中国10个地区老年人长寿影响因素的前瞻性队列研究

李烁宇; 张艺倩; 肖梦; 孙点剑一; 余灿清; 王月清; 裴培; 陈君石; 陈铮鸣; 李立明; 吕筠; 代表中国慢性病前瞻性研究项目协作组

Abstract

李烁宇,张艺倩,肖梦,孙点剑一,余灿清,王月清,裴培,陈君石,陈铮鸣,李立明,吕筠,代表中国慢性病前瞻性研究项目协作组.中国10个地区老年人长寿影响因素的前瞻性队列研究[J].Chinese journal of Epidemiology,2024,45(1):26-34

中国10个地区老年人长寿影响因素的前瞻性队列研究

A prospective cohort study of factors associated with longevity in older adults in 10 areas of China

Received:July 24, 2023

DOI：10.3760/cma.j.cn112338-20230724-00035

KeyWord: 长寿生活方式影响因素队列研究中国人

English Key Word: Longevity Lifestyle factor Risk factor Cohort study Chinese

FundProject:中国工程院2022年战略研究与咨询项目（2022-XBZD-30-3）；国家自然科学基金（82192904，82192901，82192900，81941018）

Author Name	Affiliation	E-mail
Li Shuoyu	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Zhang Yiqian	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
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 Key Laboratory of Epidemiology of Major Diseases(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 Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China
Wang Yueqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Pei Pei	Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, 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, United Kingdom
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 Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, 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 Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China	lvjun@bjmu.edu.cn
for the China Kadoorie Biobank Collaborative Group

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Abstract:

目的分析影响中国人群长寿的社会人口学特征和生活方式相关因素。方法基于中国慢性病前瞻性研究（CKB），排除1938年12月31日之后出生者，纳入分析51 870人，将到达年龄定义为研究对象在随访期间死亡时的年龄或截至2018年12月31日的年龄，根据到达年龄对研究对象进行分组：非长寿组（80岁以前死亡）和长寿组（到达年龄≥80岁），长寿组进一步分组为长寿但死亡、长寿且存活。社会人口学和生活方式信息为2004-2008年基线调查时采集。采用无序多分类logistic回归模型分析暴露因素与结局的关联，以非长寿组为参照组。结果纳入分析的51 870人的基线年龄范围为65~79岁，经过（10.2±3.5）年的随访，38 841人长寿，其中30 354人存活。以男性、农村人群、非在婚者、家庭年收入<10 000元者和小学及以下文化程度者为参照，女性、城市人群、在婚者、家庭年收入≥20 000元者、大专及以上文化程度者长寿且存活的OR值（95%CI）分别为1.68（1.58~1.78）、1.69（1.61~1.78）、1.15（1.10~1.21）、1.44（1.36~1.53）和1.32（1.19~1.48）。对于生活方式相关因素，总体力活动水平每增加4 MET-h/d，长寿且存活的OR值（95%CI）为1.09（1.08~1.10）。分别以从不或偶尔吸烟者、非每周饮酒者、正常体重者（BMI 18.5~23.9 kg/m²）和腰围<85 cm（男性）/<80 cm（女性）者为参照组，吸烟或因病戒烟者中每日吸烟≥20支者长寿且存活的OR值（95%CI）为0.64（0.60~0.69），每周但非每日饮酒者和每日纯酒精摄入量<30 g者为1.29（1.14~1.46）和1.13（1.01~1.26），低体重、超重和肥胖者依次为0.56（0.52~0.61）、1.27（1.19~1.36）和1.23（1.11~1.36），中心性肥胖者为0.86（0.79~0.93）。进一步按腰围进行分层分析，腰围<85 cm（男性）/<80 cm（女性）者中，BMI每增加5 kg/m²，长寿且存活的OR值（95%CI）为1.80（1.69~1.92）；而在腰围≥85 cm（男性）/≥80 cm（女性）者中，对应的OR值（95%CI）为1.02（0.96~1.08），两层关联效应值差异有统计学意义（交互检验P<0.001）。结论本研究发现女性、在婚者、高社会经济水平者、文化程度较高者以及生活方式健康者更有可能长寿。

English Abstract:

Objective To evaluate the associations of sociodemographic characteristics and lifestyle factors with longevity status in older adults in China. Methods After excluding those born after 31^st December 1938, a total of 51 870 older adults from the China Kadoorie Biobank (CKB) were included. The attained age was defined according to the survival age or age on 31^st December 2018. According to the attained age, the old persons were categorized into non-longevity (died before age 80 years) and longevity (attained age ≥80 years). The longevity group was further divided into two groups: longevity with death occurring before 2019, and longevity and survival to 2019. The information about socio-demographic characteristics and lifestyles was collected at the 2004-2008 baseline survey. Multinomial logistic regression models were used to analyze the associations between exposure factors and outcomes by taking the non-longevity group as the reference group. Results A total of 51 870 older adults aged 65-79 years in the baseline survey were included for analysis. During a follow-up for (10.2±3.5) years, 38 841 participants were longevity, and 30 354 participants still survived at the end of 2018. Compared to men, rural populations, non-married individuals, those with an annual household income of less than 10 000 yuan, and those with education levels of primary school or below, the adjusted ORs(95%CI) for longevity and survival to 2019 in women, urban residents, married individuals, those with annual household incomes ≥20 000 yuan, and those with education levels of college or university were 1.68 (1.58-1.78), 1.69 (1.61-1.78), 1.15 (1.10-1.21), 1.44 (1.36-1.53), and 1.32 (1.19-1.48), respectively. The OR (95%CI) for longevity and survival to 2019 was 1.09 (1.08-1.10) for those with an increase of 4 MET-hour/day in total physical activity level. With those who never or almost never smoked, had no alcohol drinking every week, had normal weight (BMI: 18.5-23.9 kg/m²), and WC <85 cm (man)/<80 cm (woman) as the reference groups, the ORs(95%CI) of longevity and survival to 2019 were 0.64 (0.60-0.69) for those smoking ≥20 cigarettes per day, 1.29 (1.14-1.46) for those with alcohol drinking every week, 1.13 (1.01-1.26) for those with pure alcohol drinking <30 g per day, 0.56 (0.52-0.61) for those being underweight, 1.27 (1.19-1.36) for those being overweight, 1.23 (1.11-1.36) for those with obesity, and 0.86 (0.79-0.93) for those with central obesity. Further stratified analysis by WC was performed. In the older adults with WC <85 cm (man)/<80 cm (woman), the ORs (95%CI) of longevity and survival was 1.80 (1.69-1.92) for those with each 5 kg/m² increase in BMI and 1.02 (0.96-1.08) for those with WC ≥85 cm (man)/≥80 cm (woman). There was a statistically significant difference in the association between BMI and longevity between the two WC groups (interaction test P<0.001). Conclusion This study showed that women, the married, those with higher socioeconomic status and education level, and those with healthy lifestyles were more likely to achieve longevity.

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