我国60岁及以上老年人血红蛋白与心率增快的关联研究

张笑; 张梅; 李纯; 黄正京; 于梦婷; 王丽敏

Abstract

张笑,张梅,李纯,黄正京,于梦婷,王丽敏.我国60岁及以上老年人血红蛋白与心率增快的关联研究[J].Chinese journal of Epidemiology,2023,44(2):214-220

我国60岁及以上老年人血红蛋白与心率增快的关联研究

Association between hemoglobin level and increased heart rate among people aged 60 years or above in China

Received:June 10, 2022

DOI：10.3760/cma.j.cn112338-20220519-00434

KeyWord: 老年人血红蛋白心率增快 U形关联

English Key Word: Elderly Hemoglobin Increased heart rate U-shaped association

FundProject:福建省中青年骨干人才培养项目（2021GGA037）；福建省自然科学基金（2020J01094）；福建省科技创新平台建设（2019Y2001）

Author Name	Affiliation	E-mail
Zhang Xiao	Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Zhang Mei	Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Li Chun	Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Huang Zhengjing	Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Yu Mengting	Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Limin	Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China	wanglimin@ncncd.chinacdc.cn

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Abstract:

目的探讨我国老年人血红蛋白水平与心率增快的关联性。方法研究对象来源于2018年中国慢性病及危险因素监测中≥60岁的老年人。根据WHO关于贫血严重程度的定义和非贫血者血红蛋白浓度的三分位数，将男性和女性研究对象分别分为5组。考虑群内相关性后用多因素logistic回归分析血红蛋白分组与心率增快风险的关联，用限制性立方样条探讨两者间的剂量反应关系。结果最终纳入≥60岁老年人71 409名。血红蛋白浓度为（142.6±17.7）g/L，心率为（78.5±12.2）次/min。调整混杂因素后，与男性血红蛋白130~147 g/L组相比，<110、110~129、148~158、≥159 g/L组心率增快的优势比（OR值）分别为1.39（95%CI：1.17~1.64）、1.10（95%CI：0.99~1.21）、1.16（95%CI：1.09~1.23）、1.42（95%CI：1.33~1.51）。与女性血红蛋白120~133 g/L组相比，<110、110~119、134~142、≥143 g/L组心率增快的OR值分别为1.17（95%CI：1.02~1.33）、1.02（95%CI：0.93~1.12）、1.13（95%CI：1.07~1.19）、1.40（95%CI：1.32~1.48）。用年龄和肥胖分层的结果表明60~74岁男性中血红蛋白<110 g/L组较130~147 g/L组心率增快的OR值为1.41（95%CI：1.15~1.73），不肥胖女性中血红蛋白<110 g/L组较120~133 g/L组心率增快的OR值为1.22（95%CI：1.07~1.40），未在≥75岁男性和肥胖女性中观察到类似结果。限制性立方样条的结果提示血红蛋白与心率增快风险间存在U形关联。结论较低和较高水平血红蛋白均与我国老年人心率增快风险有关。控制血红蛋白在一定范围可能有助于老年人的心率管理，从而减少心血管疾病的发生。

English Abstract:

Objective To examine the association between hemoglobin level and increased heart rate among the Chinese elderly. Methods The study subjects were those 60 years or above and participated in the 2018 of China Chronic Disease and Risk Factor Surveillance. According to the hemoglobin level used to define anemia severity and corresponding tertiles among non-anemia, men and women were separately categorized into five groups. Multivariable logistic regression of increased heart rate on hemoglobin groups was performed, with confounders and intracluster correlation taken into account. Additionally, a restricted cubic spline was employed to interrogate their dose-response relationship. Results A total of 71 409 elderly were finally included in the analysis. The weighted mean of hemoglobin concentration and heart rate was (142.6±17.7) g/L and (78.5±12.2) times/minute, respectively. In comparison to men with hemoglobin concentration between 130 and 147 g/L or women between 120 and 133 g/L, the odds ratio (OR) of increased heart rate were 1.39 (95%CI:1.17-1.64), 1.10 (95%CI:0.99-1.21), 1.16 (95%CI:1.09-1.23), and 1.42 (95%CI:1.33-1.51) for men with a hemoglobin concentration of <110, 110-129, 148-158, and ≥ 159 g/L, respectively, and was 1.17 (95%CI:1.02-1.33), 1.02 (95%CI:0.93-1.12), 1.13 (95%CI:1.07-1.19), and 1.40 (95%CI:1.32-1.48) for women with a hemoglobin concentration of <110, 110-119, 134-142, and ≥ 143 g/L, respectively. Higher odds of increased heart rate associated with a hemoglobin concentration of <110 g/L were only observed among men aged 60-74 years (OR=1.41, 95%CI:1.15-1.73) and non-obese women (OR=1.22, 95%CI:1.07-1.40) but not their counterparts. The results from restricted cubic spline suggested that hemoglobin concentration, as a continuous variable, showed a U-shaped association with odds of increased heart rate. Conclusions Lower and higher hemoglobin levels were positively associated with the risk of increased heart rate among the Chinese elderly. Maintaining hemoglobin levels within a specific range may be helpful for the management of heart rate, which in turn reduces the burden of cardiovascular diseases among older adults.

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