河南农村人群中血清孕酮水平与成年人冠心病的关联分析及体力活动的修饰效应  

Association between serum progesterone level and coronary heart disease in adults from Henan rural area and the modification effect of physical activity

作　　者：刘欢 黄奕琰 刘道瀚 任心宇 刘贺洋 宋宇 王冕 郇昌盛 贾泽鑫 聂璐婷 毛振兴 霍文倩 LIU Huan;HUANG Yiyan;LIU Daohan;REN Xinyu;LIU Heyang;SONG Yu;WANG Mian;XUN Changsheng;JIA Zexin;NIE Luting;MAO Zhenxing;HUO Wenqian(Department of Environmental Health,College of Public Health,Zhengzhou University,Zhengzhou 450001;Department of Health Statistics,College of Public Health,Zhengzhou University,Zhengzhou 450001)

机构地区：[1]郑州大学公共卫生学院环境卫生学教研室,郑州450001 [2]郑州大学公共卫生学院卫生统计学教研室,郑州450001

出　　处：《郑州大学学报（医学版）》2023年第5期671-676,共6页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(21806146);国家博士后科学基金项目(2021M702934,2020T130604);河南省重点研发与推广专项(科技攻关)(212102310074);河南省大学生创新创业训练计划项目(S202010459154);郑州大学青年骨干教师项目(2021ZDGGJS057)。

摘　　要：目的:研究血清孕酮水平与成年人冠心病(CHD)患病的关联性及体力活动对此关系的修饰作用。方法:以“河南农村队列研究”为依托,采用病例对照(1∶1)研究方法,共纳入CHD患者253例、正常人253人。运用Logistic回归模型和限制性立方样条图探讨孕酮与CHD之间的关联性及其剂量反应关系。根据体力活动程度的不同进行亚组分析,并比较不同亚组中孕酮与CHD关联性的差异,以评估体力活动对孕酮-CHD关联的修饰效应。结果:在总人群中,调整相关混杂因素后,与低水平血清孕酮组相比,中水平血清孕酮组CHD患病风险降低(OR=0.27,95%CI为0.14~0.52),高水平血清孕酮组CHD患病风险增加(OR=2.34,95%CI为1.46~3.74)。限制性立方样条图显示孕酮在总人群中以0.66μg/L为剂量反应关系改变的临界点。体力活动程度分层分析结果显示,中度体力活动下高水平血清孕酮不增加CHD患病风险,而轻度、重度体力活动下中水平孕酮对CHD的保护作用不再显著。中度-轻度体力活动对高水平孕酮修饰效应显著(P<0.05)。结论:在河南农村人群中,中水平孕酮与CHD患病风险降低相关,而高水平孕酮与CHD患病风险升高相关,中等体力活动可以改善孕酮对CHD的不良效应。Aim:To study the effect of serum progesterone level on coronary heart disease(CHD)in adults and the modification effect of physical activity.Methods:Based on the"Henan Rural Cohort Study",506 subjects were included in this case-control study.Logistic regression model and restricted cubic spline plot were used to explore the association and dose-response relationship between progesterone and CHD.Subgroup analyses were performed according to different levels of physical activity,and the association between progesterone and CHD was compared in different subgroups to assess the modification effect of physical activity on the progesterone-CHD association.Results:In the total population,after adjusting for relevant confounders,compared with the low-concentration serum progesterone group,the risk of CHD was reduced(OR=0.27,95%CI:0.14-0.52)in the group with moderate-concentration serum progesterone and increased(OR=2.34,95%CI:1.46-3.74)in the high concentration group.The restricted cubic spline plots showed that 0.66μg/L progesterone was the critical point for the change of dose-response relationship in the total population.The results of stratified analysis of physical activity showed that high-concentration of serum progesterone did not increase the risk of CHD under moderate physical activity,while the protective effect of moderate-concentration of progesterone on CHD under mild or severe physical activity was not significant.Mild to moderate physical activity could significantly modify the association between high-concentration of progesterone and CHD.Conclusion:In rural population of Henan Province,moderate-concentration progesterone was associated with reduced risk of CHD,while high-concentration progesterone was related with increased risk of CHD,and moderate physical activity could ameliorate the adverse effects of progesterone on CHD.

关 键 词：孕酮 冠心病 体力活动 修饰效应 河南农村队列研究 

分 类 号：R181.2[医药卫生—流行病学] R541.4[医药卫生—公共卫生与预防医学]