医学英语课件资料：在不同身体质量指数的同卵双胞胎中心肌梗塞、死亡和糖尿病的风险

1、Risks of Myocardial Infarction, Death, and Diabetes in Identical Twin Pairs With Different Body Mass Indexes在不同身体质量指数的同卵双胞胎中心肌梗塞、死亡和糖尿病的风险01 文章内容3OVERWEIGHT & OBESITY /obesity/4/health-risks-linked-to-obesity-p279Overweight and obesityHow to evaluate?Body mass index (BMI)It is defined as a persons w

2、eight in kilograms divided by the square of his height in meters (kg/m2).Overweight: BMI greater than or equal to 25Obesity: BMI greater than or equal to 30For adult56Global prevalence of overweight and obesity/gho/ncd/risk_factors/overweight/en/Common health consequencesCardiovascular diseases (mai

3、nly heart disease and stroke), which were the leading cause of death in 2012;Diabetes;Musculoskeletal disorders (especially osteoarthritis a highly disabling degenerative disease of the joints);Some cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon).7/m

4、ediacentre/factsheets/fs311/en/8Key pointsQUESTIONDoes genetic confounding influence the associationbetween obesity, diabetes, and cardiovascular disease?Selection bias Genetic confoundingPROBLEMSA cohort of BMI-discordant monozygotic twin pairs HOW TO RESOLVE9Main results10Main results11Conclusions

5、 BMI & CVD or deathHigher BMI was not associated with an increased risk of MI or deathHigher BMI was associated with the onset of diabetesBMI & diabetesLifestyle interventions to reduce obesity are more effective in decreasing the risk of diabetes than the risk of cardiovascular disease or death.BMI

6、 & LIFESTYLES02 词 根 谢予婳my/omuscle（肌）heart（心脏） cardi/opertaining to （有关于；的）-al13myocardial,makrdladj. 心肌的Myocardial infarction 心肌梗塞14cardi/oheart（心脏）vascul/oblood vessel（血管）-arpertaining to（有关于；的）cardiovascular ,krdovskjl adj. 心血管的15artery arteri/o动脉vessels angi/o血管与血管有关的词根aorta aort/o主动脉vessel vas/o

7、血管venul/o small vein小静脉veni- vein静脉 blood vesselvascul/o 血管ven/o vein静脉16monozygotic ,mnzagtk adj. 单合子的mono-single（单）-icpertaining to有关于；的zyg/ofertilize; join（接合；合子）multi-many（多） multivariable 多变量的 hypertensionhapten()nn. 高血压17-tensionpressure（压）hyper-above; excessive（过度；过高）18hyper-above; excessive（

8、过度；过高）lipid脂肪-emiablood condition（血；血态）hyperlipidemia ,hap,lpdimi; ,hap,lapdimi n. 高血脂 hypo-deficient; below; under（低下）lip/ofat（脂肪）adip/ofat（脂）steat/ofat（脂肪）seb/osebum（皮脂）subgroupsub-below, under（在下）19词根+已知词汇antidiabeticanti- against（抗）dissimilaritydis- not; separating（非；分离）03 专业词汇 崔雀玄21Baseline基线指临

9、床研究中，患者已经过筛选加入研究但还未开始用药治疗的时间，在基线时采集试验所关注的变量，一段时间后同基线期作对比得出结论22Primary End PointSecondary End Point主要终点次要终点临床试验设计中的主要终点和次要终点，实际上就是要设计者根据研究目的确定主要（次要）结局指标(测量/变量)23Obesity Paradox肥胖悖论患有同样慢性疾病的超重和中度肥胖病人一般都比有同样疾病的正常体重的病人活得更长久、质量也更高24Residual ConfoundingResidual rzdul残余混杂指虽然已经经过统计学调整混杂因素，但由于测量误差的存在，测量有误的那一

