中国中老年人群体力活动量与全因死亡风险关系及其中介因子分析  

Association between physical activity and all-cause mortality risk and related mediators in middle-aged and elderly Chinese population:an analysis of CHARLS data

作　　者：魏嘉畅 刘姿琪 孙嘉鸿 赵敏 席波 WEI Jiachang;LIU Ziqi;SUN Jiahong;ZHAO Min;XI Bo(Department of Epidemiology,School Public Health,Cheeloo College of Medicine,Shandong University,Ji'nan 250012,China;Department of Toxicolog and Nutrition,School of Public Health,Cheeloo College of Medicine,Shandong University,Ji'nan 250012,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院流行病学系,济南250012 [2]山东大学齐鲁医学院公共卫生学院毒理与营养学系,济南250012

出　　处：《中国公共卫生》2024年第6期730-736,共7页Chinese Journal of Public Health

摘　　要：目的探讨中国中老年人群体力活动量与全因死亡风险的关系以及影响此种关系的中介变量,为减少我国中老年人群全因死亡风险提供科学依据。方法收集2011—2018年中国健康与养老追踪调查(CHARLS)中完成基线调查和3次随访调查的5727名≥45岁中老年人群的相关数据,采用多因素Cox比例风险回归模型和限制性立方样条模型分析其体力活动量与全因死亡风险之间的关系,并根据随访期间体质指数(BMI)、血压和血生化指标等数据进行中介效应分析。结果中国5727名≥45岁中老年人群中,体力活动量最低四分位数组(<1720.95 METs-分/周)1813人(31.66%),第二四分位数组(1720.95~5543.99 METs-分/周)1082人(18.89%),第三四分位数组(5544.00~12263.99 METs-分/周)1374人(23.99%),最高四分位数组(≥12264.00METs-分/周)1458人(25.46%)。随访期间发生全因死亡事件者509例,全因死亡率为8.92%,其中体力活动量最低四分位数组、第二四分位数组、第三四分位数组和最高四分位数组中老年人群发生全因死亡事件者分别为271、85、80和73例,全因死亡率分别为14.99%、7.88%、5.89%和5.01%,中国中老年人群全因死亡率随着体力活动量的增加呈下降趋势(χ^(2)趋势=653.81,P趋势<0.001)。在调整了性别、年龄、文化程度、婚姻状况、居住地、吸烟情况、饮酒情况、BMI、收缩压(SBP)、舒张压(DBP)、白细胞(WBC)、平均红细胞体积(MCV)、血小板计数(PLT)、血红蛋白(Hb)、红细胞压积(HCT)、C反应蛋白(CRP)、血糖(GLU)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、尿素氮(BUN)、肌酐、尿酸(UA)和半胱氨酸蛋白酶抑制物C(CysC)等混杂因素后,多因素Cox比例风险回归模型分析结果显示,体力活动量第二四分位数组、第三四分位数组和最高四分位数组中老年人群全因死亡风险分别为体力活动量最低四分位数组�Objective To examine the association between physical activity and risk of all-cause mortality and related mediators in middle-aged and elderly people in China to provide evidence for reducing mortality in the population.Methods Data were collected from 5727 individuals aged≥45 years who completed baseline and 3 follow-up surveys in the China Health and Retirement Longitudinal Study(CHARLS)from 2011 to 2018.We used multivariable Cox proportional hazards regression models and restricted cubic spline models to examine the association between physical activity levels and risk of all-cause mortality.In addition,we conducted a mediation analysis based on body mass index(BMI),blood pressure,and blood biochemical indicators collected during follow-up.Results Of all the individuals analyzed,1813(31.66%)were classified as having physical activity(measured in metabolic equivalents[METs]-min/week)in the lowest quartile(<1720.95),and the number(proportion)of the individuals with physical activity in the second quartile(1720.95-5543.99),third quartile(5544.00-12263.99),and highest quartile(≥12264.00)were 1082(18.89%),1374(23.99%),and 1458(25.46%),respectively.During the follow-up,a total of 509 deaths were observed and the all-cause mortality rate was 8.92%,with the number of all-cause deaths(mortality rate)being 271(14.99%),85(7.88%),80(5.89%),and 73(5.01%)among those with physical activity in the lowest,second,third,and the highest quartiles of METs-min/week,respectively.All-cause mortality showed a significant downward trend with increasing levels of physical activity among the individuals(x2trend=653.81,Ptrend<0.001).After adjustment for sex,age,education level,marital status,place of residence,smoking,alcohol consumption,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),white blood cells(WBC),mean corpuscular volume(MCV),platelets(PLT),hemoglobin(Hb),hematocrit(HCT),C-reactive protein(CRP),glucose(GLU),hemoglobin Alc(HbAlc),total cholesterol(TC),triglycerides(TG),low-density lipoprotein(LDL),high-density

关 键 词：体力活动量 全因死亡 风险 关系 中介因子 中老年人群 中国 

分 类 号：R195[医药卫生—卫生统计学]