文章摘要
翟屹,任泽萍,魏国华,贾永军,张梅,张坚,姜勇,米生权,王卓群,赵艳芳,宋鹏坤,殷召雪,赵文华.山西营养与慢性病家庭队列人群体质指数与死亡率的关系[J].中华流行病学杂志,2019,40(4):433-439
山西营养与慢性病家庭队列人群体质指数与死亡率的关系
Body mass index and related attribution to all-cause mortality in adults of Family Cohort of Nutrition and Chronic Diseases in Shanxi province
投稿时间:2018-08-02  
DOI:10.3760/cma.j.issn.0254-6450.2019.04.012
中文关键词: 体质指数;死亡率;队列
英文关键词: Body mass index;All-cause mortality;Cohort study
基金项目:国家重点研发计划(2016YFC0901001);国家科技支撑项目(2008BAI56B04)
作者单位E-mail
翟屹 首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心, 北京 100070  
任泽萍 山西省疾病预防控制中心慢病所, 太原 030012  
魏国华 山西省忻州市忻府区疾病预防控制中心 034000  
贾永军 山西省天镇县疾病预防控制中心 038200  
张梅 中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050  
张坚 中国疾病预防控制中心营养与健康所老年营养室, 北京 100050  
姜勇 首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心, 北京 100070  
米生权 北京联合大学健康与环境学院食品科学系 100023  
王卓群 中国疾病预防控制中心慢性非传染性疾病预防控制中心科教室, 北京 100050  
赵艳芳 中国疾病预防控制中心慢性非传染性疾病预防控制中心科教室, 北京 100050  
宋鹏坤 中国疾病预防控制中心营养与健康所老年营养室, 北京 100050  
殷召雪 中国疾病预防控制中心慢病防治与社区卫生处, 北京 102206  
赵文华 中国疾病预防控制中心营养与健康所老年营养室, 北京 100050 zhaowh@chinacdc.cn 
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中文摘要:
      目的 分析山西营养与慢性病家庭队列人群BMI与总死亡率的关系。方法 以"2002年中国居民营养与健康状况调查"山西省调查人群为基线建立队列,于2015年12月至2016年3月对研究对象进行随访调查,对逝者进行死因回顾调查。2002年基线信息完整的≥ 18岁研究对象7 007人,随访到5 360人,随访率为76.5%。将研究对象按BMI分为8组,计算死亡率,以死亡率最低组作为参照,采用Cox比例风险回归模型估计全人群、分性别、年龄(≥ 60岁、<60岁)的各组死亡风险比(HR)及95% CI,模型调整基线年龄、性别、吸烟、饮酒、文化程度等因素,并进行敏感性分析。结果 共随访67 129人年,平均随访12.5年,死亡615人,队列总死亡率为916/10万人年。BMI为26.0~27.9 kg/m2组死亡率最低,以该组为参照组,多因素调整后,BMI<18.5、18.5~19.9、22.0~23.9和≥ 30.0 kg/m2组的死亡风险明显升高,调整HR值(95% CI)分别为1.90(1.26~2.86)、1.68(1.15~2.45)、1.49(1.08~2.06)和1.72(1.07~2.76)。对于≥ 60岁老年人,BMI<18.5 kg/m2组的死亡风险明显升高,调整HR值(95% CI)为1.94(1.20~3.15)。结论 BMI ≤ 19.9、22.0~23.9及≥ 30.0 kg/m2均会增加全因死亡风险。除关注肥胖外,低体重营养不良造成的老年人高死亡风险应特别引起重视。
英文摘要:
      Objective To assess the relationship between body mass index (BMI) and mortality in adults of Shanxi, China. Methods Baseline data were from the ‘2002 China Nutrition and Health Survey’ in Shanxi province. All the death-related investigation and follow-up visits were carried out from December 2015 to March 2016. The follow-up program covered 5 360 people from all the 7 007 participants aged 18 years and over that having complete core information, with a rate as 76.5%. Participants of this study were divided into eight groups, according to the appearance of BMI. Taking the group with the lowest mortality density as the reference group, Cox regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of deaths by the whole population, gender and age groups (≥ 60 years, <60 years). Results were then adjusted by age, gender, smoking, alcohol use and education level from the baseline survey. Sensitivity analysis was also conducted. Results Results from the study showed that among the total number of 67 129 person-years from the average period of 12.5 years, there were 615 deaths occurred, with the mortality density as 916 per 100 000 person-years. Taking the BMI range of 26.0-27.9 kg/m2 as the reference, the aHRs of death increased to 1.90 (95% CI:1.26-2.86), 1.68 (95% CI:1.15-2.45), 1.49 (95% CI:1.08-2.06) and 1.72 (95% CI:1.07-2.76) after the multivariate adjustment, in these four groups (BMI<18.5, 18.5-19.9, 22.0-23.9 and ≥ 30.0 kg/m2), respectively. Low body weight (BMI<18.5 kg/m2) was associated with higher risks of death in the elderly of ≥ 60 years, with the aHR of death as 1.94 (95% CI:1.20-3.15). Conclusions When BMI appeared as ≤ 19.9 kg/m2, 22.0-23.9 kg/m2 and ≥ 30.0 kg/m2, the risks of death would increase. In addition to programs that focusing on obesity, special attention should be paid to the high risk of mortality which was caused by low-weight and malnutrition in the elderly.
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