Abstract
吕跃斌,殷召雪,罗杰斯,施小明,曾毅.中国长寿地区高龄老年人贫血及其3年死亡风险关系的研究[J].Chinese journal of Epidemiology,2015,36(7):682-686
中国长寿地区高龄老年人贫血及其3年死亡风险关系的研究
Association between anemia and 3-year all-cause mortality among oldest old people in longevity areas in China
Received:December 29, 2014  
DOI:10.3760/cma.j.issn.0254-6450.2015.07.004
KeyWord: 贫血  死亡  高龄老年人  Cox回归
English Key Word: Anemia  Mortality  Oldest old people  Cox regression
FundProject:国家自然科学基金(81273160,71233001,71110107025); 联合国人口基金和美国国立卫生研究院(R01 AG23627)
Author NameAffiliationE-mail
Lyu Yuebin Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Yin Zhaoxue Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Luo Jiesi Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Shi Xiaoming Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China shixm@chinacdc.cn 
Zeng Yi Center for Study of Healthy Aging and Development Studies, Peking University
Center for the Study of Aging and Human Development and the Geriatic Division of School of Medicine, Duke University 
zengyi68@gmail.com 
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Abstract:
      目的 探讨中国长寿地区80岁以上老年人贫血及其3年死亡风险的关系。方法2009年6月中国老年健康影响因素跟踪调查(CLHLS)项目在中国7个长寿地区选取929名80岁以上老年人进行问卷调查、身体测量和血生化检测,于2012年8月随访生存结局。采用Cox比例风险模型分析贫血和不同Hb水平对死亡风险的影响。结果 929名老年人贫血患病率为49.6%,贫血主要类型为正常细胞性贫血。经3年随访共计447人死亡,死亡率为49.8%,其中贫血组为56.0%,高于非贫血组的43.3%(P<0.01)。校正混杂因素后,贫血组3年死亡风险高于非贫血组25%(HR=1.25,95%CI:1.03~1.52),除正常细胞性贫血与老年人死亡风险的无关外,大细胞性贫血、单纯小细胞性贫血和小细胞低色素性贫血与老年人的高死亡风险相关联,高龄老年人不同类型贫血的死亡风险存在性别差异。与低Hb水平者相比,高Hb水平者死亡风险较低(HR=0.87,95%CI:0.77~0.99),且女性更显著。结论 贫血或低Hb水平与中国长寿地区高龄老年人较高的死亡风险相关联。
English Abstract:
      Objective To explore the association between anemia and 3-year all-cause mortality among the oldest old people in longevity areas in China. Methods In August 2012, questionnaire survey, health examination and blood test were conducted among 929 old people aged ≥80 years in 7 longevity areas in China, who were included in Chinese Longitudinal Healthy Longevity Survey(CLHLS) 2009. Cox regression model was used to evaluate the association between anemia or different hemoglobin levels and mortality. Results Among the 929 subjects, the prevalence of anemia was 49.6%, the main form of anemia was normocytic anemia. During the three year follow-up period, a total of 447 subjects died, the overall mortality was 49.8% (56.0% in subjects with anemia and 43.3% in subjects without anemia). Compared with the subjects without anemia, the mortality risk increased by 25% in the subjects with anemia after adjusting confounding factors (HR=1.25, 95%CI:1.03-1.52). Macrocytic anemia, simplex microcytic anemia and microcytic hypochromic anemia were all associated with the increased mortality in the oldest old people. Compared with the subjects with low hemoglobin concentration, the subjects with high hemoglobin concentration had a lower mortality risk, and the association was more obvious in women. Conclusion Anemia and low hemoglobin concentration were associated with higher mortality risk in the oldest old people in China, indicating the importance of anemia prevention and treatment among this population.
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