中国成年人体质指数和腰围与肾结石住院风险的关联研究  

Associations of body mass index and waist circumference with hospitalization risk of kidney stones in Chinese adults

作　　者：汪涵 樊俊宁 余灿清[1] 郭彧 裴培[3] 陈君石 陈铮鸣[5] 吕筠[1] 李立明[1] 中国慢性病前瞻性研究项目协作组 Wang Han;Fan Junning;Yu Canqing;Guo Yu;Pei Pei;Chen Junshi;Chen Zhengming;Lyu Jun;Li Liming(Department of Epidemiology and Biostatistics,School of Public Health,Peking University/Peking University Center for Public Health and Epidemic Preparedness and Response/Key Laboratory of Molecular Cardiovascular Sciences(Peking University),Ministry of Education,Beijing 100191,China;Fuwai Hospital Chinese Academy of Medical Sciences,National Center for Cardiovascular Diseases,Beijing 100037,China;Chinese Academy of Medical Sciences,Beijing 100730,China;China National Center for Food Safety Risk Assessment,Beijing 100022,China;Nuffield Department of Population Health,Center for Clinical and Epidemiological Studies/Population Health Research Unit,Medical Research Council,University of Oxford,Oxford OX37LF,UK)

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系/北京大学公众健康与重大疫情防控战略研究中心/北京大学分子心血管学教育部重点实验室,北京100191 [2]中国医学科学院阜外医院,国家心血管病中心,北京100037 [3]中国医学科学院,北京100730 [4]国家食品安全风险评估中心,北京100022 [5]英国牛津大学医学研究委员会人口健康研究组/临床与流行病学研究中心纳菲尔德人群健康系OX37LF [6]不详

出　　处：《中华流行病学杂志》2022年第2期154-161,共8页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(81941018);国家重点研发计划(2016YFC0900500,2016YFC0900501,2016YFC0900504);中国香港Kadoorie Charitable基金。

摘　　要：目的分析中国成年人体质指数(BMI)和腰围与肾结石住院风险的关联。方法本研究利用中国慢性病前瞻性研究的长期随访数据,剔除基线自报患有慢性肾病、恶性肿瘤、BMI和腰围为极端值的研究对象,最终纳入502096人。采用Cox比例风险回归模型分析BMI和腰围与肾结石住院风险之间的关联。结果研究对象随访(10.7±2.2)年,随访期间记录肾结石导致的首次住院共12396例。调整潜在混杂因素后,以BMI(kg/m^(2))20.5~22.4者为参照组,<18.5、18.5~20.4、22.5~23.9、24.0~25.9、26.0~27.9、28.0~29.9、≥30.0者的风险比(HR)(95%CI)依次为:0.96(0.87~1.05)、0.94(0.88~1.00)、1.11(1.05~1.17)、1.25(1.18~1.32)、1.29(1.21~1.37)、1.39(1.28~1.50)、1.54(1.40~1.71);BMI每增加1 kg/m^(2),肾结石住院风险的HR值增加4%(HR=1.04,95%CI:1.04~1.05)。与腰围(cm)75.0~79.9者相比,<65.0、65.0~69.9、70.0~74.9、80.0~84.9、85.0~89.9、90.0~94.9、≥95.0者的HR值(95%CI)依次为:0.82(0.74~0.91)、0.85(0.80~0.92)、0.95(0.89~1.00)、1.16(1.09~1.22)、1.22(1.15~1.30)、1.28(1.19~1.38)、1.46(1.35~1.58);腰围每增加5 cm,肾结石住院风险的HR值增加9%(HR=1.09,95%CI:1.08~1.10)。在上述模型中相互调整BMI或腰围后,BMI与肾结石住院风险的关联消失,腰围与肾结石住院风险的关联趋势不变。结论中国成年人BMI和腰围与肾结石住院风险呈正向关联,腰围增加是肾结石住院风险升高的独立危险因素。Objective To evaluate the associations of body mass index(BMI)and waist circumference with hospitalization risk of kidney stones in Chinese adults.Methods This study used long-term follow-up data from China Kadoorie Biobank.After excluding participants with chronic kidney disease,cancer,and extreme BMI or waist circumference values at baseline,502096 participants were included in the present analysis.Cox proportional hazards regression models were used to estimate the associations of BMI and waist circumference with hospitalization risk of kidney stones.Results During an average follow-up period of(10.7±2.2)years,12396 participants were hospitalized for the first time with kidney stones.Using the participants with BMI(kg/m^(2))of 20.5-22.4 as reference,the multivariable-adjusted HR(95%CI)for those with BMI of<18.5,18.5-20.4,22.5-23.9,24.0-25.9,26.0-27.9,28.0-29.9,and≥30.0 were 0.96(0.87-1.05),0.94(0.88-1.00),1.11(1.05-1.17),1.25(1.18-1.32),1.29(1.21-1.37),1.39(1.28-1.50),and 1.54(1.40-1.71),respectively.For every 1 kg/m^(2) increase in BMI,the HR of kidney stones hospitalization increased by 4%(HR=1.04,95%CI:1.04-1.05).Using the participants with waist circumference(cm)of 75.0-79.9 as reference,the multivariable-adjusted HR(95%CI)for those with waist circumference of<65.0,65.0-69.9,70.0-74.9,80.0-84.9,85.0-89.9,90.0-94.9,and≥95.0 were 0.82(0.74-0.91),0.85(0.80-0.92),0.95(0.89-1.00),1.16(1.09-1.22),1.22(1.15-1.30),1.28(1.19-1.38),and 1.46(1.35-1.58),respectively.For every 5 cm increase in waist circumference,the HR of kidney stones hospitalization increased by 9%(HR=1.09,95%CI:1.08-1.10).After mutually adjusting for BMI and waist circumference in the above models,the association between BMI and hospitalization risk of kidney stones disappeared.In contrast,the association between waist circumference and hospitalization risk of kidney stones remained unchanged.Conclusions BMI and waist circumference were positively associated with hospitalization risk of kidney stones.The increased waist circumference was an in

关 键 词：体质指数 腰围 肾结石 队列研究 中国人 

分 类 号：R692.4[医药卫生—泌尿科学]