生活方式风险评分与韩国成年人的死亡率:一项基于人群的队列研究。
Lifestyle risk score and mortality in Korean adults: a population-based cohort study.
机构信息
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Public Health Sciences, BK21PLUSProgram in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul, Republic of Korea.
出版信息
Sci Rep. 2020 Jun 24;10(1):10260. doi: 10.1038/s41598-020-66742-y.
Individual lifestyle risk factors have been associated with an increased risk of mortality. However, limited evidence is available on the combined association of lifestyle risk factors with mortality in non-Western populations. The analysis included 37,472 participants (aged ≥19 years) in the Korea National Health and Nutrition Examination Surveys (2007-2014) for whom the data were linked to death certificates/medical records through December 2016. A lifestyle risk score was created using five unhealthy behaviors: current smoking, high-risk alcohol drinking, unhealthy weight, physical inactivity, and insufficient/prolonged sleep. Cox proportional hazards models were used to estimate hazard ratio (HR) and 95% confidence interval (CI). During up to 9 years of follow-up, we documented 1,057 total deaths. Compared to individuals with zero lifestyle risk factor, those with 4-5 lifestyle risk factors had 2.01 times (HR = 2.01, 95% CI = 1.43-2.82) and 2.59 times (HR = 2.59, 95% CI = 1.24-5.40) higher risk of all-cause and cardiovascular mortality, respectively. However, higher lifestyle risk score was not significantly associated with cancer mortality (p-trend >0.05). In stratified analyses, the positive associations tended to be stronger in adults aged <65 years, unemployed, and those with lower levels of education. In conclusion, combined unhealthy lifestyle behaviors were associated with substantially increased risk of total and cardiovascular mortality in Korean adults.
个体生活方式风险因素与死亡率增加相关。然而,在非西方人群中,关于生活方式风险因素与死亡率的综合关联的证据有限。该分析纳入了韩国国家健康和营养检查调查(2007-2014 年)中的 37472 名参与者(年龄≥19 岁),这些参与者的数据通过与死亡证明/医疗记录链接到 2016 年 12 月。使用五种不健康行为:当前吸烟、高风险饮酒、不健康体重、身体活动不足和睡眠不足/过长,创建了生活方式风险评分。使用 Cox 比例风险模型估计危险比(HR)和 95%置信区间(CI)。在长达 9 年的随访期间,我们记录了 1057 例总死亡。与没有生活方式风险因素的个体相比,具有 4-5 个生活方式风险因素的个体全因死亡率和心血管死亡率的风险分别高出 2.01 倍(HR=2.01,95%CI=1.43-2.82)和 2.59 倍(HR=2.59,95%CI=1.24-5.40)。然而,更高的生活方式风险评分与癌症死亡率之间没有显著相关性(p 趋势>0.05)。分层分析表明,在年龄<65 岁、失业和教育程度较低的成年人中,这种正相关关系更为明显。总之,在韩国成年人中,综合不健康的生活方式行为与总死亡率和心血管死亡率的显著增加相关。