Abstract
王浩,杜怀东,胡如英,钱一建,王春梅,谢开婿,陈玲琍,潘东霞,卞铮,郭彧,俞敏,李立明,陈铮鸣.浙江省成年人饮茶与脑卒中发生关联的前瞻性研究[J].Chinese journal of Epidemiology,2018,39(9):1200-1205
浙江省成年人饮茶与脑卒中发生关联的前瞻性研究
Association between tea drinking and stroke in adults in Zhejiang province: a prospective study
Received:February 28, 2018  
DOI:10.3760/cma.j.issn.0254-6450.2018.09.011
KeyWord: 饮茶  脑卒中  前瞻性研究
English Key Word: Tea drinking  Stroke  Prospective study
FundProject:国家重点研发计划精准医学研究重点专项(2016YFC0900500,2016YFC0900501,2016YFC0900502,2016YFC0900504);中国香港KadoorieCharitable基金;英国WellcomeTrust(202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z)
Author NameAffiliationE-mail
Wang Hao Department of Chronic and Non-communicable Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China  
Du Huaidong Clinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom  
Hu Ruying Department of Chronic and Non-communicable Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China  
Qian Yijian Department of Chronic and Non-communicable Disease Prevention and Control, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314500, China  
Wang Chunmei Department of Chronic and Non-communicable Disease Prevention and Control, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314500, China  
Xie Kaixu Department of Chronic and Non-communicable Disease Prevention and Control, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314500, China  
Chen Lingli Department of Chronic and Non-communicable Disease Prevention and Control, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314500, China  
Pan Dongxia Department of Chronic and Non-communicable Disease Prevention and Control, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314500, China  
Bian Zheng Department of China Kadoorie Biobank, Chinese Academy of Medical Sciences, Beijing 102308, China  
Guo Yu Department of China Kadoorie Biobank, Chinese Academy of Medical Sciences, Beijing 102308, China  
Yu Min Department of Chronic and Non-communicable Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China myu@cdc.zj.cn 
Li Liming School of Public Health, Peking University, Beijing 100191, China lmlee@pumc.edu.cn 
Chen Zhengming Clinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom zhengming.chen@ctsu.ox.ac.uk 
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Abstract:
      目的 探讨饮茶和成年人脑卒中发病的前瞻性关联。方法 使用“中国慢性病前瞻性研究”(CKB)浙江省桐乡市数据,剔除基线时自报患有恶性肿瘤、心脏病、脑卒中和糖尿病患者后,纳入分析30~79岁53 916人。采用Cox比例风险模型计算脑卒中发病风险比(HR)。结果 桐乡居民最主要的饮茶品种为红茶(79.78%),其次是绿茶(20.08%)。调查对象中,每周饮茶者的比例为31.27%,其中男性和女性分别为60.24%和10.30%;调查对象累计随访391 512人年(平均随访7.26年)。随访期间,1 487例男性和1 769例女性被新诊断为脑卒中。在调整了人口社会学因素、生活方式、BMI、腰围和SBP等多种危险因素后,脑卒中发病风险随日均饮茶克数的增加而降低,趋势性检验差异有统计学意义(P=0.000 6)。与非每周饮茶者相比,日均饮茶0.1~、3.0~和≥5.0 g者脑卒中发病HR值(95% CI)分别为0.93(0.85~1.00)、0.88(0.77~0.99)和0.79(0.69~0.89)。与非每周饮茶者相比,日均饮茶≥5 g者脑卒中发病HR值(95% CI)在吸烟和不吸烟人群中分别为0.71(0.59~0.86)和0.97(0.77~1.21),差异有统计学意义(P=0.040 0),在不饮酒与饮酒的人群中分别为0.70(0.58~0.84)和0.96(0.76~1.22),差异有统计学意义(P=0.040 0),在中心性肥胖与非中心性肥胖人群中分别为0.60(0.44~0.81)和0.86(0.73~1.01),差异有统计学意义(P=0.040 0)。结论 饮茶可以降低脑卒中发病风险。与非每周饮茶者相比,饮茶的保护作用在吸烟者、不饮酒者以及中心性肥胖者中更明显。
English Abstract:
      Objective To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province. Methods After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis. Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke. Results The main type of drinking tea was black tea (79.78%), followed by green tea (20.08%). Of the 53 916 participants, the proportion of participants who drank tea at least once per week was 31.27%. The corresponding proportions for men and women were 60.24% and 10.30%, respectively. Among 391 512 person-years of the follow-up program (median 7.26 years), a total of 1 487 men and 1 769 women were diagnosed with stroke. After adjusting for socio-demographic status, lifestyle, BMI, waist circumference, and systolic blood pressure, HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6). Compared with participants who did not drink tea weekly, the HRs for incident stroke in those consuming tea 0.1-, 3.0- and ≥ 5.0 g/d were 0.93 (95% CI:0.85-1.00), 0.88 (95% CI:0.77-0.99) and 0.79 (95% CI:0.69-0.89), respectively. The HRs for incident stroke in smokers and non-smokers who consumed tea ≥ 5.0 g/d were 0.71 (95% CI:0.59-0.86) and 0.97 (95% CI:0.77-1.21), respectively, compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0). The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95% CI:0.76-1.22) and 0.70 (95% CI:0.58-0.84), respectively (P=0.040 0). The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95% CI:0.44-0.81) and 0.86 (95% CI:0.73-1.01), respectively (P=0.040 0). Conclusion Tea drinking had an effect on reducing the possibility of incident stroke, especially among those who were current smokers, non-alcohol drinkers and central obese.
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