epidemiology >Smoking, other risk factors and fibrinogen levels. evidence of effect modification.
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Smoking, other risk factors and fibrinogen levels. evidence of effect modification.

机译：吸烟，其他危险因素和纤维蛋白原水平。效果修改的证据。

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PURPOSE: Recent investigations have indicated that smoking may act as an important modifier of the risk associated with dyslipidemia. We hypothesized as a potential mechanism that smoking modifies the association between traditional risk factors of early atherosclerosis, such as dyslipidemia, hypertension, or diabetes, with fibrinogen, a risk factor more closely related to plaque progression and thrombosis. METHODS: The sample for this cross-sectional study, was collected from the MONICA Augsburg population survey of 1989/90 and included 1840 men and 1784 women, aged 25 to 64 years. Traditional risk factors hypertension, diabetes mellitus, and dyslipidemia were assessed by personal interviews, and medical examinations. Plasma fibrinogen concentration was determined by nephelometry. Effect modification was assessed by stratified analyses and tests for statistical interaction. RESULTS: Fibrinogen levels were higher in women than in men and, after adjustment for potential confounders, higher in smokers than in nonsmokers (each p < 0.001). The effect of smoking was greater in men (p < 0.001). The elevation of mean adjusted fibrinogen levels associated with hypertension or with diabetes in men was significantly higher in smokers as compared to nonsmokers (test for interaction, p < 0.001). By contrast, smoking in women showed significantly stronger impacts only with regard to the association of dyslipidemia and fibrinogen (p < 0.001). Comparing groups of subjects with increasing numbers of concomitant risk factors, stratified according to their smoking status, effect modification by smoking was particularly evident in male participants with two or more risk factors. Numbers of women with more than one risk factor and smoking were too low for analysis. CONCLUSIONS: We demonstrate that smoking contributes more than additively to the strong influences of single and combined traditional risk factors on fibrinogen levels. These data confirm that smoking is a dominant determinant of fibrinogen levels in the general population.
机译：目的：最近的研究表明，吸烟可能是血脂异常风险的重要调节剂。我们假设吸烟是一种潜在的机制，它可以改变早期动脉粥样硬化的传统危险因素（例如血脂异常，高血压或糖尿病）与纤维蛋白原之间的关联，纤维蛋白原是与斑块进展和血栓形成密切相关的危险因素。方法：该横断面研究的样本来自1989/90年度MONICA奥格斯堡人口调查，其中包括1840名男性和1784名女性，年龄在25至64岁之间。通过个人访谈和医学检查评估了传统的危险因素高血压，糖尿病和血脂异常。通过比浊法测定血浆纤维蛋白原浓度。通过分层分析和统计交互作用测试评估效果改善。结果：女性的纤维蛋白原水平高于男性，经过潜在混杂因素调整后，吸烟者的纤维蛋白原水平高于不吸烟者（每个P <0.001）。吸烟对男性的影响更大（p <0.001）。与不吸烟者相比，吸烟者的男性与高血压或糖尿病相关的平均调节纤维蛋白原水平的升高显着更高（相互作用测试，p <0.001）。相比之下，女性吸烟仅在血脂异常和纤维蛋白原的相关性上显示出明显更强的影响（p <0.001）。比较具有增加的并发危险因素的受试者组（根据其吸烟状况进行分层），在有两个或更多危险因素的男性参与者中，吸烟对效果的改善作用尤为明显。危险因素多于一种且吸烟的女性人数太少而无法进行分析。结论：我们证明吸烟对单一和综合传统危险因素对血纤蛋白原水平的强烈影响具有累加作用。这些数据证实，吸烟是普通人群中纤维蛋白原水平的主要决定因素。

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