Ferrero-Hernández Paloma, O'Donovan Gary, Petermann-Rocha Fanny, Christofaro Diego G D, Cristi-Montero Carlos, Marques Adilson, Nascimento Marcelo de Maio, Farías-Valenzuela Claudio, Rezende Leandro F M, Ferrari Gerson
Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile.
Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia.
Sci Rep. 2025 Jan 2;15(1):145. doi: 10.1038/s41598-024-84104-w.
Unhealthy lifestyles risk factors, such as smoking, alcohol consumption, physical inactivity, poor diet, and obesity, have been associated with a higher risk of all-cause and cause-specific mortality. However, composite score of these unhealthy behaviours has not been considered, particularly in Latin American populations. Herein, we examined the association of lifestyle risk factors score with all-cause and cause-specific mortality in Mexican adults. A total of 159,517 adults from the Mexico City Prospective Study (MCPS) were included. Data on sociodemographic, lifestyle risk factors and medical histories was collected through a self-reported baseline questionnaire in a census-style door-to-door interviews. Lifestyle risk factors assessment was based on five modifiable lifestyle risk factors and their respective cut-off points according to current health recommendations, including obesity, physical inactivity, tobacco, alcohol consumption and fruits and vegetables intake. Multivariable Cox regression models were used to estimate the associations of lifestyle risk factor score (ranging from 0 to 5) with all-cause and cause-specific mortality (cardiovascular disease, renal or hepatobiliary diseases, diabetes, respiratory diseases, cancer and all-cause mortality). We excluded the first 2, 5, 10, and 15 years of follow-up to account for reverse causation bias. We found a high prevalence (77%) of Mexican adults, with two or more lifestyle risk factors. Hazard ratio for respiratory diseases and renal or hepatobiliary diseases were 1.86 (95%CI: 1.45-2.39) and 2.00 (95%CI: 1.60-2.52) comparing participants with 4-5 lifestyle risk factors vs. those with none. For all-cause mortality, participants with 4-5 lifestyle risk factors had a 49% (HR: 1.49; 95%CI: 1.03-2.16) higher risk as compared to participants with none. The magnitude of the associations increased as the exclusion of follow-up time increased after 2, 5, 10 and 15 years. There was a positive association between the number of lifestyle risk factors and all-cause and cause-specific mortality, showing the highest rate of respiratory, renal or hepatobiliary and all-cause mortality among participants with 4-5 lifestyle risk factors. After accounting for reverse causation, associations were stronger.
不健康的生活方式风险因素，如吸烟、饮酒、缺乏身体活动、不良饮食和肥胖，与全因死亡率和特定病因死亡率的较高风险相关。然而，尚未考虑这些不健康行为的综合评分，尤其是在拉丁美洲人群中。在此，我们研究了生活方式风险因素评分与墨西哥成年人全因死亡率和特定病因死亡率之间的关联。纳入了来自墨西哥城前瞻性研究（MCPS）的总共159,517名成年人。通过在普查式挨家挨户访谈中使用的自我报告基线问卷收集了社会人口统计学、生活方式风险因素和病史数据。生活方式风险因素评估基于五个可改变的生活方式风险因素及其根据当前健康建议的各自切点，包括肥胖、缺乏身体活动、烟草、饮酒以及水果和蔬菜摄入量。使用多变量Cox回归模型来估计生活方式风险因素评分（范围从0到5）与全因死亡率和特定病因死亡率（心血管疾病、肾脏或肝胆疾病、糖尿病、呼吸系统疾病、癌症和全因死亡率）之间的关联。我们排除了随访的前2年、5年、10年和15年，以考虑反向因果关系偏差。我们发现墨西哥成年人中生活方式风险因素达到两个或更多的比例很高（77%）。与没有生活方式风险因素的参与者相比，有4 - 5个生活方式风险因素的参与者患呼吸系统疾病和肾脏或肝胆疾病的风险比分别为1.86（95%置信区间：1.45 - 2.39）和2.00（95%置信区间：1.60 - 2.52）。对于全因死亡率，有4 - 5个生活方式风险因素的参与者与没有这些因素的参与者相比，风险高出49%（风险比：1.49；95%置信区间：1.03 - 2.16）。随着在2年、5年、10年和15年后排除随访时间的增加，关联的强度增加。生活方式风险因素的数量与全因死亡率和特定病因死亡率之间存在正相关，在有4 - 5个生活方式风险因素的参与者中，呼吸系统、肾脏或肝胆以及全因死亡率的发生率最高。在考虑反向因果关系后，关联更强。
