摘要
目的分析老年人家务性和休闲性体力活动(HLPA)与心血管代谢性共病发病风险的关联性。方法本研究为回顾性队列研究, 基于中国老年健康与家庭幸福调查(CLHLS-HF)2008—2018年、2011-2018年、2014-2018年3个纵向调查数据集, 纳入10 876例完成≥1次随访的≥65岁老年人进行队列研究, 收集其一般资料、生活方式、慢性病史及体格检查结果。以HLPA评分作为评估研究对象HLPA参与程度的指标, 分别按四分位数分为Q1~Q4共4组, 以性别、居住地类别及家庭收入联合分层, 应用分层Cox回归模型分析HLPA评分与心血管代谢性共病发病风险的关联, 采用Cox回归结合限制性立方样条(RCS)模型分析HLPA评分与心血管代谢性共病发病的剂量-反应关系。结果队列共观察51 630.24人年, 中位随访时间3.95(2.57, 6.04)年, 共有576例新发心血管代谢性共病患者, 发病密度为11.16/千人年。与Q1组HLPA评分比较, Q2组(HR=0.69, 95%CI:0.53~0.90)、Q3组(HR=0.59, 95%CI:0.45~0.77)、Q4组(HR=0.56, 95%CI:0.42~0.74)老年人心血管代谢性共病发病风险分别降低31%、41%、44%(均P<0.05)。HLPA评分与心血管代谢性共病发病呈非线性关联(P_(非线性)=0.010), 心血管代谢性共病发病风险随HLPA评分的增加而降低, 在中位数之前, 下降趋势明显, 而后下降趋于平缓。HLPA评分与锻炼身体情况存在交互作用(P_(交互)=0.016), 在不参加锻炼人群中, HLPA评分与心血管代谢性共病发病风险呈负关联(HR=0.65, 95%CI:0.52~0.80, P<0.001)。结论我国老年人HLPA与心血管代谢性共病发病风险呈非线性负关联, 重点针对不参加锻炼的人群进行干预可能获得更佳的效果。
ObjectiveTo analyze the association between household and leisure-time physical activity(HLPA)and the risk of cardiometabolic multimorbidity(CMM)in the elderly.MethodsThis retrospective cohort study utilized three longitudinal datasets from the Chinese Longitudinal Healthy Longevity and Happy Family Study(CLHLS-HF)covering 2008-2018,2011-2018,and 2014-2018.A total of 10876 participants aged≥65 years who completed at least one follow-up were enrolled for cohort analysis.The general data,lifestyle,histories of chronic diseases,and physical examination results were collected.The HLPA score was utilized as an indicator to assess the degree of HLPA participation of the study subjects,the subjects were divided into 4 groups by quartile of HLPA score(Q1,Q2,Q3,and Q4),and were stratified jointly by sex,type of residence and household income;stratified Cox regression was applied to analyze the association between HLPA score and the risk of CMM morbidity,and Cox regression combined with restricted cubic spline(RCS)model was utilized to analyze the dose-response relationship between HLPA score and CMM morbidity.ResultsThe cohort was observed for a total of 51630.24 person-years,with a median follow-up time of 3.95(2.57,6.04)years,with 576 new cases of CMM and an incidence density of 11.16 per 1000 person-years.Compared with the HLPA score Q1 group,the risk of CMM morbidity was significantly reduced by 31%,41%,and 44%in the elderly in the Q2(HR=0.69,95%CI:0.53-0.90),Q3(HR=0.59,95%CI:0.45-0.77)and Q4(HR=0.56,95%CI:0.42-0.74)groups,respectively(all P<0.05).The HLPA score was non-linearly associated with CMM morbidity(P for nonlinear=0.010),with the risk of CMM morbidity decreasing with the increase of HLPA score,with a significant downward trend up to the median,after which the decline leveled off.There was an interaction between the HLPA score and exercise(P for interaction=0.016);there was a negative association between the HLPA score and the risk of CMM morbidity in the no-exercise population(HR=0.65,95%CI:0.52-0.80,P<0.001).ConclusionThere is a nonlinear negative association between HLPA and the risk CMM morbidity in elderly in China,and interventions focused on those who do not exercise may yield better results.
作者
陈剑锋
呼景飞
史艳君
张柯
陆杰
Chen Jianfeng;Hu Jingfei;Shi Yanjun;Zhang Ke;Lu Jie(Qingpu District Center for Disease Control and Prevention,Shanghai 201799,China)
出处
《中华健康管理学杂志》
北大核心
2025年第12期986-993,共8页
Chinese Journal of Health Management
基金
上海市青浦区卫生健康委员会科研课题(QWJ2022-31)。
关键词
老年人
体力活动
心血管疾病
代谢疾病
共病现象
发病率
Elderly
Physical activity
Cardiovascular diseases
Metabolic diseases
Comorbidity
Incidence
