上海市社区居民静坐时间与全因死亡风险关系的队列研究  

A cohort study on the relationship between sedentary time and all-cause mortality in community residents in Shanghai

作　　者：张妍 段春梅 金亚清[1] 龚刚 赵琦[2] 赵根明[2] 彭谦[1] 于宏杰[1] ZHANG Yan;DUAN Chunmei;JIN Yaqin;GONG Gang;ZHAO Qi;ZHAO Genming;PENG Qian;YU Hongjie(General Office,Jiading District Center for Disease Control and Prevention,Shanghai 201899,China;School of Public Health,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市嘉定区疾病预防控制中心综合办,上海201899 [2]复旦大学公共卫生学院,上海200032

出　　处：《中华疾病控制杂志》2024年第6期672-677,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家重点研发计划精准医学重点专项(2017YFC0907000);上海市加强公共卫生体系建设三年行动计划优青项目(GWIV-11.2-YQ18);上海市疾病预防控制青年骨干人才培养项目(21QNGG22)。

摘　　要：目的探索上海市嘉定区20~74岁社区居民静坐时间与全因死亡风险的关系,为静坐行为指导提供科学依据。方法基于上海市高峰人群队列在嘉定区的项目点数据,排除静坐时间缺失的个体后,最终纳入10038人。个体的静坐时间通过基线调查问卷获得,个体的死亡信息通过链接死亡监测系统和主动的定向监测获取。采用Cox比例风险回归模型评估死亡风险。结果2017年7月1日―2022年12月31日,研究对象平均随访(5.4±0.4)年(共观察53985.7人年),随访期间发生205例死亡事件。静坐时间0~<4 h/d、4~<6 h/d、6~<8 h/d、≥8 h/d组的死亡率分别为1.8%(89/5040)、2.0%(54/2654)、2.8%(26/945)、2.6%(36/1399)。Kaplan-Meier生存曲线显示,4组的全因死亡风险随着随访时间增加而上升,组间差异无统计学意义(Log-Rankχ^(2)=6.230,P=0.101)。Cox比例风险回归模型显示,调整混杂后,与静坐时间0~<4 h/d组相比,6~<8 h/d、≥8 h/d组的全因死亡发生风险均增加(HR_(6~<8 h/d组)=1.602,95%CI:1.007~2.548,P=0.047;HR_(≥8 h/d组)=1.670,95%CI:1.100~2.538,P=0.016)。结论静坐时间是全因死亡发生风险的独立危险因素,每天静坐时间≥6 h后死亡风险增加。未来仍需针对不同人群采取个性化的干预措施,避免长时间静坐。Objective To explore the relationship between sedentary time and mortality of the community residents aged 20-74 in Jiading District,Shanghai,in order to provide a scientific basis for the guidance of sedentary behavior.Methods Based on the project site data of Shanghai Peak Cohort in Jiading District,a total of 10038 individuals without missing sedentary time were used as baseline data.Sedentary time was obtained through baseline questionnaires,and individual death information was obtained from the death surveillance system and active surveillance.The Cox proportional risk model was used to assess the risk of death.Results As of December 31,2022,the mean follow-up was(5.4±0.4)years(53985.7 person-years).During the follow-up period,205 deaths occurred.The mortality rates in the groups 0-<4 h/d,4-<6 h/d,6-<8 h/d and≥8 h/d were 1.8%(89/5040),2.0%(54/2654),2.8%(26/945)and 2.6%(36/1399),respectively.Kaplan-Meier curve showed that the risk of all-cause death increased with the increase of follow-up time in the four groups,but there was no statistically significant difference between groups(Log-Rankχ^(2)=6.230,P=0.101).Compared to the community residents with sedentary time 0-<4 h/d,those with sedentary time 6-<8 h/d and≥8 h/d had an increased risk of all-cause death(HR_(6-<8 h/d group)=1.602,95%CI:1.007-2.548,P=0.047;HR_(≥8 h/d group)=1.670,95%CI:1.100-2.538,P=0.016).Conclusions Sedentary time is an independent risk factor for all-cause mortality in the community residents,and those with sedentary time≥6 h/d have an increased risk of all-cause death.In the future,we need to take personalized intervention to avoid high levels of sedentary behavior.

关 键 词：静坐时间 社区居民 死亡风险 队列研究 

分 类 号：R161.1[医药卫生—公共卫生与预防医学]