北京农村老年人群握力值与全因死亡的关联研究  

Correlation between hand grip strength value and all-cause death in Beijing rural elderly

作　　者：石岳庭 王盛书 杨姗姗 刘少华 李雪航 陈仕敏 李志强 李皓炜 王建华 李蓉蓉 杨钧涵 李怀昊 鲍颖慧 何耀 刘淼[2] SHI Yueting;WANG Shengshu;YANG Shanshan;LIU Shaohua;LI Xuehang;CHEN Shimin;LI Zhiqiang;LI Haowei;WANG Jianhua;LI Rongrong;YANG Junhan;LI Huaihao;BAO Yinghui;HE Yao;LIU Miao(Medical School of Chinese People's Liberation Army,Beijing 100853,China;Department of Anti Nuclear,Biological and Chemical Medicine,Graduate School,Chinese People's Liberation Army General Hospital,Beijing 100853,China;不详)

机构地区：[1]解放军医学院,北京100853 [2]中国人民解放军总医院研究生院三防教研室,北京100853 [3]中国人民解放军总医院第二医学中心老年医学研究所,衰老及相关疾病研究北京市重点实验室,国家老年疾病临床医学研究中心,北京100853 [4]中国人民解放军总医院第一医学中心疾病预防控制科,北京100853

出　　处：《中国慢性病预防与控制》2024年第1期2-7,14,共7页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家自然科学基金(82173589、82173590);首都卫生发展科研专项(首发2022-2G-5031);国家重点研发计划(2022YFC2503605)。

摘　　要：目的探究北京农村老年人群握力值与全因死亡的关联,为明确该人群握力水平与全因死亡的关联提供科学依据。方法数据来源于北京城乡老年人群健康综合研究(Beijing Elderly Comprehensive Health Cohort Study,BECHCS)。于2014年6—9月,采用两阶段随机抽样方法选取北京市密云区巨各庄镇和冯家峪镇的老年居民(≥60岁)为研究对象,进行问卷调查、体格检查和实验室检测,每2~3年随访1次,随访截至2021年3月31日。使用SPSS 26.0和R 4.2.3软件进行t检验、χ^(2)检验、Fisher精确检验。使用Kaplan-Meier法绘制不同握力农村老年人的累计生存曲线。使用Cox比例风险回归模型分析基线握力值与全因死亡风险之间的关联,并按照性别、年龄进行亚组分析。结果共纳入2004名研究对象,年龄中位数为68.0岁(P25~P75:64.0~74.0岁)。握力值中位数为22.08 kg(P25~P75:16.00~29.95 kg),其中低握力915人(45.7%),正常握力1089人(54.3%)。截至2021年3月31日,研究的中位随访时间为80.36月(P25~P75:68.93~81.06月),死亡率为11.5%(231/2004),累计死亡密度为15.7/万人月。多因素Cox比例风险回归模型分析结果显示,与低握力值组相比,正常握力值组农村老年人全因死亡风险降低36.7%(HR=0.633,95%CI:0.475~0.846,P<0.01),握力值每增加5 kg,农村老年人全因死亡风险降低12.8%(HR=0.872,95%CI:0.808~0.940,P<0.01)。按性别分层结果显示,在男性农村老年人中,与低握力值组相比,正常握力值组全因死亡风险降低43.3%(HR=0.567,95%CI:0.386~0.833,P<0.05),握力值每增加5 kg,全因死亡风险降低11.7%(HR=0.883,95%CI:0.808~0.964,P<0.05)。在女性农村老年人中,握力值每增加5 kg,全因死亡风险降低15.9%(HR=0.841,95%CI:0.717~0.985,P<0.05)。按年龄分层结果显示,在60~69岁农村老年人群中,与低握力值组相比,正常握力值组全因死亡风险降低45.7%(HR=0.543,95%CI:0.319~0.924,P<0.05),握力值每增加5 kg,全因死亡风险降低15.2%(HR=0.848,Objective To explore the correlation between hand grip strength(HGS)and all-cause death in the rural elderly of Beijing,and provide the scientific basis for understanding the correlation between HGS and all-cause death in rural elderly.Methods Data were from the Beijing Elderly Comprehensive Health Cohort Study(BECHCS).From June to September 2014,twostage random sampling method was used to select the elderly residents(≥60 years old)in Jugezhuang town and Fengjiayu town of Miyun district as the subjects.The investigation was conducted with questionnaires,physical examinations and laboratory test,and one time of following up every 2-3 years until March 31,2021.The t test,χ^(2) tests and Fisher's precision probability test were used to analyze the data.The used software was SPSS 26.0 and R 4.2.3.The Kaplan-Meier method was used to depict the cumulative survival curves in the rural elderly with different grip strengths.The Cox proportional hazards regression models were used to analyze the correlation between HGS and all-cause death in the rural elderly,the subgroup analysis performed according to gender and age.Results The included subjects were 2004 cases,the age median was 68.00 years old(P25-P75:64.00-74.00 years old).The HGS median was 22.08 kg(P25-P75:16.00-29.95 kg),915 cases(45.7%)had low HGS and 1089 cases(54.3%)had normal HGS.As of March 31,2021,the median of follow-up duration of the study was 80.36 months(P25-P75:68.93-81.06 months).The mortality was 11.5%(231 cases/2004 cases),and the accumulative total death density was 15.7/104 person-months.Multivariate Cox proportional risk regression model showed that as compared with the low HGS group,the risk of all-cause death in normal HGS group decreased by 36.7%(HR=0.633,95%CI:0.475-0.846,P<0.01),and when the HGS value increased 5 kg,the risk of allcause death in rural elderly decreased by 12.8%(HR=0.872,95%CI:0.808-0.940,P<0.01).The results stratified by sex showed that in rural male elderly,as compared with the low HGS value group,the risk of all-cause de

关 键 词：农村老年人群 握力值 死亡风险 

分 类 号：R181.3[医药卫生—流行病学]