生物质燃料使用与老年人全因死亡的关系: 一项前瞻性队列研究

江丽丽; 甘婷; 丁明峰; 韩雪梅; 高银燕

doi:10.16462/j.cnki.zhjbkz.2023.08.004

生物质燃料使用与老年人全因死亡的关系: 一项前瞻性队列研究

doi: 10.16462/j.cnki.zhjbkz.2023.08.004

1.
成都东软学院健康医疗科技学院流行病与卫生统计学，成都 610000
2.
昆士兰科技大学公共卫生与社会工作学院流行病与卫生统计学，昆士兰 4019
3.
兰州大学公共卫生学院社会医学与卫生事业管理，兰州 730000
4.
中南大学湘雅公共卫生学院流行病与卫生统计学，长沙 410000

基金项目:

甘肃省自然科学基金 22JR5RA498

详细信息

通讯作者:
高银燕，E-mail: gaoyy20@csu.edu.cn

中图分类号: R122
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- 被引次数: 0
出版历程
- 收稿日期: 2022-09-20
- 修回日期: 2022-12-23
- 网络出版日期: 2023-09-02
- 刊出日期: 2023-08-10

The relationship between biomass fuel use and all-cause mortality in older adults: a prospective cohort study

1.
Epidemiology and Health Statistics, School of Health and Medical Technology, Chengdu Neusoft University, Chengdu 610000, China
2.
Epidemiology and Health Statistics, School of Public Health and Social Work, Queensland University of Technology, Queensland 4019, Australia
3.
Social Medicine and Health Service Management, School of Public Health, Lanzhou University, Lanzhou 730000, China
4.
Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410000, China

Funds:

Natural Science Foundation of Gansu Province 22JR5RA498

More Information

Corresponding author: GAO Yinyan, E-mail: gaoyy20@csu.edu.cn

摘要

摘要: 目的评估生物质燃料使用与老年人全因死亡的关系。方法纳入2011―2012年进入中国老年健康影响因素跟踪调查(the Chinese Longitudinal Healthy Longevity Survey, CLHLS)并被随访至2018年的≥65岁的参与者共5 853人。采用加权Cox和稳健型逆概率加权后的Cox回归模型评估生物质燃料使用与老年人全因死亡的关系，并探讨随访期间更换使用燃料对全因死亡的影响。结果生物质燃料使用与老年人的全因死亡风险增加有关[平均风险比(average hazard ratio, AHR)=1.17, 95% CI: 1.08~1.28]。与一直使用生物质燃料的老年人相比，改用清洁能源的老年人全因死亡风险更低(AHR=0.21，95% CI: 0.18~0.24)。结论生物质燃料使用可增加老年人的全因死亡风险，改用清洁能源后能够降低老年人的全因死亡风险。
- 生物质燃料 /
- 老年人 /
- 全因死亡 /
- 队列研究
Abstract: Objective To evaluate the relationship between biomass fuel use and all-cause mortality in older adults. Methods This cohort study included participants aged 65 years and older from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2011-2012 who were followed up until 2018. A total of 5 853 participants were included. The Weighted Cox regression model and robust inverse probability weighted Cox regression model were used to explore the association between biomass fuel use and all-cause mortality in older people. In addition, we examined the effect of switching cooking fuels on all-cause mortality during follow-up. Results Biomass fuel use increased the risk of all-cause mortality in older adults [average hazard ratio (AHR)=1.17, 95% CI: 1.08-1.28]. Older adults who switched to clean fuel had a lower risk of all-cause mortality compared with those who kept using biomass fuel (AHR=0.21, 95% CI: 0.18-0.24). Conclusions Biomass fuel use increases the risk of all-cause mortality in older adults, while switching to clean fuel could reduce the risk.
- Biomass fuel /
- Older adults /
- All-cause mortality /
- Cohort study

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图 1 生物燃料使用与全死因关系的亚组分析和敏感性分析

Figure 1. Subgroup and sensitivity analyses for association between biomass fuel use and all-cause mortality

