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高血压人群中体质指数与全死因死亡风险的队列研究

A cohort study on body mass index and risk of all-cause mortality among hypertensive population
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摘要 目的探讨高血压队列人群中BMI和全死因死亡风险的关系。方法研究对象为河南省某农村地区高血压队列人群,应用Cox风险比例回归模型计算基线时不同BMI水平人群随访期间的全死因死亡比例HR值及其95%CI,并采用限制性立方样条模型拟合BMI与全死因死亡风险的剂量一反应关系。结果5461名高血压队列人群累积随访31048.38人年,平均随访6年,随访期间死亡589人。控制潜在的混杂因素后,以基线正常体重组(18.5kg/m2〈BMI〈24.0kg/m^2)为参照,低体重组(BMI〈18.5kg/m2)、超重组(24.0kg/m2〈BMI〈28.0kg/m2)和肥胖组(BMI≥28kg/m^2)人群发生死亡的HR值(95%C/)分别为0.83(0.37~1.87)、0.81(O.67~0.97)和0.72(0.56-0.91)。限制性立方样条模型分析结果显示,在高血压队列人群中,基线BMI和全死因死亡风险关联强度呈现倒“S”形非线性剂量反应关系(非线性检验P〈0.001)。结论超重和肥胖可能是高血压人群死亡风险的保护因素,与“肥胖悖论”一致。 Objective To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose- response relation. Results Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m2〈BMI〈24.0 kg/m2) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (〈 18.5 kg/m2, 24-28 kg/m2, and≥28 kg/m2) were 0.83 (95%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P〈0.001). Conclusion Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.
作者 刘雪娇 王炳源 任永成 赵阳 刘德臣 张冬冬 陈序 刘磊磊 程诚 刘飞燕 周琼桂 陈国桢 洪士皓 刘丹 胡思琦 张明 胡东生 Liu Xuejiao, Wang Bingyuan, Ren Yongcheng, Zhao Yang, Liu Dechen, Zhang Dongdong, Chen Xu, Liu Leilei, Cheng Cheng, Liu Feiyan, Zhou Qionggui, Chen Guozhen, Hoag Shihao, Liu Dan, Hu Siqi, Zhang Ming, Hu Dongsheng (1Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China ;2 Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China )
出处 《中华流行病学杂志》 CSCD 北大核心 2018年第7期914-919,共6页 Chinese Journal of Epidemiology
基金 国家自然科学基金(81373074,81402752,81673260)
关键词 体质指数 死亡 高血压 肥胖悖论 Body mass index Mortality Hypertension Obesity paradox
作者简介 通信作者:胡东生,Email:bud@szu.edu.cn
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