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中国成年人自评健康状况与中风风险之间的关联:一项前瞻性研究

[Association between self-rated health status and risk of stroke in Chinese adults: a prospective study].

作者信息

Cong X F, Liu S B, Ma J X, Wang W J, Chen B, Li J H

机构信息

National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

Office of Non-Communicable Diseases and Ageing Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Mar 10;42(3):513-519. doi: 10.3760/cma.j.cn112338-20200103-00006.

Abstract

To explore the relationship between self-rated health status and risk of stroke in Chinese adults. Data was collected from the Chronic Disease Risk Factor Surveillance in China (2010) as baseline. A total of 60 follow-up monitors (25 urban and 35 rural) in 11 provinces were selected. A total of 36 195 participants without prior cardiovascular diseases were followed and investigated 27 441 people in 2016 and 2017. Cox proportional hazard regression model was used to analyze the self-assessed health status and stroke onset hazard ratio (), further conducted several subgroup analyses by demographic characteristics such as age and gender, and sensitivity analysis was performed by excluding death and baseline diabetes. A total of 26 699 study subjects were included according to the inclusion criteria. We identified 1 332 stroke cases (32 subarachnoid hemorrhage, 197 cerebral hemorrhage, and 1 149 cerebral infarction) during an average of 6.4 years (171 431.1 person-years) of follow-up, and the incidence density was 7.77/1 000 person-years. After adjusting the related factors, the risk of stroke in participants with poor self-related health increased by 68% (=1.68, 95%:1.22-2.32) and the risk of ischemic stroke increased by 47% (=1.47, 95%:1.05-2.05), with a reference of excellent ones. In subgroup analysis, only age and BMI had an effect-modifying effect on the association between self-rated health and risk of stroke. Only age and dyslipidemia had an effect-modifying effect on the association between self-rated health and ischemic stroke risk (interaction <0.05). The results of the sensitivity analysis were consistent with the results of the total population. People with poor self-assessed health, especially for those who were overweight/obesity with poor self-assessed health or age less than 60 or dyslipidemia are at increased risk of stroke and ischemic stroke and should be targeted for intervention.

摘要

探讨中国成年人自评健康状况与中风风险之间的关系。数据收集自中国慢性病危险因素监测(2010年)作为基线。在11个省份共选取了60个随访监测点(25个城市和35个农村)。共有36195名无心血管疾病史的参与者接受随访,并在2016年和2017年对27441人进行了调查。采用Cox比例风险回归模型分析自评健康状况与中风发病风险比(),进一步按年龄、性别等人口学特征进行了多项亚组分析,并通过排除死亡和基线糖尿病进行了敏感性分析。根据纳入标准共纳入26699名研究对象。在平均6.4年(171431.1人年)的随访期间,我们共识别出1332例中风病例(32例蛛网膜下腔出血、197例脑出血和1149例脑梗死),发病密度为7.77/1000人年。调整相关因素后,自评健康状况较差者中风风险增加68%(=1.68,95%:1.22 - 2.32),缺血性中风风险增加47%(=1.47,95%:1.05 - 2.05),以自评健康状况极佳者为参照。在亚组分析中,仅年龄和体重指数对自评健康与中风风险之间的关联有效应修饰作用。仅年龄和血脂异常对自评健康与缺血性中风风险之间的关联有效应修饰作用(交互作用<0.05)。敏感性分析结果与总体人群结果一致。自评健康状况较差的人群,尤其是自评健康状况较差的超重/肥胖者、年龄小于60岁者或血脂异常者,中风和缺血性中风风险增加应作为干预目标。

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