受教育年限与心血管疾病患病率的相关性:孟德尔随机化研究  

Causal associations of educational attainment with cardiovascular diseases: a Mendelian randomization study

作　　者：张春娟 马小董 汪玉龙[3] 邱刚[4] 邬梅珍 Zhang Chunjuan;Ma Xiaodong;Wang Yulong;Qiu Gang;Wu Meizhen(Department of Science and Education,Haiyan People's Hospital,Jiaxing 314300,China;Department of Neurology,Haiyan People's Hospital,Jiaxing 314300,China;Department of Cardiovascular Medicine,Haiyan People's Hospital,Jiaxing 314300,China;Department of Pharmacy,Haiyan People's Hospital,Jiaxing 314300,China)

机构地区：[1]海盐县人民医院科教部,嘉兴314300 [2]海盐县人民医院神经内科,嘉兴314300 [3]海盐县人民医院心血管内科,嘉兴314300 [4]海盐县人民医院药剂科,嘉兴314300

出　　处：《国际流行病学传染病学杂志》2025年第1期55-60,共6页International Journal of Epidemiology and Infectious Disease

摘　　要：目的:采用孟德尔随机化(MR)方法探索受教育年限与行为因素、心血管疾病(CVDs)患病风险的相关性。方法:以教育年限作为暴露因素,以CVDs和行为因素作为结局,采用逆方差加权法、加权中位数法、MR-Egger法、简单模式法和加权模式法5种MR分析方法进行因果关联性分析。结果:在CVDs患者风险方面,受教育年限与冠心病(OR=0.62,95%CI:0.52~0.73)、2型糖尿病(OR=0.53,95%CI:0.41~0.66)、心力衰竭(OR=0.71,95%CI:0.62~0.83)、心房颤动(OR=0.84,95%CI:0.75~0.94)、缺血性卒中(OR=0.77,95%CI:0.64~0.90)、短暂性脑缺血(OR=0.75,95%CI:0.64~0.90)和心脏骤停(OR=0.54,95%CI:0.34~0.84)存在反向因果关系;在社会行为方面,受教育年限与新鲜水果摄入(OR=1.09,95%CI:1.01~1.11)和家庭收入(OR=1.92,95%CI:1.89~1.96)存在正向因果关系;与盐分摄入(OR=0.84,95%CI:0.81~0.87),吸烟(OR=0.68,95%CI:0.64~0.73),饮酒(OR=0.61,95%CI:0.55~0.66)和身体活动(OR=0.79,95%CI:0.73~0.85)存在反向因果关系。结论:教育年限可能通过社会经济因素影响CVDs,有必要对普遍接受教育年限较短的基层地区患者进行健康水平教育和生活方式干预。Objective:To explore the correlation between years of schooling and behavioral factors,as well as cardiovascular diseases(CVDs)from the perspective of Mendelian randomization(MR).Methods:Educational attainment was considered as the exposure factor,and CVDs and behavioral factors as outcome factors.Five methods of MR analysis:inverse variance weighting method,weighted median,MR-Egger,simple mode and weighted mode were used to conduct causal association analysis.Results:In terms of the risk of CVDs,educational attainment was negatively associated with the risks of coronary heart disease(OR=0.62,95%CI:0.52-0.73),type 2 diabetes(OR=0.53,95%CI:0.41-0.66),heart failure(OR=0.71,95%CI:0.62-0.83),atrial fibrillation(OR=0.84,95%CI:0.75-0.94),ischemic stroke(OR=0.77,95%CI:0.64-0.90),transient ischemic attack(OR=0.75,95%CI:0.64-0.90),and cardiac arrest(OR=0.54,95%CI:0.34-0.84).In terms of social behaviors,educational attainment was positively associated with the intake of fresh fruits(OR=1.09,95%CI:1.01-1.11)and household income(OR=1.92,95%CI:1.89-1.96),and was negatively associated with the intake of salt(OR=0.84,95%CI:0.81-0.87),smoking(OR=0.68,95%CI:0.64-0.73),alcohol consumption(OR=0.61,95%CI:0.55-0.66),and physical activity(OR=0.79,95%CI:0.73-0.85).Conclusions:The educational attainment may influence the risk of CVDs through socio-economic factors.Therefore,it is crucial to conduct health education and comprehensive lifestyle interventions among patients in rural areas with generally lower educational attainment to effectively manage CVDs.

关 键 词：心血管疾病 受教育年限 因果关系 孟德尔随机化 健康干预 

分 类 号：R54[医药卫生—心血管疾病]