虚弱状态变化与心房颤动发生风险的队列研究  

A cohort study of changes in frailty status and risk of developing atrial fibrillation

作　　者：程盼 唐钰铃 左传隆 张婷 刘元元 郭冰 张菊英 邓燕[2] 许欢 赵星 CHENG Pan;TANG Yu-ling;ZUO Chuan-long;ZHANG Ting;LIU Yuan-yuan;GUO Bing;ZHANG Ju-ying;DENG Yan;XU Huan;ZHAO Xing(Department of Epidemiology and Health Statistics,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系,四川成都610041 [2]四川省人民医院(电子科技大学附属医院)超声心脏电生理学与生物力学四川省重点实验室

出　　处：《现代预防医学》2025年第6期983-988,共6页Modern Preventive Medicine

基　　金：国家自然科学基金(81973151,82103943,82073667);四川省自然科学基金项目(2023NSFSC0038)。

摘　　要：目的探究虚弱状态的变化与新发房颤的关联。方法基于英国生物银行(UK Biobank,UKB)基线调查和第二次重复调查收集的问卷数据和人体测量数据,通过Fried虚弱表型进行虚弱状态评估,分为非虚弱、虚弱前期或虚弱,联合基线和第二次重复调查时的虚弱状态评估虚弱状态的变化。使用Cox比例风险模型评估虚弱状态变化与新发房颤的关联,并根据第二次重复调查时的虚弱状态按性别、年龄、是否超重、是否患高血压、是否血脂异常和是否患糖尿病进行亚组分析。结果共纳入56394名研究对象。在非虚弱组中,由非虚弱发展为虚弱前期或虚弱的人群发生房颤的风险是未变化人群的1.23倍(HR=1.23,95%CI:1.05~1.44,P=0.010)。在虚弱前期组中,恢复为非虚弱的人群和发展为虚弱的人群发生房颤的风险分别是未变化人群的0.74倍(HR=0.74,95%CI:0.60~0.93,P=0.009)和1.71倍(HR=1.71,95%CI:1.16~2.54,P=0.007)。在虚弱组中,恢复为虚弱前期或非虚弱的人群发生房颤的风险是未变化人群的0.38倍(HR=0.38,95%CI:0.16~0.87,P=0.022)。结论虚弱状态的恶化会增加房颤发生的风险,而虚弱状态的恢复会降低房颤发生的风险。Objective To investigate the association between changes in frailty status and new-onset atrial fibrillation(AF).Methods Based on questionnaire data and anthropometric data collected from the baseline and second repeat surveys of the UK Biobank(UKB),frailty status was assessed by the Fried frailty phenotype,categorized as non-frailty,pre-frailty or frailty,and changes in frailty status were assessed by combining frailty status at baseline and at the second repeat survey.The association between change in frailty status and new-onset AF was assessed using a Cox proportional risk model,and subgroup analyses were performed according to frailty status at the time of the second repeat survey by sex,age,overweight,hypertension,dyslipidemia and diabetes.Results A total of 56394 study participants were included.In the non-frailty group,the risk of AF in those who progressed from non-frailty to pre-frailty or frailty was 1.23 times higher than in those who did not change(HR=1.23,95%CI:1.05-1.44,P=0.010).In the pre-frailty group,those who recovered to non-frailty and those who developed frailty had 0.74(HR=0.74,95%CI:0.60-0.93,P=0.009)and 1.71(HR=1.71,95%CI:1.16-2.54,P=0.007)times the risk of developing AF compared with the unchanged population,respectively.In the frailty group,the risk of AF was 0.38 times higher in those who returned to pre-frailty or non-frailty than in those who remained unchanged(HR=0.38,95%CI:0.16-0.87,P=0.022).Conclusion Worsening of frailty status increases the risk of AF occurrence,whereas recovery from frailty status decreases the risk of AF occurrence.

关 键 词：虚弱变化 心房颤动 前瞻性研究 

分 类 号：R541.7[医药卫生—心血管疾病]