| 裴赫铭,张雅璐,李佳佳,武继磊,刘尚君,陈功.代谢综合征对中国中老年人日常生活活动能力影响的前瞻性队列研究[J].中华流行病学杂志,2022,43(1):65-71 |
| 代谢综合征对中国中老年人日常生活活动能力影响的前瞻性队列研究 |
| Influence of metabolic syndrome on activities of daily living in middle-aged and elderly population in China: a prospective cohort study |
| 收稿日期:2021-04-01 出版日期:2022-01-26 |
| DOI：10.3760/cma.j.cn112338-20210401-00265 |
| 中文关键词: 代谢综合征 日常生活活动能力 前瞻性队列研究 |
| 英文关键词: Metabolic syndrome Activities of daily living Prospective cohort study |
| 基金项目:国家重点研发计划（2018YFC2000603） |
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| 中文摘要: |
| 目的 探讨我国中老年人代谢综合征（MS）与日常生活活动能力（ADL）受损的关联，为提高人口健康预期寿命提供依据。方法 采用前瞻性队列研究设计，利用2011-2018年中国健康与养老追踪调查数据，以2011年数据为基线，分别在2013、2015和2018年随访ADL结局，且以2013年和2015年新进入队列的人群作为基线。剔除三次基线人群中已发生ADL的中老年人。采用Cox比例风险回归模型分析MS组分异常及异常数目对中老年人群ADL受损的影响。结果 观察总人年数为59 795人年，发生ADL受损人数为1 011人，发病密度为16.91/1 000人年。Cox模型分析结果显示，调整混杂因素后，分析MS组分异常种类发现，1种MS组分异常、血脂异常合并高血糖、超重/肥胖合并1种MS组分异常、高血压合并血脂异常、高血压合并高血糖及MS分别是没有MS组分异常中老年人发生ADL风险的1.29（95%CI：1.12~1.50）倍、1.32（95%CI：1.07~1.64）倍、1.78（95%CI：1.22~2.59）倍、2.48（95%CI：1.59~3.85）倍、3.51（95%CI：1.66~7.43）倍及1.80（95%CI：1.40~2.32）倍；与没有MS组分异常的中老年人比较，1、2和≥3种MS组分异常使中老年人ADL受损风险分别增加30%（HR=1.30，95%CI：1.13~1.51）、54%（HR=1.54，95%CI：1.28~1.85）和87%（HR=1.87，95%CI：1.45~2.41），随着MS组分异常数目的增加，中老年人发生ADL风险升高，并存在剂量-反应关系（P < 0.001）。结论 MS组分异常是中老年人发生ADL受损的重要危险因素，早期预防和干预超重/肥胖、高血压、血脂异常、高血糖及MS可以降低或延缓ADL受损的发生。 |
| 英文摘要: |
| Objective To examine the associations between metabolic syndrome (MS) and the risks for impaired activities of daily living (ADL) in the middle-aged and elderly population in China and provide basis for improving healthy life expectancy.Methods Prospective cohort study design was used in this study. Based the data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 and the baseline data in 2011, the follow up for ADL outcomes was conducted in 2013, 2015 and 2018 respectively, and the participants recruited in 2013 and 2015 were new baseline populations. The participants with impaired ADL in three baseline populations were excluded. Cox proportional hazard model was used to estimate the effect of different components and number of MS components on the risk for ADL impairment in the middle-aged and elderly population in China.Results In 59 795 person-years of follow-up, a total of 1 011 cases of ADL impairments were recorded. The incidence density of ADL impairment was 16.91 per 1 000 person-year; The findings of Cox regression analysis showed that compared with the middle aged and elderly people without MS, the risk for ADL impairments was 1.29 times higher (95%CI: 1.12-1.50) for those with one component of MS, 1.32 times higher (95%CI: 1.07-1.64) for those with hyperlipemia complicated with diabetes, 1.78 times higher (95%CI: 1.22-2.59) for those with obesity and one component of MS, 2.48 times higher (95%CI: 1.59-3.85) for those with hypertension complicated with hyperlipemia, 3.51 times higher (95%CI: 1.66-7.43) for those with hypertension complicated with diabetes, 1.80 times higher (95%CI: 1.40-2.32) for those with ≥3 MS, respectively. Compared with the middle-aged and elderly population without MS, the risk for impaired ADL increased by 30% (HR=1.30, 95%CI: 1.13-1.51), 54% (HR=1.54, 95%CI: 1.28-1.85) and 87% (HR=1.87, 95%CI: 1.45-2.41), respectively, in the middle-aged and elderly with one, two, and more than three components of MS, with a significant dose-response relationship that ADL impaired risks increased as the number of MS components increased (P < 0.001).Conclusions Our findings suggested that MS is a risk factor for ADL impairment in middle-aged and elderly population in China. Prevention and early intervention of obesity, hypertension, hyperlipemia, diabetes and metabolic syndrome could help to reduce or delay the incidence of ADL impairment. |
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