基于人群的身体活动水平与脑卒中发病风险的队列研究

娄阁; 李思萱; 龚清海; 朱银潮; 应焱燕; 王永; 刘杨; 董文兰; 刘世炜; 李辉

Abstract

娄阁,李思萱,龚清海,朱银潮,应焱燕,王永,刘杨,董文兰,刘世炜,李辉.基于人群的身体活动水平与脑卒中发病风险的队列研究[J].Chinese journal of Epidemiology,2021,42(6):1030-1036

基于人群的身体活动水平与脑卒中发病风险的队列研究

Association between physical activity and risk of stroke among adults aged 40 years and above: a prospective cohort study

Received:October 10, 2020

DOI：10.3760/cma.j.cn112338-20201010-01221

KeyWord: 脑卒中危险因素身体活动

English Key Word: Stroke Risk factors Physical activity

FundProject:国家自然科学基金（81872721）；国家重点研发计划防控研究专项课题（2017YFC1310902）；宁波市医学品牌学科（PPXK2018-10）

Author Name	Affiliation	E-mail
Lou Ge	Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Li Sixuan	Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
Gong Qinghai	Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
Zhu Yinchao	Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
Ying Yanyan	Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
Wang Yong	Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
Liu Yang	Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Dong Wenlan	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Liu Shiwei	Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing 100050, China National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China	shiwei_liu@aliyun.com
Li Hui	Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China	lihui4329@163.com

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Abstract:

目的探讨≥40岁成年人身体活动水平对脑卒中发病的影响。方法通过宁波市2015年具有人群代表性的成年人慢性病监测调查获得身体活动和人口特征基线数据，利用2015-2019年宁波市慢性病监测信息协同管理系统获得脑卒中发病数据，将数据库进行匹配形成队列。身体活动按照每周身体活动量（METs）分为低、中等和高强度身体活动。采用Cox回归分析计算不同身体活动分类脑卒中的发病风险。结果 2015年基线调查共纳入3 353名研究对象，截至2019年12月31日，随访时间（50.28±2.54）个月，共发生脑卒中事件31人，累积发病率为242/10万。多因素Cox回归分析结果显示，在控制性别、年龄、文化程度、吸烟情况、饮酒情况、BMI、是否高血压等因素后，身体活动强度越高，脑卒中发病风险越低，平均降低37.9%（HR=0.621，95%CI：0.393~0.983）。与低强度身体活动者相比，高强度身体活动者脑卒中发病风险降低了63.1%（HR=0.369，95%CI：0.139~0.976），而中等强度身体活动者与低强度身体活动者的脑卒中发病风险差异无统计学意义（HR=0.712，95%CI：0.323~1.569）。结论身体活动强度越高，脑卒中发病风险越低，应加强社区支持性环境建设，提高人群身体活动水平。

English Abstract:

Objective To examine the effect of physical activity (PA) on the incident risk of stroke among adults aged 40 years and above. Methods The baseline data including PA and demographic characteristics were obtained from the Adult Chronic Disease Surveillance with population representativeness in Ningbo in 2015. The follow-up data of interested health outcomes from 2015 to 2019 were retrieved from a population-based Integrated Noncommunicable Disease Collaborative Management System in Ningbo. The two databases were matched to form a queue. PA was divided into three levels of low-intensity, moderate-intensity, and vigorous-intensity according to the metabolic equivalents (METs) spent per week. Cox regression model was used to calculate the hazard ratio (HR) and 95% confidence interval. Results A total of 3 353 subjects were included at baseline survey in 2015. Until Dec 31, 2019, there had been 31 stroke events had occurred since then, with accumulative incidence rate of 242/100 000, and an average follow-up time of (50.28±2.54) months. When adjusted for gender, age, education level, smoking status, alcohol consumption, BMI and hypertension, multivariate Cox regression analysis showed that greater PA was associated with a 37.9% reduction of incidence of stroke (HR=0.621,95%CI:0.393-0.983). Compared with those who had low-intensity PA, those who were with vigorous-intensity. PA appeared associated with a 63.1% decrease in the incidence of stroke (HR=0.369, 95%CI:0.139-0.976). However, there was no statistical significance with moderate-intensity PA (HR=0.712,95%CI:0.323-1.569), noticed.Conclusions Greater PA is likely to reduce the incidence of stroke. Our findings indicated that people should be encouraged to increase the PA level and developing a healthy supportive environment in the community.

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