中国老年人群不同体重指数水平下血红蛋白浓度与全因死亡率的关联分析——基于CLHLS数据的实证研究  

Hemoglobin and all-cause mortality in China elderly population with varying degree of body mass index:Analysis of CLHLS data

作　　者：刘学奎[1] 刘莹[1] 耿厚法 徐伟 梁军[1] Liu Xuekui;Liu Ying;Geng Houfa;Xu Wei;Liang Jun(Department of Endocrinology,Xuzhou Central Hopsital,Xuzhou 221000,China)

机构地区：[1]徐州市中心医院内分泌科,221009

出　　处：《中华内分泌代谢杂志》2022年第3期214-218,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：探讨不同体重指数水平下血红蛋白浓度与中国老年人群全因死亡率的相关性。数据来源于2008年至2018年中国老年健康影响因素跟踪调查数据库和2008年生物医学指标数据库,共1449名参与者被纳入本研究,随访期间失落247名。按照血红蛋白水平分为3组:低血红蛋白组(男性<120 g/L、女性<110 g/L)、正常血红蛋白组(120 g/L≤男性<160 g/L、110 g/L≤女性<150 g/L)和高血红蛋白组(男性≥160 g/L、女性≥150 g/L)。按照体重指数水平分为3组:超重或肥胖组(体重指数≥25 kg/m^(2))、正常体重组(18.5 kg/m^(2)≤体重指数<25 kg/m^(2))和消瘦组(体重指数<18.5 kg/m^(2))。分析不同组间血红蛋白与全因死亡率之间的相关性。人群中,贫血人群占比23.1%(334/1449),消瘦人群占比26.6%(385/1449);随访期间,共死亡778例,其中低血红蛋白组死亡233例,占其总数的77.2%,高血红蛋白组死亡87例,占其总数的55.4%。在体重指数的亚组分析中,同时存在消瘦和贫血的老年人群累积死亡率最高(79.1%),超重或肥胖合并血红蛋白高水平人群累积死亡率均最低(46.2%),差异有统计学意义。在低体重指数的人群中,血红蛋白每增加一个单位,死亡风险下降0.572(95%CI 0.446~0.734,P<0.001);在正常体重指数人群中,血红蛋白每增加一个单位,死亡风险下降0.717(0.620~0.829,P<0.001)。血红蛋白水平降低增加了老年人群全因死亡风险,这种相关性在低体重指数人群中表现尤为突出。To explore the association between hemoglobin and all-cause mortality in China elderly population varying level of body mass index.The data were from Chinese Longitudinal Healthy Longevity Survey 2008 to 2018.A total of 1449 elderly participants were included with 247 lost to follow-up.According to the hemoglobin levels,the participants were divided into three groups:low hemoglobin group(male<120 g/L,female<110 g/L),normal hemoglobin group(120 g/L≤male<160 g/L,110 g/L≤female<150 g/L),and high hemoglobin group(male≥160 g/L,female≥150 g/L).According to the BMI levels,the data was divided into three groups:overweight or obesity(BMI≥25 kg/m^(2)),normal weight(18.5 kg/m^(2)≤BMI<25 kg/m^(2)),and malnutrition(BMI<18.5 kg/m^(2)).Differences of association between hemoglobin and mortality were analyzed.In this dataset,the constituent ratio of anemia was 23.1%(334/1449),and malnutrition was 26.6%(385/1449).During the follow-up,a total of 778 participants died.Among whom,233 cases(77.2%)were in the low hemoglobin group and 87 cases(55.4%)in the high hemoglobin group.In the BMI subgroup analysis,the people combined malnutrition and anemia had the highest cumulative mortality rate(79.1%),and the people with overweight and higher hemoglobin had a lower cumulative mortality rate(46.2%).In people with low BMI,increase in hemoglobin by one category reduced the risk of death by 0.572(95%CI 0.446-0.734,P<0.001).In people with normal BMI,improvement in hemoglobin by one category reduced the risk of death by 0.717(95%CI 0.620-0.829,P<0.001).The reduction of hemoglobin levels increases the risk of all-cause mortality rate.And this correlation is particularly prominent in the population with low BMI.

关 键 词：血红蛋白浓度 营养不良 贫血 全因死亡率 

分 类 号：R556[医药卫生—血液循环系统疾病]