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上海市社区居民静坐时间与全因死亡风险关系的队列研究

张妍 段春梅 金亚清 龚刚 赵琦 赵根明 彭谦 于宏杰

张妍, 段春梅, 金亚清, 龚刚, 赵琦, 赵根明, 彭谦, 于宏杰. 上海市社区居民静坐时间与全因死亡风险关系的队列研究[J]. 中华疾病控制杂志, 2024, 28(6): 672-677. doi: 10.16462/j.cnki.zhjbkz.2024.06.009
引用本文: 张妍, 段春梅, 金亚清, 龚刚, 赵琦, 赵根明, 彭谦, 于宏杰. 上海市社区居民静坐时间与全因死亡风险关系的队列研究[J]. 中华疾病控制杂志, 2024, 28(6): 672-677. doi: 10.16462/j.cnki.zhjbkz.2024.06.009
ZHANG Yan, DUAN Chunmei, JIN Yaqin, GONG Gang, ZHAO Qi, ZHAO Genming, PENG Qian, YU Hongjie. A cohort study on the relationship between sedentary time and all-cause mortality in community residents in Shanghai[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(6): 672-677. doi: 10.16462/j.cnki.zhjbkz.2024.06.009
Citation: ZHANG Yan, DUAN Chunmei, JIN Yaqin, GONG Gang, ZHAO Qi, ZHAO Genming, PENG Qian, YU Hongjie. A cohort study on the relationship between sedentary time and all-cause mortality in community residents in Shanghai[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(6): 672-677. doi: 10.16462/j.cnki.zhjbkz.2024.06.009

上海市社区居民静坐时间与全因死亡风险关系的队列研究

doi: 10.16462/j.cnki.zhjbkz.2024.06.009
基金项目: 

国家重点研发计划精准医学重点专项 2017YFC0907000

上海市加强公共卫生体系建设三年行动计划优青项目 GWIV-11.2-YQ18

上海市疾病预防控制青年骨干人才培养项目 21QNGG22

详细信息
    通讯作者:

    于宏杰,E-mail:jiecky2002@163.com

  • 中图分类号: R161.1

A cohort study on the relationship between sedentary time and all-cause mortality in community residents in Shanghai

Funds: 

National Key Research and Development Plan Precision Medicine Key Project 2017YFC0907000

Talent Youth Project, Three-year (2023-2025) Action Plan of Shanghai Public Health System Development GWIV-11.2-YQ18

Key Young Talents Training Program for Shanghai Disease Control and Prevention 21QNGG22

More Information
  • 摘要:   目的  探索上海市嘉定区20~74岁社区居民静坐时间与全因死亡风险的关系,为静坐行为指导提供科学依据。  方法  基于上海市高峰人群队列在嘉定区的项目点数据,排除静坐时间缺失的个体后,最终纳入10 038人。个体的静坐时间通过基线调查问卷获得,个体的死亡信息通过链接死亡监测系统和主动的定向监测获取。采用Cox比例风险回归模型评估死亡风险。  结果  2017年7月1日―2022年12月31日,研究对象平均随访(5.4±0.4)年(共观察53 985.7人年),随访期间发生205例死亡事件。静坐时间0~<4 h/d、4~<6 h/d、6~<8 h/d、≥8 h/d组的死亡率分别为1.8%(89/5 040)、2.0%(54/2 654)、2.8%(26/945)、2.6%(36/1 399)。Kaplan-Meier生存曲线显示,4组的全因死亡风险随着随访时间增加而上升,组间差异无统计学意义(Log-Rank $\chi^2$=6.230,P=0.101)。Cox比例风险回归模型显示,调整混杂后,与静坐时间0~<4 h/d组相比,6~<8 h/d、≥8 h/d组的全因死亡发生风险均增加(HR6~<8 h/d组=1.602, 95% CI:1.007~2.548, P=0.047; HR≥8 h/d组=1.670, 95% CI:1.100~2.538, P=0.016)。  结论  静坐时间是全因死亡发生风险的独立危险因素,每天静坐时间≥6 h后死亡风险增加。未来仍需针对不同人群采取个性化的干预措施,避免长时间静坐。
  • 图  1  静坐时间与全因死亡关系的生存函数图

