金昌队列人群代谢性疾病与脑卒中发病关系前瞻性研究

Prospective study of relationship between metabolic diseases and stroke in Jinchang Cohort

目的了解金昌队列人群脑卒中发病状况,探讨代谢性疾病与脑卒中发病之间的联系,为人群脑卒中防治提供科学依据。方法收集金昌队列随访人群33042人的流行病学调查资料和体检数据,通过前瞻性队列研究的方法揭示金昌队列人群脑卒中的发病状况,研究代谢性疾病对脑卒中发病的影响,使用限制三次样线条法来分析各代谢性指标与脑卒中发病风险之间的剂量反应关系。结果金昌队列人群脑卒中发病率为1.59%,标化发病率为3.99%。高血压(男性HR=2.20,女性HR=4.45)与血脂异常(男性HR=1.49,女性HR=1.79)是队列人群脑卒中发病的危险因素,糖尿病仅影响男性人群脑卒中的发病(HR=1.79),肥胖仅影响女性人群脑卒中的发病(HR=1.64),且罹患代谢性疾病种类越多,脑卒中发病风险越大。SBP与脑卒中发病风险之间呈非线性剂量反应关系,而DBP与脑卒中发病风险呈正向线性相关关系。结论金昌队列人群脑卒中发病率在国内外均处于较高水平;代谢性疾病人群为脑卒中的高危人群,在脑卒中防治中应予以重视;DBP可能与脑卒中具有更密切的联系。

Objective To understand the incidence of stroke in the population of Jinchang Cohort and the relationship between metabolic diseases and stroke, and provide scientific evidence for the prevention and treatment of stroke in the population. Methods The epidemiological investigation data and physical examination data of the 33 042 follow-up participants in Jinchang Cohort were collected for a prospective cohort study. Restricted cubic splines functions was used to analyze the dose-response relationship between metabolic indexes and the risk of stroke incidence. Results 1) The incidence rate of stroke in Jinchang Cohort was 1.59%, and the standardized incidence rate was 3.99%. 2) Hypertension (male HR=2.20, female HR=4.45) and dyslipidemia (male HR=1.49, female HR=1.79) were the risk factors of stroke incidence in the population and diabetes had influence on the incidence of stroke only in the males (HR=1.79), while obesity had influence only in the females (HR=1.64). The more kinds of metabolic diseases, the higher risk of stroke incidence was. 3) Systolic blood pressure had a non-linear dose-response correlation with the risk of stroke incidence, while diastolic blood pressure had a positive linear correlation with the risk of stroke incidence. Conclusions The incidence of stroke in Jinchang Cohort population was high compared with both domestic level and oversea level. The patients with metabolic diseases were the population at high-risk for stroke, and more attention should be paid to them in the prevention and treatment of stroke. Diastolic blood pressure might be more closely related to stroke.