| 董文红,吴晶,余灿清,宋兴月,吕筠,郭彧,卞铮,杨玲,陈怡平,陈铮鸣,潘安,李立明.中国10个地区成年人自评健康状况与全因死亡、心血管疾病死亡风险的关联研究[J].Chinese journal of Epidemiology,2021,42(5):763-770 |
| 中国10个地区成年人自评健康状况与全因死亡、心血管疾病死亡风险的关联研究 |
| Self-rated health measures and their relations to all-cause and cardiovascular mortality in adults from 10 regions of China |
| Received:June 22, 2020 |
| DOI：10.3760/cma.j.cn112338-20200622-00872 |
| KeyWord: 自评健康状况 心血管疾病 死亡 队列研究 |
| English Key Word: Self-rated health status Cardiovascular disease Mortality Cohort study |
| FundProject:国家重点研发计划精准医学研究重点项目（2017YFC0907504，2016YFC0900500，2016YFC0900501，2016YFC0900504）；中国香港KadoorieCharitable基金 |
| Author Name | Affiliation | E-mail | | Dong Wenhong | Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | | | Wu Jing | Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | | | Yu Canqing | Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China | | | Song Xingyue | Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | | | Lyu Jun | Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China | | | Guo Yu | Chinese Academy of Medical Sciences, Beijing 100730, China | | | Bian Zheng | Chinese Academy of Medical Sciences, Beijing 100730, China | | | Yang Ling | Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health/Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK | | | Chen Yiping | Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health/Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK | | | Chen Zhengming | Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health/Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK | | | Pan An | Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | panan@hust.edu.cn | | Li Liming | Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China | lmleeph@vip.163.com |
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| Abstract: |
| 目的 分析自评健康状况（SRH）与全因死亡和心血管疾病（CVD）死亡风险的关联性。方法 研究对象来自中国慢性病前瞻性研究，剔除有逻辑错误和信息缺失的个体，最终纳入512 713名研究对象。SRH在基线问卷调查时搜集，包括整体自评健康状况（GSRH）及与同龄人相比自评健康状况（ASRH）；死亡事件及原因通过链接到疾病死亡监测系统和国家医保系统获取。采用多因素校正的Cox比例风险回归模型估计SRH与全因死亡和CVD死亡的关联性。结果 在平均9.9年的随访时间里，共观测到44 065例死亡事件，其中17 648例死于CVD。与GSRH良好的人相比，GSRH较差的研究对象未来发生全因死亡及CVD死亡的风险效应（HR）值（95%CI）分别是1.84（1.78~1.91）和1.94（1.82~2.06）。与ASRH更好的人相比，ASRH更差的研究对象未来发生全因死亡及CVD死亡的HR值（95%CI）分别是1.75（1.70~1.81）和1.83（1.73~1.92）。两种SRH指标与全因死亡和CVD死亡的关联性在各个亚组分析和敏感性分析中都保持显著，且SRH越差、死亡风险越高。结论 SRH简单易用，SRH越差、个体未来全因死亡/CVD死亡风险越高。 |
| English Abstract: |
| Objective To examine the association between self-rated health status (SRH) and all-cause and cardiovascular mortality. Methods A total of 512 713 adults aged 30-79 years from 10 areas of China were followed from baseline (2004-2008) until 31 December 2016 in the China Kadoorie Biobank study. Global and age-comparative SRH[general self-rated health status (GSRH) and age-comparative self-rated health status (ASRH), respectively] were asked in baseline questionnaires. Causes for mortality were monitored through linkage with established Disease Surveillance Point system and health insurance records. Multivariable Cox proportional regression models were used to estimate the HRs and 95%CIs for the association between SRH measures and all-cause or cardiovascular mortality. Results During an average of 9.9 years' follow-up, 44 065 deaths were recorded, among which 17 648 were from cardiovascular disease. Compared with excellent GSRH, the HR(95%CI) for all-cause and cardiovascular mortality associated with poor GSRH was 1.84(1.78-1.91) and 1.94(1.82-2.06), respectively. Relative to better ASRH, the HR(95%CI) for all-cause and cardiovascular mortality associated with worse ASRH was 1.75(1.70-1.81) and 1.83(1.73-1.92), respectively. Conclusion In this large prospective cohort study in China, participants reporting poor GSRH or worse ASRH had significantly higher risk of all-cause and cardiovascular mortality. |
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