基于两个重要数据集,重新审视膳食脂肪和其他风险因素与心血管疾病之间的统计关系

Jiarui Ou, Le Zhang, Xiaoli Ru
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摘要

心血管疾病(CVD)是世界上许多地区的主要死因,其中一些风险因素可能与饮食有关。为了提高公众健康水平并加深对这一主题的理解,我们研究了最近的明尼苏达冠心病实验(MCE)分析,该分析采用了 t 检验和 Cox 模型来评估心血管疾病的风险。然而,这些参数方法可能存在三个问题:样本量小、右删失偏差和缺乏长期证据。为了克服第一个问题,我们采用了非参数置换检验来研究膳食脂肪与血清总胆固醇之间的关系。为了解决第二个问题,我们使用了基于重抽样的秩检验来检验血清总胆固醇水平是否会影响心血管疾病死亡人数。针对第三个问题,我们利用弗雷明汉心脏研究(FHS)的一些额外数据,通过 A/B 检验来寻找饮食、危险因素和心血管疾病风险之间的元相关性。我们发现,首先,低饱和脂肪膳食与降低血清总胆固醇之间的联系非常紧密。其次,在饮食组中,降低血清总胆固醇对心血管疾病危害的影响并不明显。最后,A/B 测试结果表明,饮食导致的舒张压范围异常以及这些异常如何影响胆固醇水平与心脏病风险之间的关联关系更为复杂。这项研究不仅帮助我们深入分析了 MCE 数据,而且结合长期的 FHS 数据,揭示了饮食、风险因素和心脏病背后可能存在的复杂关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Re‐examination of statistical relationships between dietary fats and other risk factors, and cardiovascular disease, based on two crucial datasets
Cardiovascular disease (CVD) is the major cause of death in many regions around the world, and several of its risk factors might be linked to diets. To improve public health and the understanding of this topic, we look at the recent Minnesota Coronary Experiment (MCE) analysis that used t‐test and Cox model to evaluate CVD risks. However, these parametric methods might suffer from three problems: small sample size, right‐censored bias, and lack of long‐term evidence. To overcome the first of these challenges, we utilize a nonparametric permutation test to examine the relationship between dietary fats and serum total cholesterol. To address the second problem, we use a resampling‐based rank test to examine whether the serum total cholesterol level affects CVD deaths. For the third issue, we use some extra‐Framingham Heart Study (FHS) data with an A/B test to look for meta‐relationship between diets, risk factors, and CVD risks. We show that, firstly, the link between low saturated fat diets and reduction in serum total cholesterol is strong. Secondly, reducing serum total cholesterol does not robustly have an impact on CVD hazards in the diet group. Lastly, the A/B test result suggests a more complicated relationship regarding abnormal diastolic blood pressure ranges caused by diets and how these might affect the associative link between the cholesterol level and heart disease risks. This study not only helps us to deeply analyze the MCE data but also, in combination with the long‐term FHS data, reveals possible complex relationships behind diets, risk factors, and heart disease.
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