Analysis and judgment of age of physiological aging inflection point of Jiangxi community residents
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摘要:
目的 探究不同年龄居民生理衰老的动态变化规律及拐点，为不同年龄段人群延缓衰老措施的研究提供参考。 方法 采用多阶段分层整群抽样方法，抽取江西省部分社区≥20岁5 106名社区居民为研究对象。采用《生理-心理-社会三维人体衰老度量表》(physiological-psychological-social three dimensional human aging scale, PPSHAS)测量样本人群的生理衰老度分值，通过局部加权回归(locally weighted regression，LOESS)平滑曲线拟合样本人群的生理衰老变化曲线；根据生理衰老度评分结果将居民分为衰老组和未衰老组，绘制受试者工作特征曲线(receiver operator characteristic, ROC)以确定生理衰老度拐点的截断值，并采用曲线下面积(area under curve, AUC)等系列指标评价其预测价值；对影响拐点的混杂因素进行二元logistic回归分析模型调整，用C指数验证拐点年龄对衰老度的预测价值。 结果 不同年龄段居民生理衰老度随年龄呈曲线升高；生命不同阶段的拐点年龄有4个，分别是38.2(AUC=0.586，P＜0.01)、49.4(AUC=0.555，P＜0.01)、68.9(AUC=0.545，P＜0.01)和76.9岁(AUC=0.546，P＜0.01)；Logistic回归分析模型分析结果显示，控制混杂影响后，拐点年龄对生理衰老度变化具有预测价值，其中青年人C指数为0.694(P=0.03)、中年人C指数为0.601(P＜0.01)、年轻老人C指数为0.658(P＜0.01)、老年人C指数为0.627(P＜0.01)。 结论 人体生理衰老的过程并非匀速，不同年龄段人群生理衰老均有拐点，且经模型验证均有显著性意义。 Abstract:Objective To explore the dynamic changes and inflection points of physiological aging in residents of different ages, and to provide reference for the study of anti-aging/anti-aging measures in different age groups. Methods A multi-stage stratified cluster sampling method was used to select 5 106 community residents aged over 20 years in some communities in Jiangxi Province. The physiological aging degree score of the sample population was measured by physiological-psychological-social three dimensional human aging scale, and the physiological aging curve of the sample population was fitted by locally weighted scatterplot smoothing curve method. According to the results of physiological aging score, the residents were divided into aging group and non-aging group, and the receiver operator characteristic curve was drawn to determine the cut-off value of the inflection point of physiological aging, and a series of indicators such as area under curve value were used to evaluate its predictive value. The binary logistic regression model adjustment of the confounding factors affecting the inflection point was carried out, and the predictive value of the age of the inflection point on aging degree was verified by the C index. Results The physiological aging degree of residents of different ages increased with age; There were four inflection point ages at different stages of life, namely 38.2 years(AUC=0.586, P < 0.01), 49.4 years(AUC=0.555, P < 0.01), 68.9 years(AUC=0.545, P < 0.01), 76.9 years(AUC=0.546, P < 0.01); The logistic regression results showed that after controlling for the mixed effects, the inflection point age had predictive value on the change of physiological aging, and the C index of young people was 0.694 (P=0.03), that of middle-aged people was 0.601 (P < 0.01), that of young and elderly people was 0.658 (P < 0.01), and that of the elderly was 0.627 (P < 0.01). Conclusions The process of physiological aging in human body is not uniform, and physiological aging of people of different ages has inflection points, and inflection points are significant after model verification. -
图 1 不同年龄层人群生理衰老度分值局部加权回归散点平滑图
Figure 1. Locally weighted scatterplot smoothing plot of physiological aging score of different age groups
表 1 不同年龄层、性别人群生理衰老标准化分值分布及比较
Table 1. Distribution and comparison of standardized scores of physiological aging in different age groups and genders
年龄层
Age groups年龄组/岁
Age group /years男性 Male 女性 Female 合计 Total 人数(占比/%)
