中国老年人体型与全因死亡风险的关系

Associations of body figure and all-cause mortality among Chinese elderly

目的研究中国老年人体型与全因死亡风险的关系。方法利用中国老年健康影响因素跟踪调查(CLHLS)2011—2018年数据,纳入5860例≥65岁老年人为研究对象,收集人口社会学信息、生活方式、饮食、日常活动、疾病及死亡情况等资料,根据中国人群体重指数(BMI)和腰围的分类标准将研究对象分成6种体型,采用多因素Cox回归分析体型与全因死亡风险的关系。结果研究对象累计随访25121人年(平均4.29±2.53年)。多因素调整后,低体重组较正常体重死亡风险升高(HR=1.28,95%CI:1.19~1.37),腰围超标者较腰围正常者死亡风险下降(HR=0.80,95%CI:0.75~0.85)。6种体型中,与腰围&体重均正常组相比,低体重&腰围正常者死亡风险最高(HR=1.16,95%CI:1.06~1.28),而体重正常&腰围超标者(HR=0.80,95%CI:0.72~0.89)、体重&腰围均超标者(HR=0.76,95%CI:0.66~0.88)死亡风险下降。亚组分析显示年龄、性别、吸烟、慢性疾病数量、日常生活活动能力残疾、睡眠时长与体型均无交互作用(P>0.05)。结论对于中国老年人群,低体重者全因死亡风险升高,而体重和/或腰围超标者全因死亡风险降低。

Objective To explore the relationship between different types of body figure and all-cause mortality among older adults in China.Methods The study used data from Chinese Longitudinal Healthy Longevity Survey(CLHLS)between 2011-2018.A total of 5860 participants aged≥65 years were included and the demographic information,lifestyle,dietary intake,activities of daily living,chronic diseases information and deaths were collected.All the participants were categorized into 6 body figure groups according to their body mass index(BMI)and waist circumference(WC).Cox regression analysis was used to evaluate the hazard ratios(HRs)and 95%confidence intervals(95%CIs)of all-cause mortality and figure.Results A total of 25121 person-years were followed up between 2011 and 2018(mean 4.29±2.53 years).After adjusted for confounding factors,an increased risk of all-cause mortality was shown in underweight group compared with normal weight group(HR=1.28,95%CI:1.19-1.37),high WC was associated with decreased risk for death compared to normal WC(HR=0.80,95%CI:0.75-0.85).Compared to those with normal BMI and WC,people with underweight and normal WC had the highest mortality risk(HR=1.16,95%CI:1.06-1.28)among 6 figure groups,those with normal weight&high WC(HR=0.80,95%CI:0.72-0.89),people who were overweight with high WC(HR=0.76,95%CI:0.66-0.88)showed lower risks for death.Subgroup analysis showed no significant interaction between stratification variables(age,gender,smoking,number of chronic diseases,activities of daily living disability and sleep duration)and body figure(P>0.05).Conclusions Among Chinese older adults,underweight was associated with an increased risk of all-cause mortality,whereas people with exceeding BMI and/or WC had a lower all-cause mortality risk.