    Figure  1.  Survival function graph of the relationship between sedentary time and all-cause death

    表  1  调查人群的基线特征描述

    Table  1.   Description of baseline characteristics in the survey population

    变量 Variable 合计 Total (n=10 038) 通常1 d静坐时间 Typical sedentary time in 1 day $\chi^2$/F/H值 value P值 value
    0~<4/(h·d-1) (n=5 040) 4~<6/(h·d-1) (n=2 654) 6~<8/(h·d-1) (n=945) ≥8/(h·d-1) (n=1 399)
    年龄/岁 Age/years 57.5±10.4 58.8±8.8 58.2±10.2 56.0±11.8 52.6±13.3 148.875 <0.001
    性别 Gender 74.366 <0.001
      男性 Male 4 013(40.0) 1 838(36.5) 1 074(40.5) 436(46.1) 665(47.5)
      女性 Female 6 025(60.0) 3 202(63.5) 1 580(59.5) 509(53.9) 734(52.5)
    文化程度 Education level 416.760 <0.001
      小学及以下 Elementary school or below 540(5.4) 270(5.4) 164(6.2) 46(4.9) 60(4.3)
      初中 Middle school 2 240(22.3) 1 210(24.0) 592(22.3) 199(21.0) 239(17.1)
      高中/中专 High/technical secondary school 6 205(61.8) 3 260(64.7) 1 637(61.7) 535(56.6) 773(55.2)
      大专及以上 College or above 1 053(10.5) 300(5.9) 261(9.8) 165(17.5) 327(23.4)
    婚姻状况 Marital status 9.861 0.020
      在婚 Married 9 257(92.2) 4 682(92.9) 2 442(92.0) 868(91.9) 1 265(90.4)
      非在婚 Single 781(7.8) 358(7.1) 212(8.0) 77(8.1) 134(9.6)
    BMI/(kg·m-2) 22.928 0.006
      低体重 Underweight 369(4.0) 163(3.5) 95(3.9) 40(4.6) 71(5.6)
      正常 Standard 4 599(50.1) 2 362(51.3) 1 153(47.5) 432(49.7) 652(51.1)
      超重 Overweight 3 253(35.5) 1 613(35.2) 906(37.4) 313(35.9) 421(33.0)
      肥胖 Obesity 951(10.4) 464(10.1) 271(11.2) 85(9.8) 131(10.3)
    吸烟 Smoking 56.969 <0.001
      是 Yes 2 687(26.8) 1 197(23.8) 742(28.0) 301(31.9) 447(32.0)
      否 No 7 351(73.2) 3 843(76.2) 1 912(72.0) 644(68.1) 952(68.0)
    饮酒 Drinking 4.406 0.221
      是 Yes 1 312(13.1) 626(12.4) 365(13.8) 123(13.0) 198(14.2)
      否 No 8 726(86.9) 4 414(87.6) 2 289(86.2) 822(87.0) 1 201(85.8)
    体力活动 Physical activity 358.109 <0.001
      高水平 High level 4 425(44.1) 2 490(49.4) 1 215(45.8) 351(37.1) 369(26.4)
      中等水平 Moderate level 3 855(38.4) 1 866(37.0) 1 025(38.6) 377(39.9) 587(41.9)
      低水平 Low level 1 758(17.5) 684(13.6) 414(15.6) 217(23.0) 443(31.7)
    睡眠时间/(h·d-1) Sleep duration/(h·d-1) 16.844 0.010
      0~<7 1 193(11.8) 599(11.9) 313(11.8) 114(12.0) 167(11.9)
      7~<10 8 467(84.4) 4 283(85.0) 2 240(84.4) 786(83.3) 1 158(82.8)
      ≥10 377(3.8) 158(3.1) 101(3.8) 44(4.7) 74(5.3)
    高血压 Hypertension 45.746 <0.001
      有 Yes 3 798(37.8) 1 968(39.0) 1 074(40.5) 327(34.6) 429(30.7)
      无 No 6 240(62.2) 3 072(61.0) 1 580(59.5) 618(65.4) 970(69.3)
    糖尿病 Diabetes 5.680 0.128
      有 Yes 867(8.6) 423(8.4) 243(9.2) 95(10.1) 106(7.6)
      无 No 9 171(91.4) 4 617(91.6) 2 411(90.8) 850(89.9) 1 293(92.4)
    冠心病 Coronary heart disease 24.126 <0.001
      有 Yes 558(5.6) 245(4.9) 190(7.2) 63(6.7) 60(4.3)
      无 No 9 480(94.4) 4 795(95.1) 2 464(92.8) 882(93.3) 1 339(95.7)
    脑卒中 Stroke 6.669 0.083
      有 Yes 549(5.5) 256(5.1) 171(6.4) 49(5.2) 73(5.2)
      无 No 9 489(94.5) 4 784(94.9) 2 483(93.6) 896(94.8) 1 326(94.8)
    恶性肿瘤 Malignant tumor 2.995 0.539
      有 Yes 169(1.7) 91(1.8) 45(1.7) 17(1.8) 16(1.1)
      无 No 9 869(98.3) 4 949(98.2) 2 609(98.3) 928(98.2) 1 383(98.9)
    注:①以人数(占比/%)或(x±s)表示;②缺失866例。
    Note:①Number of people (proportion/%) or (x±s); ② 866 cases were missing.
    下载: 导出CSV

