河南省成年居民生活方式与死亡结局关联的前瞻性研究  

A prospective study on the association between lifestyles and mortality risk in adults in Henan Province

作　　者：范雷[1] 戚敏杰 邢天放 侯刚[2] 张寒雪 梁森[3] 韩莉[4] 丁文燮[5] 康锴[1] 韩志伟 Fan Lei;Qi Minjie;Xing Tianfang;Hou Gang;Zhang Hanxue;Liang Sen;Han Li;Ding Wenxie;Kang Kai;Han Zhiwei(Department of Chronic Non-communicable Disease Control and Prevention,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China;Department of Disease Control and Prevention,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Chronic Non-communicable Disease Control and Prevention,Puyang Center for Disease Control and Prevention of Henan,Puyang 457000,China;Department of Chronic Non-communicable Disease Control and Prevention,Hebi Center for Disease Control and Prevention of Henan,Hebi 458000,China;Department of Chronic Non-communicable Disease Control and Prevention,Shangqiu Center for Disease Control and Prevention of Henan,Shangqiu 476000,China;Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)

机构地区：[1]河南省疾病预防控制中心慢病所,郑州450016 [2]河南省人民医院疾控科,郑州450003 [3]河南省濮阳市疾病预防控制中心慢病科,濮阳457000 [4]河南省鹤壁市疾病预防控制中心慢病科,鹤壁458000 [5]河南省商丘市疾病预防控制中心慢病科,商丘476000 [6]河南省疾病预防控制中心,郑州450016

出　　处：《中华流行病学杂志》2024年第8期1052-1058,共7页Chinese Journal of Epidemiology

基　　金：国家重大公共卫生项目;河南省卫生科技攻关项目(LHGJ20220176)。

摘　　要：目的分析河南省成年居民健康生活方式与死亡风险的关联。方法以河南省16个县(区)参加心血管病高危人群早期筛查与综合干预项目的99133名成年居民为研究对象,通过询问调查获取健康生活方式类型,通过中国CDC死因监测系统获取终点事件信息。采用Cox比例风险回归模型分析健康生活方式与死亡风险关联和人群归因分值(PAF)。结果河南省成年居民有1种健康生活方式的比例为50.6%,有全部4种健康生活方式的比例为0.1%。平均随访4.5年,共观察到死亡病例2685人,因心脑血管病死亡病例1283人。不吸烟、适量饮酒、充足运动和健康饮食人群死亡风险分别为0.85(95%CI:0.77~0.94)、0.75(95%CI:0.63~0.89)、0.73(95%CI:0.67~0.79)和0.86(95%CI:0.77~0.96),对全因死亡的调整PAF分别为5.2%(95%CI:2.5%~7.9%)、24.0%(95%CI:10.7%~36.4%)、19.4%(95%CI:13.8%~24.8%)和12.3%(95%CI:3.4%~20.9%)。坚持健康生活方式数量越多,对死亡结局影响越大,有全部4种健康生活方式的调整PAF上升至49.1%。结论坚持健康生活方式可以降低河南省成年居民死亡风险,健康生活方式数量越多,死亡风险越低。Objective To analyze the association between healthy lifestyle and mortality among Henan Province 35-74 years old individuals.Methods Data from the programme of screening and intervention subjects with high-risk cardiovascular disease 99133 adults were analyzed in a provincial cohort study of 16 counties.Four healthy lifestyle behaviors were assessed based on a questionnaire survey.Information on mortality endpoints was retrieved from the national death surveillance system.Cox proportional hazards regression models were used to estimate the associations between healthy lifestyles,mortality risk and population attributable fraction(PAF).Results Out of the adult participants in Henan,50.6%adhered to a healthy lifestyle,and only 0.1%adhered to 4 healthy lifestyle behaviours.During a mean of 4.5 years,2685 all-cause death and 1283 cardiovascular deaths were documented.The decreased risk of mortality among individuals with non-smoking,moderate drinking,adequate exercise and healthy diet were 0.85(95%CI:0.77-0.94),0.75(95%CI:0.63-0.89),0.73(95%CI:0.67-0.79)and 0.86(95%CI:0.77-0.96),while the adjusted PAF for all-cause deaths were 5.2%(95%CI:2.5%-7.9%),24.0%(95%CI:10.7%-36.4%),19.4%(95%CI:13.8%-24.8%)and 12.3%(95%CI:3.4%-20.9%),respectively.A combined healthy lifestyle can bring more health benefits.Adherence to 4 healthy lifestyle behaviours could avoid 49.1%of all-cause death.Conclusion Adherence to a healthy lifestyle can reduce the risk of death,and participants with a healthy lifestyle had a lower mortality risk.

关 键 词：健康生活方式 死亡风险 前瞻性研究 

分 类 号：R195[医药卫生—卫生统计学]