身体衰老引发的衰弱状态与健康进展  

The frailty status and health progression caused by physical aging

作　　者：苗鑫蕾 徐菲 芦欣怡 祝伊琳 赵辉[1] 郭秀花 孟群 冷松[1] MIAO XinLei;XU Fei;LU XinYi;ZHU YiLin;ZHAO Hui;GUO XiuHua;MENG Qun;LENG Song(The Second Hospital of Dalian Medical University,Dalian 116023,China;Beijing Municipal Key Laboratory of Clinical Epidemiology,Beijing 100069,China;School of Public Health,Dalian Medical University,Dalian 116000,China;Peking University Third Hospital,Beijing 100089,China;School of Public Health,Capital Medical University,Beijing 100069,China;Continuing Education Professional Committee,Chinese Preventive Medicine Association,Beijing 100069,China)

机构地区：[1]大连医科大学附属第二医院,大连116023 [2]北京市临床流行病学重点实验室,北京100069 [3]大连医科大学公共卫生学院,大连116000 [4]北京大学第三医院,北京100089 [5]首都医科大学公共卫生学院,北京100069 [6]中华预防医学会,北京100069

出　　处：《中国科学:生命科学》2025年第3期575-589,共15页Scientia Sinica(Vitae)

基　　金：大连市科技人才创新项目(批准号:2024RQ059);大连市医学科学研究计划(批准号:2322001);大连医科大学附属第二医院“1+X”计划项目(批准号:2022DXDL01,YJ2024000102)资助。

摘　　要：人群健康发展过程中的衰弱状态被认为是一种新兴的健康负担,大部分研究关注住院患者衰弱流行状况,主要是老年人.但在普通人群中的衰弱状态与健康进展之间的关联尚不清楚.本研究使用了为数较少的大型体检人群的前瞻性队列评估衰弱的动态转变情况.共有66152人受邀参加,通过生物标志物、心理状况等49个项目计算衰弱指数并将人群划分为健康状态、轻度衰弱、中度衰弱和重度衰弱.同时,4种衰弱状态构建12条健康过渡路径,我们使用马尔可夫模型来计算过渡模式.基于这些路径,健康进展过程也分为健康改善和健康恶化.在调整潜在的混杂因素后,在5598名参与者中使用Cox比例风险模型计算生活方式对健康进展的风险比(HR)和95%置信区间(95%CI).本研究发现在10年的人群自然衰老中,维持自己健康状况的概率为0.574,45.33%参与者健康进展发生恶化.女性的整体衰弱率高于男性.研究发现,摄入含糖饮料会使健康恶化的风险增加至少17%,喝茶会使风险降低16%,牛奶摄入不足会使风险增加22%以上(P<0.001).总人群中不健康刷牙行为(每天刷牙少于两次)的风险值为HR=1.13(95%CI:1.04~1.22,P<0.001).尽管存在局限性,但这项研究有助于为人口衰弱转变的强度和早期识别人口衰弱风险提供见解.衰弱在健康发展中经历着动态的转变,生活方式与衰弱状态的不同变化有关,尤其是饮料消费(含糖饮料、茶、牛奶)和口腔健康.应特别关注老年女性的健康发展和年轻人(45岁以下)的饮料消费水平.未来需要更多的研究制定精准的预防策略,以延缓衰弱的进展.The frailty status during the process of population health development is considered an emerging health burden,and most studies focus on the prevalence of frailty among hospitalized patients,mainly the elderly.But the association between frailty and health progression in the general population is still unclear.This study used a prospective cohort of a small population undergoing largescale physical examinations to assess the dynamic changes in frailty.A total of 66152 people were invited to participate,and the frailty index was calculated based on 49 items including biomarkers and psychological status,and the population was divided into healthy status,mild frailty,moderate frailty,and severe frailty.At the same time,12 healthy transition paths were constructed for the four frailty status,and we used a Markov model to calculate the transition patterns.Based on these pathways,the process of health progression is also divided into health improvement and health deterioration.After adjusting for potential confounding factors,Cox proportional hazards model was used to calculate the hazard ratio(HR)and 95%confidence interval(95%CI)of lifestyle on health progression among 5598 participants.This study found that the probability of maintaining own health status during 10 years of natural aging in the population was 0.574,with 45.33%of participants experiencing deterioration in their health progress.The overall frailty rate of women is higher than that of men.Research has found that consuming sugary drinks increases the risk of health deterioration by at least 17%,drinking tea reduces the risk by 84%,and insufficient milk intake increases the risk by over 22%,P<0.001.The risk value for unhealthy brushing behavior(brushing less than twice a day)in the general population is HR=1.13(95%CI:1.04~1.22,P<0.001).Despite its limitations,this study contributes to providing insights into the intensity of population health transitions and early identification of population frailty risks.Frailty undergoes dynamic changes in health progr

关 键 词：衰弱状态 健康进展 衰老 

分 类 号：R339.38[医药卫生—人体生理学]