10、部分混杂产生的效应仍然会歪曲暴露对结局的真实联系；或者未知潜在的未被调整的混杂所导致的真实效应的歪曲。25Causal Link因果关联Caloric Restriction卡路里限制Late-onset Disease迟发型疾病Singleton单胎26Treatment RegimenRegimen rdmn治疗方案27Bariatric Surgery减肥手术对肥胖患者进行的以减轻体重为目的的手术，包括通过束胃带或胃部分切除以减小胃的体积，或通过小肠切除和改道以得到较小的胃囊28VisceralObesity内脏型肥胖内脏型肥胖是指由于内脏脂肪过多导致的肥胖。内脏脂肪是腹腔内的脂肪，被包

11、裹于内脏及躯干之间，包括肠系膜、附睾白色脂肪组织、腹腔脂肪04 问卷词汇 周潇翔30Vocabulary of questionnaireSocial statusMarried 已婚Cohabitant 同居Divorced 离异Widow/widowed 丧偶Single 单身Living apart 分居31Vocabulary of questionnaireCohabitSingleMarriedWidow/widowedLiving apartDivorced32Vocabulary of questionnaireHighest educational levelPhysical

12、 activity Little or none 很少或没有Not a lot 不是很多Rather much or very much 很多33Vocabulary of questionnaireDiagnoses at baselineMyocardial infarction 心肌梗塞Stroke 中风Diabetes 糖尿病Cancer 癌症Alcohol abuse 酗酒SmokingNeverPreviousCurrent34Vocabulary of questionnaireAgeWeightBirth weightHeightBorn firstBMI in 1972aCh

13、anges in BMI from 1973Income35Vocabulary of questionnaireDisability pension伤残抚恤金Financial support for people who have a physical, intellectual or psychiatric condition that stops them from working or people who are permanently blind05 统计学词汇 陈梦寅Abbreviation SDstandarddeviationheavier twins (mean SD B

14、MI, 25.9 3.6) .BMI discordance of 7.0 or more (mean SE, 9.3 0.7) SEstandard error37公式图片来源： /Abbreviation38 OR & CI OROdds ratio CI Confidence interval 图片来源： http:/the risk of incident diabetes was greater in heavier twins (OR, 2.14; 95% CI, 1.61-2.84). Statistical words39Imputation /mpjten/归罪？诋毁？rep

15、lacingmissing data with substituted values.(Wiki)No imputations for missing data were performed. Mean ImputationRegression ImputationMultiple ImputationStatistical words40Exposure /mpjten/分为不同的亚组某一特定人群判定某因素与该结局之间有无因果关联及关联程度Statistical words cohort /kohrt/图片来源： /Statistical words cohort /kohrt/A coho

16、rt of 4046 MZ twin pairs with discordant BMIs (difference 0.01) was identified using the nationwide Swedish twin registry. The study was conducted from March 17, 1998, to January 16, 2003, with follow-up regarding incident outcomes until December 31, 2013. 42Statistical words相关 relate - 5is strongly

17、 related to CVD. 43 link - 3BMI was linked to the de- velopment of diabetes. association - 20the results revealed a significant association between obesity and diabetes Statistical words因果 causally related is not causally related to an increased risk of CVD 44 causal linkThese results suggest a caus

18、al link between obesity and the risk of diabetes causal effectto evaluate causal effects of obesity on disease causally associatedobesity is causally associated with an increased risk of MI Statistical pharases KaplanMeier curves45Statistical pharases Conditional logistic regression analysis条件逻辑回归分析

19、 46 Cox proportional hazards regression model Cox比例风险回归模型06 长难句解析 刘磊通读全句断句找主、谓、宾语找动词确定定语（或从句）修饰的名词调整句式（主被动）调整语序48一点微小的长难句翻译建议The strengths of the present study include the unique design used to evaluate causal effects of obesity on disease and death （after adjusting for genetic influences） and the l

