文章摘要
朱国玲,陈朔华,樊学东,樊家成,门秀丽,张艳敏,孙秋,张冰,吉瑞更,王珊,佟博,张杰,吴寿岭,蒋晓忠.基线BMI水平对急性胰腺炎发病风险影响的前瞻性队列研究[J].中华流行病学杂志,2021,42(12):2131-2137
基线BMI水平对急性胰腺炎发病风险影响的前瞻性队列研究
A prospective cohort study on BMI levels and risk of acute pancreatitis
收稿日期:2020-10-27  出版日期:2021-12-16
DOI:10.3760/cma.j.cn112338-20201027-01286
中文关键词: 肥胖;体质指数;急性胰腺炎;队列研究
英文关键词: Obesity;BMI;Acute pancreatitis;Cohort studies
基金项目:河北省卫生与计划委员会专项科研基金(20171437)
作者单位E-mail
朱国玲 开滦总医院消化内科, 唐山 063000  
陈朔华 开滦员工健康保障中心, 唐山 063000  
樊学东 开滦总医院心胸外科, 唐山 063000  
樊家成 内蒙古科技大学包头医学院, 包头 014010  
门秀丽 华北理工大学, 唐山 063000  
张艳敏 唐山中心医院消化内科, 唐山 063000  
孙秋 开滦总医院肝胆外科三病区, 唐山 063000  
张冰 开滦总医院肝胆外科三病区, 唐山 063000  
吉瑞更 开滦总医院肝胆外科三病区, 唐山 063000  
王珊 开滦总医院消化内科, 唐山 063000  
佟博 开滦总医院消化内科, 唐山 063000  
张杰 开滦总医院消化内科, 唐山 063000  
吴寿岭 开滦总医院心内科, 唐山 063000  
蒋晓忠 开滦总医院消化内科, 唐山 063000 tyjiangxiaozhong@126.com 
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中文摘要:
      目的 探讨不同BMI水平对新发急性胰腺炎(AP)发病风险的影响。方法 观察人群来自开滦研究队列,按基线BMI水平分为:正常体重组(BMI<24 kg/m2),超重组(BMI 24~28 kg/m2)和肥胖组(BMI ≥ 28 kg/m2),观察不同BMI组人群新发AP发病密度。经Kaplan-Meier法绘制生存曲线,计算累积发病率,以log-rank法进行检验,并采用多因素Cox比例风险回归模型分析基线BMI水平对新发AP事件的影响。结果 共纳入统计分析者123 841人,随访(11.94±2.13)年,共发生AP 395例,总人群AP发病密度为2.67例/万人年,正常体重组、超重组和肥胖组AP发病密度分别为2.20、2.72和3.58例/万人年,累积发病率分别为0.32%、0.40%和0.49%。经log-rank检验,累积发病率的组间比较差异有统计学意义(χ2=13.17,P<0.01)。校正多因素Cox比例风险回归模型分析显示,与正常体重组比较,肥胖组AP发病风险增加,HR=1.45(95%CI:1.10~1.92)。对年龄及性别进行分层,年龄<60岁时,肥胖组发生AP的HR=1.58(95%CI:1.14~2.19);男性肥胖组发生AP的HR=1.40(95%CI:1.03~1.90)。排除随访2年内发生的AP病例,肥胖组发生AP的HR=1.60(95%CI:1.18~2.15)。结论 肥胖是新发AP的危险因素,中青年男性肥胖人群发病风险更高。
英文摘要:
      Objective To investigate the effects of body mass index (BMI) levels at different baseline on the risk of new-onset acute pancreatitis (AP). Methods The subjects were from the Kailuan Study Cohort and divided into 3 groups according to baseline BMI levels:BMI<24 kg/m2, normal weight; BMI 24-28 kg/m2, overweight; BMI ≥ 28 kg/m2, obesity. The incidence of new-onset AP in these three groups was analyzed. The survival curve was plotted by Kaplan-Meier method, the cumulative incidence was calculated and tested by log-rank method. Multivariate Cox proportional hazards regression model was used to calculate HR of baseline BMI levels for AP.Results A total of 123 841 subjects were included and followed up for (11.94±2.13) years, during which, 395 cases were found with AP. The incidence of AP was 2.67 per 10 000 person years in total population, and the incidences of AP were 2.20, 2.72 and 3.58 per 10 000 person-years in the normal, overweight and obesity groups, respectively. The cumulative incidences of AP was 0.32%, 0.40% and 0.49% in normal, overweight and obesity groups, respectively, which showed a significant inter-group difference by log-rank test (χ2=13.17,P<0.01). The results of multivariable adjusted Cox proportional hazards regression model analysis indicated that obesity group (HR=1.45, 95%CI:1.10-1.92) had a higher risk for AP compared with the normal BMI group. The subgroup analyses by age and sex showed that compared with the normal weight group,the HRs for AP in the obesity group was 1.58(95%CI:1.14-2.19) and 1.40(95%CI:1.03-1.90) among subjects younger than 60 years old and male subjects, respectively. After excluded onset AP within two years from baseline,with a control group from normal weight,the results of multivariate Cox proportional hazards regression model analysis indicated that the AP in the obesity group was 1.60 (95%CI:1.18-2.15). Conclusion Obesity may increase the risk of developing AP, particularly among young and middle-aged men.
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