文章摘要
沈丹洋,张曼晖,郭晓敏,殷鹏,周脉耕,马吉祥,谭吉宾.农村男性人群体质指数与心血管疾病死亡关系的前瞻性随访研究[J].中华流行病学杂志,2020,41(12):2072-2079
农村男性人群体质指数与心血管疾病死亡关系的前瞻性随访研究
Boss mass index and mortality from cardiovascular disease in China: a prospective study in rural men
收稿日期:2020-05-15  出版日期:2020-12-25
DOI:10.3760/cma.j.cn112338-20200515-00728
中文关键词: 男性;体质指数;心血管疾病;死亡风险;前瞻性研究
英文关键词: Male;Boby mass index;Cardiovascular disease;Risk of death;Prospective study
基金项目:
作者单位E-mail
沈丹洋 中国疾病预防控制中心, 北京 102206  
张曼晖 北京大学第三医院 100191  
郭晓敏 中国疾病预防控制中心, 北京 102206  
殷鹏 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  
周脉耕 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  
马吉祥 中国疾病预防控制中心, 北京 102206  
谭吉宾 中国疾病预防控制中心, 北京 102206 tanjb@chinacdc.cn 
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中文摘要:
      目的 探究农村男性人群体质指数和心血管疾病死亡风险的关系。方法 以唐河、凤凰县农村地区纳入“影响成年人死亡相关危险因素的前瞻性研究”项目的22 282名≥40岁的男性人群为研究对象,应用Cox比例风险回归模型计算基线不同BMI分组的人群在随访期间的心血管疾病(CVD)死亡的风险(HR)值。结果 研究对象人群随访年限为(19.1±8.7)年,随访期间共死亡10 828人,死亡比例为48.6%,有4 504例死亡归因于心血管疾病。其中1 279例死于缺血性心脏病(IHD),1 201例死于缺血性卒中(IS),1 317例死于出血性卒中(HS),707例死于其他心血管疾病。用Cox比例风险回归模型(调整地区、年龄、民族、文化程度、职业、吸烟、饮酒、血压等因素)进行多因素分析显示,以BMI<18 kg/m2为参照,当20 kg/m2≤BMI<22 kg/m2时患CVD的死亡风险最低,HR=0.95(95% CI:0.83~1.09),但从统计学分析,各组BMI的死亡风险差异均无统计学意义(P>0.05);当20 kg/m2≤BMI<22 kg/m2时人群患IHD的死亡风险最低,HR=0.64(95% CI:0.52~0.80)(P<0.05),当BMI≥24 kg/m2时人群IHD死亡风险与BMI<18 kg/m2人群的风险之间差异无统计学意义(P>0.05);IS死亡风险与人群BMI变化无显著性差异(P>0.05);当18 kg/m2≤BMI<24 kg/m2时人群患HS的死亡风险高于BMI<18 kg/m2组人群(P<0.05),其中26 kg/m2≤BMI<28 kg/m2时人群患HS死亡风险最高,HR=1.88(95% CI:1.18~2.99)。结论 偏瘦或正常体重人群的CVD、IHD的死亡风险最低,超重人群的HS死亡风险较高,保持合理体重可降低心血管疾病患者的死亡风险。
英文摘要:
      Objective To assess the relationship between body mass index (BMI) and death risk of cardiovascular disease (CVD) in rural male population. Methods 22 282 men aged 40 years older in Tanghe county and Fenghuang county from the cohort of the "Prospective Study on Adult Behavior and Health Risk Factors in China" were selected as subjects of this study. Cox regression model was used to calculate the hazard ratios (HRs) of the death of CVD during the follow-up period with different BMI groups at baseline. Results The average follow-up period in the two counties was (19.1±8.7) years and 10 828 (48.6%) people died during the follow-up period. 4 504 deaths were attributed to CVD. Among the deaths of CVD, 1 279 cases died of ischemic heart disease (IHD), ischemic stroke (IS) died in 1 201, cases died of died of 1 317 hemorrhagic stroke (HS), other 707 cases. Compared to population with BMI <18 kg/m2, Cox regression model (adjusting factors of region, age, nationality, education level, occupation, smoking, drinking, blood pressure, blood pressure, etc.) showed that people with BMI between 20-22 kg/m2 had the lowest risk of CVD death (HR=0.95, 95% CI:0.83-1.09). But the difference was not statistically significant among each BMI group (P>0.05). The risk of IHD death was the lowest in the population with BMI between 20-22 kg/m2 (P<0.05) (HR=0.64, 95% CI:0.52-0.80). There was no statistically significant difference between the risk of IHD death in the population with BMI ≥ 24 kg/m2 and that in the population with BMI <18 kg/m2 (P>0.05). There was no statistically significant difference between the risk of IS death and BMI (P>0.05). The death risk of HS in the population with BMI between 18-24 kg/m2 was higher than that in the population with BMI <18 kg/m2 (P<0.05). The death risk of the population with BMI between 26-28 kg/m2 was the highest (HR=1.88, 95% CI:1.18-2.99). Conclusions The mortality risk of CVD and IHD was the lowest in lean or normal weight group, and HS was higher in overweight group. Maintaining a reasonable weight can reduce the risk of death in patients with CVD.
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