Aims: Previous studies have suggested that the Framingham coronary heart disease risk prediction equation underestimates risk among people with Type 2 diabetes. We compared the 10-year absolute risks of coronary heart...Aims: Previous studies have suggested that the Framingham coronary heart disease risk prediction equation underestimates risk among people with Type 2 diabetes. We compared the 10-year absolute risks of coronary heart disease (CHD) using a Framingham equation and a United Kingdom Prospective Diabetes Study (UKPDS) equation in adults with Type 2 diabetes. Methods: Participants were from a cross-sectional survey of a randomly selected population. There were 461 people with newly (n = 132) or previously diagnosed (n = 329) diabetes aged 35 to 74 years with no past history of cardiovascular disease or nephropathy. We examined predicted 10-year CHD risk by age, gender, and newly or previously diagnosed diabetes. Results: Overall the mean 10-year CHD risks predicted by the two equations were similar. Among men, the UKPDS and Framingham scores were almost identical below 60 years of age but at older ages, the UKPDS score was 4% - 11% higher than Framingham. For women, the Framingham score was higher than the UKPDS score between ages 40 and 65 years, but the UKPDS score was about 4% - 5% higher for women aged 70 years and over. The UKPDS equation tended to give higher risk estimates in people with a predicted 10-year Framingham CHD risk above 15%. Conclusion: Framingham CHD risk scores tended to be lower than UKPDS scores primarily in people above standard thresholds for drug treatment, so the clinical impact of underestimating risk is likely to be limited. Moreover, the UKPDS equation predicted lower risks than Framingham for women and newly diagnosed diabetes at otherwise low to moderate CHD risk, which could result in later initiation of therapy in these groups if the UKPDS score was used instead of the Framingham score.展开更多
Previous studies show that diet quality varies by socioeconomic gradient. We compared the influence of individual- and area-level socioeconomic characteristics on food choice behavior and dietary nutrient intakes in a...Previous studies show that diet quality varies by socioeconomic gradient. We compared the influence of individual- and area-level socioeconomic characteristics on food choice behavior and dietary nutrient intakes in a cross-sectional survey. Daily nutrient intakes were calculated from a food frequency questionnaire. Participants comprised 4007 people (1915 men, 2092 women) aged 35 to 74 years. Socioeconomic measures included the area-based deprivation NZDep2001, gross household income, education level and the occupation-based New Zealand Socioeconomic Index (NZSEI96). Results: Nutrients expressed as their percentage contribution to total energy intakes and adjusted for age, gender and ethnicity, showed that intakes of cholesterol were higher in the lower income groups, and fibre, alcohol and calcium were lower compared to the highest income group. Similarly adjusted nutrients expressed as their contribution to total energy intakes showed lower alcohol intakes in the lower NZDep2001 classes compared to the highest NZDep2001 class. Lower fruit, cheese, wine, and spirit servings were found in both the lower income and NZDep2001 groups. Lower vegetables, milk and cereal servings were found in the lowest income group compared with the highest. Higher chicken, eggs and bread servings were found in the lowest NZDep2001 group compared to the highest NZDep2001 group. Few statistically significant associations were observed with the NZSEI96 or education. Conclusion: Income was more strongly associated with nutrient intakes and NZDep2001 with food group selections. Lower fruit, cheese, wine and spirit servings in the lower SES strata showed independent associations with income and NZDep2001. However, NZDep2001 and income appear to be measuring different elements of dietary intakes and food group servings, with income being associated with lower vegetable, milk and cereal servings, and increased dietary cholesterol and lower fibre, and calcium intakes and NZDep2001 with increased chicken, eggs and bread servings. More in depth, research into area-level determinants of diet is warranted.展开更多
文摘Aims: Previous studies have suggested that the Framingham coronary heart disease risk prediction equation underestimates risk among people with Type 2 diabetes. We compared the 10-year absolute risks of coronary heart disease (CHD) using a Framingham equation and a United Kingdom Prospective Diabetes Study (UKPDS) equation in adults with Type 2 diabetes. Methods: Participants were from a cross-sectional survey of a randomly selected population. There were 461 people with newly (n = 132) or previously diagnosed (n = 329) diabetes aged 35 to 74 years with no past history of cardiovascular disease or nephropathy. We examined predicted 10-year CHD risk by age, gender, and newly or previously diagnosed diabetes. Results: Overall the mean 10-year CHD risks predicted by the two equations were similar. Among men, the UKPDS and Framingham scores were almost identical below 60 years of age but at older ages, the UKPDS score was 4% - 11% higher than Framingham. For women, the Framingham score was higher than the UKPDS score between ages 40 and 65 years, but the UKPDS score was about 4% - 5% higher for women aged 70 years and over. The UKPDS equation tended to give higher risk estimates in people with a predicted 10-year Framingham CHD risk above 15%. Conclusion: Framingham CHD risk scores tended to be lower than UKPDS scores primarily in people above standard thresholds for drug treatment, so the clinical impact of underestimating risk is likely to be limited. Moreover, the UKPDS equation predicted lower risks than Framingham for women and newly diagnosed diabetes at otherwise low to moderate CHD risk, which could result in later initiation of therapy in these groups if the UKPDS score was used instead of the Framingham score.
文摘Previous studies show that diet quality varies by socioeconomic gradient. We compared the influence of individual- and area-level socioeconomic characteristics on food choice behavior and dietary nutrient intakes in a cross-sectional survey. Daily nutrient intakes were calculated from a food frequency questionnaire. Participants comprised 4007 people (1915 men, 2092 women) aged 35 to 74 years. Socioeconomic measures included the area-based deprivation NZDep2001, gross household income, education level and the occupation-based New Zealand Socioeconomic Index (NZSEI96). Results: Nutrients expressed as their percentage contribution to total energy intakes and adjusted for age, gender and ethnicity, showed that intakes of cholesterol were higher in the lower income groups, and fibre, alcohol and calcium were lower compared to the highest income group. Similarly adjusted nutrients expressed as their contribution to total energy intakes showed lower alcohol intakes in the lower NZDep2001 classes compared to the highest NZDep2001 class. Lower fruit, cheese, wine, and spirit servings were found in both the lower income and NZDep2001 groups. Lower vegetables, milk and cereal servings were found in the lowest income group compared with the highest. Higher chicken, eggs and bread servings were found in the lowest NZDep2001 group compared to the highest NZDep2001 group. Few statistically significant associations were observed with the NZSEI96 or education. Conclusion: Income was more strongly associated with nutrient intakes and NZDep2001 with food group selections. Lower fruit, cheese, wine and spirit servings in the lower SES strata showed independent associations with income and NZDep2001. However, NZDep2001 and income appear to be measuring different elements of dietary intakes and food group servings, with income being associated with lower vegetable, milk and cereal servings, and increased dietary cholesterol and lower fibre, and calcium intakes and NZDep2001 with increased chicken, eggs and bread servings. More in depth, research into area-level determinants of diet is warranted.
