中国10个地区56~69岁成年人过早死亡及其影响因素的前瞻性队列研究

王月清; 肖梦; 吕筠; 余灿清; 郭彧; 裴培; 陈君石; 陈铮鸣; 孙点剑一; 李立明

Abstract

王月清,肖梦,吕筠,余灿清,郭彧,裴培,陈君石,陈铮鸣,孙点剑一,李立明.中国10个地区56~69岁成年人过早死亡及其影响因素的前瞻性队列研究[J].Chinese journal of Epidemiology,2022,43(7):1010-1018

中国10个地区56~69岁成年人过早死亡及其影响因素的前瞻性队列研究

A prospective cohort study of premature death and influencing factors in adults aged 56-69 years from 10 regions of China

Received:December 10, 2021

DOI：10.3760/cma.j.cn112338-20211210-00968

KeyWord: 过早死亡前瞻性队列研究危险因素

English Key Word: Premature death Prospective cohort Risk factors

FundProject:国家自然科学基金(81941018,82103920);中国香港Kadoorie Charitable基金;英国Wellcome Trust(212946/Z/18/Z,202922/Z/16/Z,104085/Z/14/Z,088158/Z/09/Z)

Author Name	Affiliation	E-mail
Wang Yueqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Xiao Meng	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Guo Yu	Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing 100037, China
Pei Pei	Chinese Academy of Medical Sciences, Beijing 100730, China
Chen Junshi	China National Center for Food Safety Risk Assessment, Beijing 100022, China
Chen Zhengming	Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Sun Dianjianyi	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China	dsun1@bjmu.edu.cn
Li Liming	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China

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Abstract:

目的描述和分析中国10个地区近10万成年人随访10年间过早死亡（死亡年龄<70岁）的流行病学特征及其影响因素。方法数据来源于CKB研究基线调查（人口学特征、生活方式、体格指标等）及随访监测（截至2017年12月31日的健康结局事件），分地区、性别、基线生活方式等变量描述研究人群10年随访期间内的过早死亡，并分析其死因情况，并利用Cox比例风险回归模型分析过早死亡的相关影响因素。结果研究纳入99 993名研究对象（56~69岁），经过10年随访，每1 000人年的过早死亡率为7.15，死因别死因以癌症（36.9%）和心脑血管疾病（35.2%）为主，过早死亡率（/1 000人年）表现为农村高于城市（9.11 vs. 4.78），北方高于南方（8.46 vs. 6.41），男性高于女性（9.57 vs. 5.31），随基线年龄增加而降低（均P<0.05）。过早死亡风险随吸烟量增加而增加，既往饮酒者和重度饮酒者（饮酒量≥60 g/d）过早死亡风险较高［HR值分别为1.25（95%CI：1.16~1.36）、1.20（95%CI：1.08~1.34）］；过早死亡风险随体力活动水平增加而降低；相对于体重正常和非中心性肥胖者，低体重者与中心性肥胖者过早死亡风险更高［HR值分别为1.67（95%CI：1.55~1.81）、1.13（95%CI：1.05~1.21）］。结论我国56~69岁成年人10年随访过早死亡以癌症和心脑血管疾病为主，存在明显的社会经人口济学特征差异，且其风险受到生活方式及体格指标等多因素影响。

English Abstract:

Objective To describe and analyze the epidemiological characteristics of premature death (death before age of 70 years) and related risk factors in approximate 100 000 adults recruited from 10 regions of China during a 10-year follow-up. Methods Data, including demographic characteristics, lifestyle and physical indicators as well as health outcomes as of December 31, 2017, were obtained from baseline survey and long-term follow-up of the China Kadoorie Biobank (CKB) study. All-cause and cause-specific premature death in different areas, in men and women and in people with different lifestyles were analyzed. Cox proportional risk model was used to analyze the associations between baseline factors and premature death. Results A total of 99 993 participants aged 56-69 years were included in the study. During 10 years of follow-up, 7 530 premature deaths were recorded and the premature death rate was 7.15 per 1 000 person-years. The main causes of premature death were cancer and cardiovascular and cerebrovascular diseases. The premature mortality rate was higher in rural areas, in northern region and in men, and decreased with age (P<0.05). Premature death was more likely to occur in smokers, and a dose-response relationship was observed. Compared with non-drinkers, the risk for premature death was higher in ex-drinkers (HR:1.25[95%CI:1.16-1.36]) and heavy drinkers (average alcohol consumption ≥ 60 g/d) (HR:1.20[95%CI:1.08-1.34]). The risk for premature death decreased with the increase of physical activity. Low body weight and central obesity were independently associated with increased risk for premature death (HR:1.67[95%CI:1.55-1.81] and 1.13[95%CI:1.05-1.21], respectively). Conclusions The main causes of premature death in adults aged 56-69 years in China during 10-year follow-up were cancer and cardiovascular and cerebrovascular diseases. The premature mortality rate varied with socioeconomic and demographic characteristics. The risk for premature death was influenced by multi factors, such as lifestyle and physical conditions.

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