限食辟谷试验干预观察和基于比例风险回归模型的限食降压的预后估计  

Effects of a Fasting Bibu Trial and Prognosis Estimation of Blood Pressure Reduction Based on the Proportional Hazards Model

作　　者：蒋志铭 苗芬[1] 黄园 李烨[1] JIANG Zhiming;MIAO Fen;HUANG Yuan;LI Ye(Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences,Shenzhen 518055,China;University of Chinese Acaderay of Sciences,Beijing 100049,China;Shenzhen Catic Wellness Group Co.,Ltd.,Shenzhen 518000,China)

机构地区：[1]中国科学院深圳先进技术研究院,深圳518055 [2]中国科学院大学,北京100049 [3]深圳市中航健康时尚集团股份有限公司,深圳518000

出　　处：《集成技术》2020年第4期25-35,共11页Journal of Integration Technology

基　　金：国家自然科学基金项目(61771465);深圳科技计划项目(20180703145202065);中国人民解放军总后勤部重大项目(AWS13C008);中国科学院战略先导科技专项项目(XDB38040200)。

摘　　要：随着人们物质生活水平的提高及生活方式的改变,高血压等慢性病的患病率呈快速增长趋势。多项动物和人体试验研究表明,一定程度限制摄入热量(限食干预)正在成为一种可有效控制体重、降低肥胖率、改善血压的治疗方法。该研究报告了一项在中国进行的149人限食辟谷试验,受试人群在连续5天的限食干预后体重、身体质量指数、腰围等生理指标对比基线值均出现显著下降(P<0.001)。其中,处于高血压状态的受试者(包括2级和1级高血压)在干预后收缩压和舒张压的下降幅度分别为11.2 mmHg(95%置信区间为7.5~14.9 mmHg,P<0.001)和7.2 mmHg(95%置信区间为4.7~9.7 mmHg,P<0.001),正常血压的受试者收缩压和舒张压均未出现明显变化。在此基础上,该研究进一步通过比例风险回归模型实现对个体进行限食干预后降压效果的预后估计,并绘制出直观方便、易于使用的列线图,模型经内部重采样1000次校正后的一致性指数(C-index)为0.891。With the improvement of people’s material lives and changes in lifestyles,the prevalence of chronic diseases such as hypertension has shown a rapidly growing trend.Numerous animal and human fasting trials have reported that fasting has been emerging as an effective tool to control weight and lower blood pressure,having a profound health benefit.In a fasting trial involving 149 participants in China,the subjects’body weight,BMI(body mass index)and waist circumference all significantly decreased from baseline after 5 consecutive days of fasting intervention(P<0.001).The magnitude of systolic and diastolic blood pressure(BP)reduction in subjects with hypertension was-11.2 mmHg(-14.9 to-7.5 mmHg,95%CI(confidence intervals),P<0.001)and-7.2 mmHg(-9.7 to-4.7,95%CI,P<0.001)after 5-day fasting intervention,respectively.No significant reduction occurred in systolic and diastolic BP of participants with normal BP.Then we implemented a further assessment of antihypertensive effects during the period of fasting trial by developing an easy-to-use nomogram based on proportional hazards regression,and the nomogram in our study achieved a bootstrap-corrected concordance index(C-index)of 0.891.

关 键 词：限食 辟谷 高血压 比例风险回归模型 列线图 

分 类 号：R544.1[医药卫生—心血管疾病]