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Suzana Alves de Moraes

e Jose Maria Pacheco de Souza

Ischemic heart disease and Diabetes mellitus:

a statistical analysis

S e v e r a l a u t h o r s h a v e d e s c r i b e d d i a b e t e s m e l l i t u s ( D M ) a s a n i n d e p e n d e n t r i s k f a c t o r f o r i s c h e m i c h e a r t d i s e a s e ( I H D ) . T h e o b j e c t i v e o f t h i s s t u d y w a s t o t e s t t h e h y p o t h e s i s o f t h e

a s s o c i a t i o n o f D M a n d I H D . A d j u s t m e n t o f t h e p o s s i b l e v a r i a b l e s o f c o n f u s i n g a n d / o r m o d i f y i n g e f f e c t s w a s p e r f o r m e d i n t h e p r e s e n t s t u d y . T h e s t u d y a l s o a s s e s s e d t h e e x i s t e n c e o f a d o s e

-r e s p o n s e g -r a d i e n t f o -r t h e f o l l o w i n g v a r i a b l e s : - d u r a t i o n o f D M ;

- d u r a t i o n o f e l e v a t e d b l o o d p r e s s u r e ;

- d u r a t i o n o f h y p e ~ c h o l e s t e r o l e m i a ; - d u r a t i o n o f s m o k i n g h a b i t s ; - n u m b e r o f c i g a r e t t e s p e r d a y ; - d u r a t i o n o f m e n o p a u s e .

T h e s t u d y w a s a c a s e - c o n t r o l t y p e . T h e t a r g e t p o p u l a t i o n

w a s m a d e o f s u b j e c t s a g e d 3 0 t o 6 9 y e a r s o f b o t h g e n d e r s a n d r e s i d e n t s o f S a o P a u l o . T h e s t u d y b e g a n M a r c h 1 9 9 3 a n d i t e n d e d

i n F e b r u a r y 1 9 9 4 . P a t i e n t s a m p l e w a s 8 3 3 s u b j e c t s . S t a t i s t i c a l a n a l y s i s e m p l o y e d w a s m u l t i v a r i a t e l o g i s t i c r e g r e s s i o n .

R a w d a t a a n a l y s i s i n d i c a t e d D M a s a r i s k f a c t o r i n a s t a -t i s -t i c a l l y s i g n i f i c a n -t w a y f o r -t h e e m e r g e n c e o f I H D ( o d d s r a t i o

=

3 .7 ; c o n f i d e n c e i n t e r v a l

=

1 .8 - 7 .6 ) . W i t h t h e i n c l u s i o n o f v a r i a b l e s s u c h a s f a m i l y h i s t o r y o f h e a r t d i s e a s e , s m o k i n g h a b

-i t s , h y p e r c h o l e s t e r o l e m -i a a n d f a m i l y h i s t o r y o f h y p e r t e n s i o n i n t h e t e s t i n g m o d e l , a n o n - s i g n i f i c a n t r e l a t i o n s h i p e m e r g e s ( o d d s r a t i o

=

1 .4 ; c o n f i d ~ n c e i n t e r v a l

=

0 .6 - 2 .3 ) .

This change might

be explained bythesefour variables known to be associated with

IHD.

I n t h e n e x t s t e p , t h e s t u d y t r i e d t o s e g r e g a t e t h e c l u s t e r o f

i n d i v i d u a l s n o t b e l o n g i n g t o a n y o f t h e g r o u p s a b o v e . T h i s w a s d o n e t o d e t e r m i n e t h e d e g r e e o f s t r e n g t h i n t h e a s s o c i a t i o n o f D M w i t h a m i n i m a l d e g r e e o f i n t e r f e r e n c e b y o t h e r v a r i a b l e s .

T h e g r e a t e s t s h o r t c o m i n g i s t h e s m a l l n u m b e r o f s u b j e c t s w i t h D M ( 9 2 ) , w h i c h i s o n l y

II

%

o f t h e e n t i r e s a m p l e .

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