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受教育水平增加,患冠心病风险降低??为了研究受教育程度在冠心病发生之间是否存在因果关系,研究人员对50多万人进行了追踪研究,结果发现增加3.6年的教育(相当于再上一个大学本科)或能降低个体三分之一患心脏病的风险(towards 3.6 years of additional education was associatedwith a one third lower risk of coronary heart disease),相关研究结果发表在BMJ上(Education and coronary heart disease: mendelianrandomisation study)。具体细节见如下网址:http://www.bmj.com/content/358/bmj.j3542; http://news.bioon.com/article/6709700.html。
Educationand coronary heart disease: mendelian randomisation study
Objective:Todetermine whether educational attainment is a causal risk factor in thedevelopment of coronary heart disease. Design:Mendelian randomisationstudy, using genetic data as proxies for education to minimise confounding.
Setting:Themain analysis used genetic data from two large consortia (CARDIoGRAMplusC4D andSSGAC), comprising 112 studies from predominantly high income countries.Findings from mendelian randomisation analyses were then compared againstresults from traditional observational studies (164 170 participants). Finally,genetic data from six additional consortia were analysed to investigate whetherlonger education can causally alter the common cardiovascular risk factors.
Participants:Themain analysis was of 543 733 men and women (from CARDIoGRAMplusC4D and SSGAC),predominantly of European origin. Exposure:A one standard deviationincrease in the genetic predisposition towards higher education (3.6 years ofadditional schooling), measured by 162 genetic variants that have beenpreviously associated with education.
Main outcome measure:Combinedfatal and non-fatal coronary heart disease (63 746 events inCARDIoGRAMplusC4D).
Results:Geneticpredisposition towards 3.6 years of additional education was associated with aone third lower risk of coronary heart disease (odds ratio 0.67, 95% confidenceinterval 0.59 to 0.77; P=3×10−8). This wascomparable to findings from traditional observational studies (prevalence oddsratio 0.73, 0.68 to 0.78; incidence odds ratio 0.80, 0.76 to 0.83). Sensitivityanalyses were consistent with a causal interpretation in which major bias fromgenetic pleiotropy was unlikely, although this remains an untestablepossibility. Genetic predisposition towards longer education was additionally associatedwith less smoking, lower body mass index, and a favourable blood lipid profile.
Conclusions:Thismendelian randomisation study found support for the hypothesis that loweducation is a causal risk factor in the development of coronary heart disease.Potential mechanisms could include smoking, body mass index, and blood lipids.In conjunction with the results from studies with other designs, these findingssuggest that increasing education may result in substantial health benefits.
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