Number of people (proportion/%)分值 Score
(x±s)人数(占比/%)
Number of people (proportion/%)分值 Score
(x±s)人数(占比/%)
Number of people (proportion/%)分值 Score
(x±s)青年人(20~＜45岁)
Youth group (20~＜45 years)20~＜25 56(16.09) 19.67±6.35 36(6.37) 16.05±3.21 92(10.08) 18.26±5.61 25~＜30 82(23.56) 25.69±7.03 104(18.41) 17.23±3.83 186(20.37) 20.96±6.89 30~＜35 57(16.38) 28.28±5.04 88(15.57) 18.62±4.64 145(15.88) 22.41±6.73 35~＜40 90(25.86) 30.32±3.26 144(25.49) 19.44±4.24 234(25.63) 23.62±6.57 40~＜45 63(18.11) 32.52±3.90 193(34.16) 21.29±5.08 256(28.04) 24.06±6.82 合计 Total 348(100.00) 27.58±6.70 565(100.00) 19.32±4.78 913(100.00) 22.47±6.88 F值 value 142.891 128.288 103.158 P值 value ＜0.05 ＜0.05 ＜0.05 中年人(45~＜60岁)
Middle-aged group(45~＜60 years)45~＜50 138(29.94) 36.38±3.53 222(29.52) 23.31±5.94 360(29.68) 28.32±8.19 50~＜55 152(32.97) 38.12±4.88 263(34.97) 25.92±4.89 415(34.21) 30.39±7.65 55~＜60 171(37.09) 34.01±5.11 267(35.51) 28.29±4.87 438(36.11) 30.53±5.69 合计 Total 461(100.00) 36.07±4.92 752(100.00) 25.99±5.58 1 213(100.00) 29.82±7.24 F值 value 54.750 115.256 20.034 P值 value ＜0.05 ＜0.05 ＜0.05 年轻老人(60~＜75岁)
Younger elderly group(60~＜75 years)60~＜65 299(34.65) 19.92±8.76 400(37.49) 30.15±4.48 699(36.22) 25.77±8.36 65~＜70 305(35.34) 22.86±4.35 373(34.96) 32.43±4.41 678(35.13) 28.12±6.47 70~＜75 259(30.01) 30.91±3.70 294(27.55) 34.86±4.51 553(28.65) 33.01±4.559 合计 Total 863(100.00) 24.26±7.60 1 067(100.00) 32.24±4.84 1 930(100.00) 28.67±7.39 F值 value 345.716 160.532 281.057 P值 value ＜0.05 ＜0.05 ＜0.05 老年人(≥75岁)
Elderly group (≥75 years)75~＜80 240(48.88) 28.06±5.06 255(45.62) 36.59±4.68 495(47.14) 32.45±6.47 80~＜85 159(32.38) 28.03±6.31 204(36.49) 38.62±4.54 363(34.57) 33.96±7.52 85~＜90 56(11.41) 28.19±1.87 67(11.99) 39.93±4.12 123(11.72) 34.58±6.72 ≥90 ① 36(7.33) 33.05±3.01 33(5.90) 41.33±6.37 69(6.57) 37.01±6.41 合计 Total 491(100.00) 28.44±5.30 559(100.00) 38.01±4.90 1 050(100.00) 33.53±6.88 F值 value 38.150 50.630 30.584 P值 value ＜0.05 ＜0.05 ＜0.05 合计 Total 2 163(100.00) 28.26±7.83 2 943(100.00) 29.26±8.05 5 106(100.00) 28.83±7.97 注：①该组的实际年龄最大为103岁。
Note：① The maximum chronological age in this group was 103 years.
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表 2 不同年龄层人群衰老度拐点年龄的受试者工作特征曲线分析
Table 2. Receiver operator characteristic curve analysis of aging inflection point age among different age groups
年龄层
Age groupsAUC值value (95% CI) 敏感度
Sensitivity特异度
Specificity最大约登指数
Youden index拐点年龄/岁
Inflection point age/yearsP值
value青年人Young group (20~＜45岁years) 0.586(0.550~0.623) 0.409 0.750 0.159 38.2 ＜0.01 中年人Middle-aged group (45~＜60岁years) 0.555(0.522~0.588) 0.750 0.367 0.117 49.4 ＜0.01 年轻老人Young elderly group (60~＜75岁years) 0.545(0.519~0.571) 0.369 0.710 0.079 68.9 ＜0.01 老年人Elderly group (≥75岁years) 0.546(0.512~0.580) 0.817 0.272 0.089 76.9 ＜0.01
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表 3 Logistic回归分析模型对不同年龄层生理拐点年龄验证
Table 3. Validation of logistic regression model on inflection point age for different age groups
年龄层
Age groupsβ值
valuesx Wald OR值value(95% CI) P值
valueC指数
C-index青年人 Young group (20~＜45岁years) 0.350 0.163 4.613 1.420(1.031~1.954) 0.03 0.694 中年人 Middle-aged group (45~＜60岁years) 0.527 0.133 15.621 1.694(1.304~2.199) ＜0.01 0.601 年轻老人 Young elderly group (60~＜75岁years) 0.419 0.102 16.851 1.521(1.245~1.858) ＜0.01 0.658 老年人 Elderly group (≥75岁years) 0.450 0.151 8.921 1.568(1.167~2.106) ＜0.01 0.627
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