不同年龄段生活方式对脑卒中影响的差异研究

Age⁃related differences in the role of lifestyle for stroke

目的探讨上海市松江区居民生活方式对脑卒中风险的影响在不同年龄段中是否存在差异。方法选取上海郊区自然人群队列和生物样本库中松江区的31771名研究对象,计算其健康生活方式评分(包括不吸烟、积极体育锻炼、均衡膳食和正常体重),并随访至2021年12月31日。分别采用Cox比例风险回归和泊松回归评估不同基线年龄组和暴露年龄组中不同的生活方式或健康生活方式评分与新发脑卒中的HR值(95%CI)和RR值(95%CI)。基线年龄分层:年轻组(20~<62岁)、中年组(62~<68岁)以及老年组(≥68岁)。暴露年龄分层:年轻组(20~<65岁)、中年组(65~<70岁)以及老年组(≥70岁)。结果在5.0年的中位随访时间内共新发488例脑卒中事件。控制混杂变量后,两种方法都未发现不吸烟、积极体育锻炼、均衡膳食和正常体重与脑卒中发病风险的关联在不同的年龄组有显著差异。与基线生活方式评分≤1分组相比,年轻组、中年组及老年组中评分≥3分组的新发脑卒中风险较低(HR=0.67,95%CI:0.43~1.03,P=0.072;HR=0.59,95%CI:0.39~0.91,P=0.015;HR=0.64,95%CI:0.42~1.00,P=0.043和RR=0.63,95%CI:0.42~0.96,P=0.028;RR=0.61,95%CI:0.40~0.94,P=0.023;RR=0.63,95%CI:0.40~0.99,P=0.045)。结论在上海市松江区居民中没有发现不同的生活方式与脑卒中的关联存在年龄差异。提示在任何年龄阶段都应重视健康的生活方式。当整体的生活方式比较健康时可大幅度降低脑卒中发病风险。

Objective To investigate whether there are differences in the influence of lifestyle on stroke risk in different age groups in Songjiang district of Shanghai.Methods A total of 31771 study participants from the Songjiang District in the Shanghai Suburban Adult Cohort and Biobank were selected to calculate their healthy lifestyle scores(including non⁃smoking,active physical activity,balanced diet,and normal body weight)and were followed until December 31,2021.Cox proportional risk regression and Poisson regression were used to determine the HR(95%CI)and RR(95%CI)of different lifestyle or healthy lifestyle scores associated with stroke in various baseline age groups and exposed age groups,respectively.Baseline age was stratified by young(20-<62 years),middle(62-<68 years),and old(≥68 years)groups.Exposure age was stratified by young(20-<65 years),middle(65-<70 years),and old(≥70 years)groups.Results Over a median follow⁃up of 5.0 years,488 participants developed stroke.After adjusting confounding factors,the associations between non⁃smoking,active physical activi⁃ty,balanced diet,or normal body weight and the risk of stroke were not significantly different across age groups,regardless of the method used.The risk of stroke was lower in the group with a score of≥3 in the young,middle,and old stratum compared with the group with a baseline lifestyle score≤1(HR=0.67,95%CI:0.43-1.03,P=0.072;HR=0.59,95%CI:0.39-0.91,P=0.015;HR=0.64,95%CI:0.42-1.00,P=0.043;RR=0.63,95%CI:0.42-0.96,P=0.028;RR=0.61,95%CI:0.40-0.94,P=0.023;RR=0.63,95%CI:0.40-0.99,P=0.045).Conclusions No age⁃related differences in the association of different lifestyles with stroke are found among residents of Songjiang District,Shanghai.It implies that a healthy lifestyle should be emphasized regardless of age.In addition,a healthy lifestyle can substantially reduce the risk of stroke.