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成人身高与心血管代谢疾病风险:陕西的中国国家健康调查。

Adult Body Height and Cardiometabolic Disease Risk: The China National Health Survey in Shaanxi.

机构信息

Graduate School, Beijing University of Chinese Medicine, Beijing, China.

International Medical Services, China-Japan Friendship Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2020 Dec 21;11:587616. doi: 10.3389/fendo.2020.587616. eCollection 2020.

Abstract

OBJECTIVES

Based on data from the China National Health Survey, we aimed to examine the association between body height and cardiometabolic disease (CMD) in a large adult population from Shaanxi province, and further to test whether this association was hinged upon other population characteristics.

METHODS

This population-based study was conducted in 2014 in Shaanxi Province, China. Utilizing a multi-stage stratified cluster sampling method, total 5,905 adults with complete data were eligible for analysis, and 1,151 (19.5%) of them had CMD. Of 1,151 CMD patients, 895 (15.1%) had one disorder and 256 (4.4%) had ≥2 disorders.

RESULTS

Using the bi-directional stepwise method and all-subsets regression, five factors-age, body mass index, family histories of CMD, exercise, and height-constituted the optimal model when predicting CMD risk. Restricted cubic spline regression showed a reduced tendency towards CMD with the increase of body height, with per 10 cm increment in body height corresponding to 14% reduced risk. Ordinal Logistic regression supported the contribution of body height on both continuous and categorical scales to CMD risk before and after adjustment, yet this contribution was significantly confounded by exercise and education, especially by exercise, which can explain 65.4% of total impact. For example, short stature was associated with an increased risk of CMD after multivariable adjustment not including exercise and education (odds ratio, 95% confidence interval, P: 1.42, 1.21 to 1.66, <0.001), and tall stature was associated with a reduced risk (0.77, 0.64 to 0.92, 0.003).

CONCLUSIONS

Our findings indicate short stature was a risk factor, yet tall stature was a protective factor for CMD in Chinese. Notably, the prediction of short and tall stature for CMD may be mediate in part by exercise.

摘要

目的

基于中国国家健康调查数据,我们旨在研究陕西省成年人中身高与心血管代谢疾病(CMD)的关联,并进一步检验这种关联是否取决于其他人口特征。

方法

这是一项基于人群的研究,于 2014 年在中国陕西省进行。采用多阶段分层聚类抽样方法,共纳入 5905 名资料完整的成年人进行分析,其中 1151 人(19.5%)患有 CMD。在 1151 名 CMD 患者中,895 人(15.1%)患有 1 种疾病,256 人(4.4%)患有≥2 种疾病。

结果

采用双向逐步法和全子集回归,在预测 CMD 风险时,有 5 个因素(年龄、体重指数、CMD 家族史、运动和身高)构成了最优模型。限制立方样条回归显示,随着身高的增加,CMD 的风险呈下降趋势,身高每增加 10cm,CMD 的风险降低 14%。有序逻辑回归支持身高对 CMD 风险的连续和分类尺度的贡献,然而,这种贡献在经过运动和教育调整后,存在显著的混杂,特别是运动,它可以解释总影响的 65.4%。例如,在不包括运动和教育的多变量调整后,矮小身材与 CMD 风险增加相关(比值比,95%置信区间,P:1.42,1.21 至 1.66,<0.001),而高个子身材与风险降低相关(0.77,0.64 至 0.92,0.003)。

结论

我们的研究结果表明,身材矮小是 CMD 的一个危险因素,而身材高大是 CMD 的一个保护因素。值得注意的是,CMD 对矮小和高大身材的预测可能部分通过运动来介导。

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