河南省成年居民生活方式与死亡结局关联的前瞻性研究

范雷; 戚敏杰; 邢天放; 侯刚; 张寒雪; 梁森; 韩莉; 丁文燮; 康锴; 韩志伟

Abstract

范雷,戚敏杰,邢天放,侯刚,张寒雪,梁森,韩莉,丁文燮,康锴,韩志伟.河南省成年居民生活方式与死亡结局关联的前瞻性研究[J].Chinese journal of Epidemiology,2024,45(8):1052-1058

河南省成年居民生活方式与死亡结局关联的前瞻性研究

A prospective study on the association between lifestyles and mortality risk in adults in Henan Province

Received:April 16, 2024

DOI：10.3760/cma.j.cn112338-20240416-00198

KeyWord: 健康生活方式死亡风险前瞻性研究

English Key Word: Healthy lifestyle Mortality risk Prospective study

FundProject:国家重大公共卫生项目；河南省卫生科技攻关项目（LHGJ20220176）

Author Name	Affiliation	E-mail
Fan Lei	Department of Chronic Non-communicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Qi Minjie	Department of Chronic Non-communicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Xing Tianfang	Department of Chronic Non-communicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Hou Gang	Department of Disease Control and Prevention, Henan Provincial People's Hospital, Zhengzhou 450003, China
Zhang Hanxue	Department of Chronic Non-communicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Liang Sen	Department of Chronic Non-communicable Disease Control and Prevention, Puyang Center for Disease Control and Prevention of Henan, Puyang 457000, China
Han Li	Department of Chronic Non-communicable Disease Control and Prevention, Hebi Center for Disease Control and Prevention of Henan, Hebi 458000, China
Ding Wenxie	Department of Chronic Non-communicable Disease Control and Prevention, Shangqiu Center for Disease Control and Prevention of Henan, Shangqiu 476000, China
Kang Kai	Department of Chronic Non-communicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Han Zhiwei	Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China	hncdcncd@126.com

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Abstract:

目的分析河南省成年居民健康生活方式与死亡风险的关联。方法以河南省16个县（区）参加心血管病高危人群早期筛查与综合干预项目的99 133名成年居民为研究对象，通过询问调查获取健康生活方式类型，通过中国CDC死因监测系统获取终点事件信息。采用Cox比例风险回归模型分析健康生活方式与死亡风险关联和人群归因分值（PAF）。结果河南省成年居民有1种健康生活方式的比例为50.6%，有全部4种健康生活方式的比例为0.1%。平均随访4.5年，共观察到死亡病例2 685人，因心脑血管病死亡病例1 283人。不吸烟、适量饮酒、充足运动和健康饮食人群死亡风险分别为0.85（95%CI：0.77~0.94）、0.75（95%CI：0.63~0.89）、0.73（95%CI：0.67~0.79）和0.86（95%CI：0.77~0.96），对全因死亡的调整PAF分别为5.2%（95%CI：2.5%~7.9%）、24.0%（95%CI：10.7%~36.4%）、19.4%（95%CI：13.8%~24.8%）和12.3%（95%CI：3.4%~20.9%）。坚持健康生活方式数量越多，对死亡结局影响越大，有全部4种健康生活方式的调整PAF上升至49.1%。结论坚持健康生活方式可以降低河南省成年居民死亡风险，健康生活方式数量越多，死亡风险越低。

English Abstract:

Objective To analyze the association between healthy lifestyle and mortality among Henan Province 35-74 years old individuals. Methods Data from the programme of screening and intervention subjects with high-risk cardiovascular disease 99 133 adults were analyzed in a provincial cohort study of 16 counties. Four healthy lifestyle behaviors were assessed based on a questionnaire survey. Information on mortality endpoints was retrieved from the national death surveillance system. Cox proportional hazards regression models were used to estimate the associations between healthy lifestyles, mortality risk and population attributable fraction (PAF). Results Out of the adult participants in Henan, 50.6% adhered to a healthy lifestyle, and only 0.1% adhered to 4 healthy lifestyle behaviours. During a mean of 4.5 years, 2 685 all-cause death and 1 283 cardiovascular deaths were documented. The decreased risk of mortality among individuals with non-smoking, moderate drinking, adequate exercise and healthy diet were 0.85 (95%CI: 0.77-0.94), 0.75 (95%CI: 0.63-0.89), 0.73 (95%CI: 0.67-0.79) and 0.86 (95%CI: 0.77-0.96), while the adjusted PAF for all-cause deaths were 5.2% (95%CI: 2.5%-7.9%), 24.0% (95%CI: 10.7%-36.4%), 19.4% (95%CI: 13.8%-24.8%) and 12.3% (95%CI: 3.4%-20.9%), respectively. A combined healthy lifestyle can bring more health benefits. Adherence to 4 healthy lifestyle behaviours could avoid 49.1% of all-cause death. Conclusion Adherence to a healthy lifestyle can reduce the risk of death, and participants with a healthy lifestyle had a lower mortality risk.

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