中老年女性高血压患者相对脂肪质量指数与全因死亡风险的因果关联研究  

Causal association study of relative fat mass index and risk of all-cause death in middle-aged and elderly women with hypertension

作　　者：杨文艳 李靓 田晶[4] 闫志佳 杨弘 闫晶晶 王雅靖 张岩波 YANG Wenyan;LI Jing;TIAN Jing;YAN Zhijia;YANG Hong;YAN Jingjing;WANG Yajing;ZHANG Yanbo(Academy of Medical Sciences,Shanxi Medical University,Taiyuan 030001,China;Department of Health Statistic,School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment,Taiyuan 030001,China;Department of Cardiology,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学医学科学院,太原030001 [2]山西医科大学公共卫生学院卫生统计学教研室,太原030001 [3]重大疾病风险评估山西省重点实验室,太原030001 [4]山西医科大学第一医院心内科,太原030001

出　　处：《中华疾病控制杂志》2024年第10期1149-1155,共7页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(82173631);山西省科技成果转化引导专项项目(202104021301063);山西省科技创新人才团队专项项目(202204051001026)。

摘　　要：目的探讨中国中老年女性高血压患者相对脂肪质量指数(relative fat mass,RFM)与全因死亡风险的因果关联,并将其与BMI比较。方法基于中国健康与养老追踪调查(China health and retirement longitudinal study,CHARLS)数据库,以符合纳入和排除标准的1958例患者为研究对象。使用绘制限制性立方样条(restricted cubic spline,RCS)方法确定RFM截断值,并据此进行分组;构建logistic回归分析模型分析RFM和BMI分组与全因死亡风险的相关性,利用双稳健估计两者与全因死亡风险的平均因果效应。结果Logistic回归分析模型显示,以39.30≤RFM≤42.10组为对照,RFM>42.10组与RFM<39.30组均会增加患者全因死亡风险;以BMI正常组为对照,消瘦组会增加患者全因死亡风险,而超重和肥胖组则降低全因死亡风险。双稳健结果显示,与39.30≤RFM≤42.10组相比,RFM<39.30组与RFM>42.10组均会增加患者全因死亡风险,其平均因果效应(average treatment effect,ATE)值分别为4%(95%CI:0.006~0.074)和12%(95%CI:0.077~0.163);与BMI正常组相比,其余BMI分组与全因死亡风险之间未发现因果关联。结论中国中老年女性高血压患者RFM与全因死亡风险存在因果关联,合理控制RFM有助于降低患者全因死亡风险。Objective This study aims to investigate the causal correlation between the relative fat mass index(RFM)and the risk of all-cause mortality among middle-aged and elderly Chinese women with hypertension.Additionally,it seeks to compare the causal correlation between RFM and the risk of all-cause mortality with that of BMI and the risk of all-cause mortality.Methods Based on the China health and retirement longitudinal study(CHARLS)database,this study took 1958 participants who met the inclusion and exclusion criteria as research subjects.the study plotted restricted cubic splines(RCS)to determine the cut-off value for RFM and subsequently grouped participants accordingly.Logistic regression models were constructed to analyze the correlation of RFM groups and BMI groups in relation to the risk of all-cause mortality.Furthermore,the average causal effects of them on the risk of all-cause mortality will would be calculated by employing double robust estimation.Results The Logistic regression models showed that compared with the 39.30≤RFM≤42.10 group,both the RFM>42.10 group and the RFM<39.30 group would increase the risk of all-cause mortality in patients.In comparison with the normal BMI group,the thin group increased the risk of all-cause mortality,while the overweight and obese groups reduced the risk.The double robust estimation revealed that in comparison to the 39.30≤RFM≤42.10 group,both the RFM>42.10 group and the RFM<39.30 group would increase the risk of all-cause mortality,with average treatment effect(ATE)values of 4%respectively(95%CI:0.006-0.074)and 12%(95%CI:0.077-0.163).However,the other groups didn′t demonstrate a causal correlation with the risk of all-cause mortality when comparing with the normal BMI group.Conclusions There is a causal correlation between RFM and all-cause mortality risk in middle-aged and elderly female with hypertension patients in China.Reasonable control of RFM may help reduce the risk of all-cause mortality in these patients.

关 键 词：中国健康与养老追踪调查 相对脂肪质量指数 全因死亡 BMI 因果关联 女性高血压 

分 类 号：R195.1[医药卫生—卫生统计学] R544.1[医药卫生—卫生事业管理]