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成人身高与中风风险的性别特异性关系:前瞻性研究的剂量反应荟萃分析。

Sex-specific relationship between adult height and the risk of stroke: A dose-response meta-analysis of prospective studies.

机构信息

Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.

Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, China.

出版信息

J Clin Hypertens (Greenwich). 2019 Feb;21(2):262-270. doi: 10.1111/jch.13458. Epub 2018 Dec 20.

Abstract

Conflicting evidence exists regarding the magnitude of the association between adult height and risk of stroke, and it is unclear whether this association is different between men and women. The authors carried out a meta-analysis to assess the sex-specific effect of adult height on the risk of stroke and its subtypes. Prospective cohort studies reporting sex-specific risk estimates of height with stroke or reported in a certain sex were included. Summary relative risks for 5-unit increments in height were calculated using random-effects, and dose-response relationships were performed using a restricted cubic spline model. Subgroup analyses, sensitivity analyses, and tests for publication bias were also performed. In all, 20 prospective studies were identified in this study. The summary of relative risks (95% CIs) of stroke for a 5 cm increase in adult height were 0.93 (0.90-0.95) for men and 0.88 (0.83-0.93) for women. There was no significant difference in the effect of height on future stroke risk between men and women (P  = 0.085). There was evidence of a nonlinear association between adult height and stroke risk, with steeper inverse associations at lower level of height, but further reductions in risk were observed at greater heights. Subgroup and sensitivity analyses showed that the significant associations were consistent in most stratifications and with various inclusion criteria. In conclusion, higher adult height was significantly associated with lower risk of stroke in both men and women.

摘要

关于成人身高与中风风险之间的关联程度存在相互矛盾的证据,并且不清楚这种关联在男性和女性之间是否存在差异。作者进行了一项荟萃分析,以评估成人身高对中风及其亚型风险的性别特异性影响。纳入了报告身高与中风风险的性别特异性风险估计值的前瞻性队列研究,或报告了特定性别的研究。使用随机效应计算身高每增加 5 个单位的汇总相对风险,并使用限制性立方样条模型进行剂量-反应关系分析。还进行了亚组分析、敏感性分析和发表偏倚检验。在这项研究中,共确定了 20 项前瞻性研究。成人身高每增加 5 厘米,男性中风风险的相对风险(95%CI)为 0.93(0.90-0.95),女性为 0.88(0.83-0.93)。男性和女性身高对未来中风风险的影响没有显著差异(P  = 0.085)。身高与中风风险之间存在非线性关联的证据,身高较低时反比关系更陡峭,但在更高的身高时风险进一步降低。亚组和敏感性分析表明,大多数分层和各种纳入标准的关联均一致。总之,较高的成人身高与男性和女性中风风险降低显著相关。

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