20、arge cohort of MZ twins with information on multiple covariates. 49参考翻译：本研究的优势包括用于评估调整基因影响后肥胖对于疾病和死亡因果效应的独特设计，和有多协变量信息的大型同卵双胞胎群组。 In particular, studies have demonstrated that |clinical and laboratory factors are improved or resolved in most patients with type 2 diabetes after bariatric surgery, whi

21、ch often results in a more than 50% weight loss in the first 2 postoperative years.50参考翻译：特别是研究表明，大多数2型糖尿病患者减肥手术后的临床或实验室指标已经改善或提高，而手术经常导致术后2年超过50的减重。The authors proposed possible explanations for the lack of effect | included insufficient weight loss in the intervention group and the consequences of

22、 more effective routine medical management of CVD in the control group.51参考翻译：作者为实验缺乏效果提出了可能的解释，包括：干预组减重不足和对照组中心血管疾病更有效的常规医疗管理。 A total of 5145 overweight or obese (mean BMI) patients with type 2 diabetes were assigned to an intervention program focusing on weight reduction through caloric restricti

23、on and increased physical activity or to a control group.52参考翻译： 5145例超重或肥胖（平均BMI）的2型糖尿病患者被分配到干预组或对照组，其中干预组通过限制热量和增加锻炼减重。 Several explanations for this obesity paradox have been suggested, including selection bias53一点微小的讨论：主动 OR 被动一些的解释被提出 OR 我们提出了的解释OR ？07 难点与趣事 倪瑞晨难点Original sentenseand educationa

24、l level were retrieved from the Statistics Sweden database in the year before the SALT study.55Retrieve难点回收recover, reclaim, retrieve挽回redeem, retrieve纠正correct, rectify, redress, right, cure, retrieve复取retrieve谷歌翻译56Retrieve有道翻译计 检索；恢复；重新得到难点检索(729)回收(107)反演(225)Cnki57Retrieve例句Retrieve the Databas

25、es of OCLC with Firstsearch用Firstsearch检索OCLC数据库难点Original sentenseTo evaluate the association between BMI and the primary end point in the total cohort of MZ twins in a nonpairwise fashion58Fashion难点时尚fashion, vogue方式manner, mode, fashion, style, pattern, way of life方法method, way, means, modus, fas

26、hion, medium谷歌翻译59Fashion有道翻译n. 时尚；时装；样式；时髦人物难点If you do something in a particular fashion or after a particular fashion, you do it in that way. 方式例：There is another drug called DHE that works in a similar fashion.另有一种叫作二氢埃托啡的药作用相似。例句60Fashion难点Original sentenseExplanations could include residual co

27、nfounding from unknown diseases or general frailty not captured at baseline in leaner twins.61General frailty难点一般脆弱谷歌翻译62有道翻译一般的脆弱General frailty难点General frailty 一般 脆弱性通用 脆弱总体Cnki63例句Further investigations are needed to clarify whether some factors, such as advanced age, being widowed, mental impai

28、rment, certain chronic conditions and general frailty are more closely related to falls among the elderly. 建议进一步研究某些因素 ,如高龄、寡 (鳏 )居、智力损害、某些慢性病、虚弱等 ,是否与老年人跌倒有更密切的关系。General frailty难点跨筛选寿命双床？谷歌翻译64有道翻译筛选在寿命的双胞胎？Screening Across Lifespan Twin (SALT) 难点终生一生整个寿命贯穿一生Across lifespan65Screening Across Lifes

29、pan Twin (SALT) 难点Original sentenseSmoking habit was classified as never smoked, previous smoking, or currently smoking, and pack-years of smoking were estimated.66Pack-years of smoking难点包年谷歌翻译67有道翻译吸烟指数包年例句：He states that he has had the cough for quite some time and attributes it to his 40-pack-year history of smoking cigarettes. 患者提及偶发干咳。患者咳嗽很有一段时间了，并将其归咎于既往40年的吸烟史。Pack-years of smoking难点The pack-year is a unit for measuring the amount a person has smoked over a long period of time.Wikipedia68公式Number of pack-years = (packs smoked pe