Zhao Z M, Pan A, Wen Y, Pan X F
Institute of Medical Biology, Chinese Academy of Medical Sciences, Peking Union Medical College, Kunming 650118, China.
Department of Epidemiology and Biostatistics, School of Public Health, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Feb 6;54(2):149-154. doi: 10.3760/cma.j.issn.0253-9624.2020.02.007.
To analyze the association between the self-rated health (SRH) status and risk of cardiovascular disease (CVD) among the middle-aged and eldly Chinese. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which enrolled 21 133 participants by using the probability proportional to size (PPS) sampling from 150 counties/districts of 28 provinces in China from 2011 to 2012. A total of 11 701 participants were included in the study. Basic information and SRH were obtained in the baseline survey via questionnaires. Information of CVD was self-reported during the follow-up. Cox proportional hazards modeling was used to analyze the association between the baseline SRH and risk of CVD. Subgroup analyses were performed by age, sex and body mass index (BMI), and their interactions with SRH for risk of CVD were examined by using the likelihood ratio test. A sensitivity analysis was conducted to test the robustness of the association. Participants were (57.9±9.7) years old, and men accounted for 48.1% (5 626). SRH was reported as the excellent, very good, good, fair and poor among 4.2% (487), 13.5% (1 583), 33.6% (3 932), 35.4% (4 147) and 13.3% (1 552), respectively. During 42 104 person-years of followed up, 590 cases of CVD were identified. Cox regression analyses showed that compared with the excellent/very good SRH, the (95) of CVD risk for the good, fair and poor SRH was 1.36 (1.02-1.80), 1.66 (1.26-2.19) and 1.89 (1.38-2.59), respectively. Subgroup analyses showed that compared with the excellent/very good SRH, (95) of CVD risk for poor SRH in the group of 45-59 years old, equal to or over 75 years old, men, women and normal BMI were 2.00 (1.32-3.04), 3.87 (1.04-14.46), 1.76 (1.07-2.91), 1.92 (1.27-2.91) and 2.30 (1.42-3.72), respectively. There were no interactions between age, sex, BMI and SRH (0.05). SRH is associated with risk of CVD among middle-aged and elderly Chinese. The CVD risk for good, fair and poor SRH is higher than that for excellent/very good SRH.
分析中国中老年人自评健康(SRH)状况与心血管疾病(CVD)风险之间的关联。数据来自中国健康与养老追踪调查(CHARLS),该调查于2011年至2012年采用与规模成比例的概率抽样(PPS)方法,从中国28个省份的150个县/区招募了21133名参与者。本研究共纳入11701名参与者。通过问卷调查在基线调查中获取基本信息和SRH。随访期间CVD信息为自我报告。采用Cox比例风险模型分析基线SRH与CVD风险之间的关联。按年龄、性别和体重指数(BMI)进行亚组分析,并通过似然比检验检验它们与SRH对CVD风险的相互作用。进行敏感性分析以检验该关联的稳健性。参与者年龄为(57.9±9.7)岁,男性占48.1%(5626人)。报告SRH为优秀、非常好、良好、中等和差的比例分别为4.2%(487人)、13.5%(1583人)、33.6%(3932人)、35.4%(4147人)和13.3%(1552人)。在42104人年的随访期间,共确诊590例CVD。Cox回归分析显示,与优秀/非常好的SRH相比,良好、中等和差的SRH发生CVD风险的(95)分别为1.36(1.02 - 1.80)、1.66(1.26 - 2.19)和1.89(1.38 - 2.59)。亚组分析显示,与优秀/非常好的SRH相比,45 - 59岁组、75岁及以上组、男性、女性和正常BMI组中差的SRH发生CVD风险的(95)分别为2.00(1.32 - 3.04)、3.87(1.04 - 14.46)、1.76(1.07 - 2.91)、1.92(1.27 - 2.91)和2.30(1.42 - 3.72)。年龄、性别、BMI与SRH之间无相互作用(0.05)。SRH与中国中老年人的CVD风险相关。良好、中等和差的SRH发生CVD的风险高于优秀/非常好的SRH。