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表 1 研究对象的基线特征

Table 1. Baseline characteristics of study participants

特征 Characteristic	清洁能源(n=2 823) [人数(占比/%)] Clean fuel (n=2 823) [Number of people (proportion/%)]	生物质燃料(n=2 134) [人数(占比/%)] Biomass fuel (n=2 134) [Number of people (proportion/%)]	t/χ²值 value	P值 value
年龄/岁, (x±s) Age /year, (x±s)	86.51±11.06	88.76±11.16	-7.07	< 0.001
性别 Gender			4.50	0.034
男 Male	1 297(45.94)	915(42.88)
女 Female	1 526(54.06)	1 219(57.12)
年收入/元 Annual income/yuan			745.99	< 0.001
≤10 000	726(25.72)	1 303(61.06)
10 000~≤30 000	680(24.09)	468(21.93)
＞30 000	1 417(50.19)	363(17.01)
居住地 Residence			924.68	< 0.001
城市 City	859(30.43)	23(1.08)
镇 Town	978(34.64)	590(27.65)
农村 Rural	986(34.93)	1 521(71.27)
婚姻状况 Marital status			3.06	0.080
已婚 Married	1 032(36.56)	728(34.11)
其他 Others	1 791(63.44)	1 406(65.89)
吸烟 Smoking			20.63	< 0.001
从不 Never	1 832(64.90)	1 460(68.42)
以前 Former	537(19.02)	302(14.15)
现在 Current	454(16.08)	372(17.43)
饮酒 Drinking			28.48	< 0.001
从不 Never	1 862(65.96)	1 511(70.81)
以前 Former	496(17.57)	258(12.09)
现在 Current	465(16.47)	365(17.10)
运动 Exercise			348.47	< 0.001
从不 Never	1 227(43.47)	1 490(69.82)
以前 Former	445(15.76)	221(10.36)
现在 Current	1 151(40.77)	423(19.82)
BMI/(kg·m^-2), (x±s)	21.36±3.93	20.33±3.60	9.39	< 0.001
睡眠质量 Sleep quality			48.41	< 0.001
非常好 Very good	599(21.22)	302(14.15)
好 Good	1 164(41.23)	1 019(47.75)
一般 General	698(24.73)	552(25.87)
差 Bad	330(11.69)	228(10.68)
很差 Very bad	32(1.13)	33(1.55)
患病情况 Disease status
高血压 Hypertension			61.33	< 0.001
是 Yes	935(33.12)	489(22.91)
否 No	1 888(66.88)	1 645(77.09)
糖尿病 Diabetes			59.11	< 0.001
是 Yes	172(6.09)	35(1.64)
否 No	2 651(93.91)	2 099(98.36)
心脏病 Heart disease			54.38	< 0.001
是 Yes	438(15.52)	181(8.48)
否 No	2 385(84.48)	1 953(91.52)
脑血管病 Cerebrovascular disease			14.02	< 0.001
是 Yes	273(9.67)	142(6.65)
否 No	2 550(90.33)	1 992(93.35)
癌症 Cancer			6.71	0.010
是 Yes	38(1.35)	12(0.56)
否 No	2 785(98.65)	2 122(99.44)
帕金森病 Parkinson′s disease			1.77	0.183
是 Yes	33(1.17)	16(0.75)
否 No	2 790(98.83)	2 118(99.25)
痴呆 Dementia			0.01	0.980
是 Yes	114(4.04)	85(3.98)
否 No	2 709(95.96)	2 049(96.02)

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表 2 生物质燃料使用与全因死亡的关系

Table 2. Association of biomass fuel use with all-cause mortality

燃料使用Fuel use	清洁能源(n=2 823) Clean fuel (n=2 823)	生物质燃料HR/AHR值 Biomass fuel HR/AHR value (n=2 134)	生物质燃料(95% CI) Biomass fuel (95% CI) (n=2 134)
人时/人年 Person-time/person years	11 157	6 854
死亡人数 Number of deaths	1 875	1 669
未调整 Unadjusted	1.00	1.36	1.27~1.46
调整多个协变量 Multivariable adjusted	1.00	1.17	1.08~1.28
稳健型逆概率加权 With stable inverse probability weighting	1.00	1.37	1.26~1.50
注：调整年龄、性别、收入、居住地、婚姻状态、吸烟、饮酒、运动、BMI、睡眠质量、自我报告基线患高血压、糖尿病、心脏病、脑血管病、癌症、帕金森病和痴呆。 Note: Adjusted age, gender, income, residence, marital status, smoking, drinking, exercise, BMI, sleep quality, self-reported hypertension, diabetes, heart disease, cerebrovascular disease, cancer, Parkinson′s disease, dementia at baseline.

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表 3 转换能源使用类型与全死因的关系

Table 3. Association of switching cooking fuel types with all-cause mortality

燃料使用 Fuel use	一直使用生物质燃料 Continuous use of biomass fuels (n=2 134)	生物质燃料转化为清洁能源HR/AHR值 Switch from biomass fuels to clean fuels HR/AHR value (n=896)	生物质燃料转化为清洁能源(95% CI) Switch from biomass fuels to clean fuels (95% CI)(n=896)
死亡人数 Number of deaths	1 669	249
人时/人年 Person-time/person years	6 854	5 341
调整多个协变量 Multivariable adjusted	1.00	0.21	0.18~0.24
稳健型逆概率加权 With stable inverse probability weighting	1.00	0.23	0.19~0.27
注：调整年龄、性别、收入、居住地、婚姻状态、吸烟、饮酒、运动、BMI、睡眠质量、自我报告基线患高血压、糖尿病、心脏病、脑血管病、癌症、帕金森病和痴呆。 Note: Adjusted age, gender, income, residence, marital status, smoking, drinking, exercise, BMI, sleep quality, self-reported hypertension, diabetes, heart disease, cerebrovascular disease, cancer, Parkinson′s disease and dementia at baseline.

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