蒙古族农牧民臀围水平和心脑血管疾病及死亡的队列研究

A cohort study on the relationship between different hip circumference levels and the events of cerebrovascular diseases and deaths in Mongolian peasants and herdsmen

目的探讨蒙古族农牧民不同臀围水平和心脑血管疾病及死亡发生的关系。方法采用队列研究的方法,基线于2003年6月~2004年8月在内蒙古通辽市蒙古族农牧民区建立,研究对象为所有年龄≥20岁的蒙古族居民,共计2 589人;分别在2008年、2009年和2010年进行1次随访,收集心脑血管事件及死亡的发生情况。采用多结局比例风险模型,以脑卒中、冠心病、死亡为多结局事件,分析基线臀围水平对多结局事件及各不同结局的HR（95%CI）值。结果随访期间心脑血管事件的累积发病率为5.64%,发病密度为787.4/10万人年,累积死亡率4.44%,死亡密度为620.2/10万人年。调整了年龄、性别、高血压家族史3个传统危险因素,多因素多结局比例风险模型结果显示,臀围与多结局事件的关联性有统计学意义（均有P〈0.05）,与最低分位数组相比,第2、3、4四分位数组的HR（95%CI）值分别为0.64（0.45~0.91）、0.75（0.53~1.04）、0.65（0.46~0.92）。结论较大的臀围可以降低发生心脑血管疾病及死亡的风险。

Objective To learn the relationship between different hip circumference levels and the events of cerebrovascular diseases and deaths in Mongolians. Methods Prospective cohort study was used. A total of 2 586 peasants and herdsmen was followed in Tongliao,Inner Mongolia,who had the age over 20. Follow-up outcome events were cardiovascular and cerebrovascular disease（ including stroke and coronary heart disease） and death in 2008,2009,2010. We calculated cumulative incidence and incidence density to describe the occurrence of cardiovascular diseases and death in outcome events,to analyze the baseline of outcome occurred. Multivariate Cox proportional hazards model was used,multioutcome events（ cardiovascular and cerebrovascular diseases and deaths） were defined as stroke,coronary heart disease and death,HR value and its 95% CI of hip circumference levels and other risk factors were calculated. Results During the follow-up period,stroke and coronary heart disease cumulative incidence was 5. 64%,the incidence density was 787. 4/100 thousands per year,and the cumulative mortality was 4. 44%,the death density was 620. 2 /100 thousands per year. Multivariate multiple Cox proportional hazards model showed that,after adjusted the three traditional risk factors of age, gender and family history of hypertension,different hip circumference levels were related with the outcome events,compared to the first level,the second,third and fourth levels related with the ending events（ cardio-cerebrovascular disease and death events）,HR（ 95% CI） value was 0. 64（ 0. 45-0. 91）,0. 75（ 0. 53-1. 04）,0. 65（ 0. 46-0. 92）,respectively（ all P 0. 05）. Conclusions Hip circumference levels negatively related with cardiovascular disease and death,and may have independent predictor for cardiovascular and cerebrovascular diseases and death.