    表  2  嘉定区社区居民全因死亡的多因素Cox比例风险回归模型分析

    Table  2.   Multivariate Cox regression analysis of all-cause deaths in Jiading District

    自变量 Independent variable 参照组 Reference β值 value sx Wald $\chi^2$值 value P值 value HR值 value(95% CI)
    年龄/岁 Age/years 0.095 0.012 63.545 <0.001 1.100 (1.075~1.126)
    性别 Gender
      女性 Female 男性 Male -0.579 0.218 7.025 0.008 0.561 (0.366~0.860)
    文化程度 Education level
      小学及以下 Elementary school or below 大专及以上 College or above 0.367 0.473 0.603 0.438 1.444 (0.571~3.650)
      初中 Middle school 0.173 0.409 0.180 0.671 1.189 (0.534~2.650)
      高中/中专 High/technical secondary school 0.138 0.394 0.123 0.725 1.148 (0.530~2.487)
    婚姻状况 Marital status
      非在婚 Single 在婚 Married -0.117 0.283 0.170 0.680 0.890 (0.511~1.549)
    BMI
      低体重 Underweight 正常 Standard 0.712 0.300 5.625 0.018 2.038 (1.132~3.671)
      超重 Overweight -0.328 0.176 3.498 0.061 0.720 (0.510~1.016)
      肥胖 Obesity 0.142 0.226 0.392 0.531 1.152 (0.739~1.796)
    吸烟 Smoking
      是 Yes 否 No 0.157 0.209 0.568 0.451 1.170 (0.777~1.762)
    饮酒 Drinking
      是 Yes 否 No -0.254 0.216 1.393 0.238 0.775 (0.508~1.183)
    体力活动 Physical activity
      高水平 High level 低水平 Low level -0.299 0.211 2.008 0.156 0.742 (0.491~1.121)
      中等水平 Moderate level -0.245 0.199 1.516 0.218 0.783 (0.530~1.156)
    睡眠时间/(h·d-1) Sleep duration/(h·d-1)
      7~<10 0~<7 0.024 0.234 0.010 0.919 1.024 (0.647~1.620)
      ≥10 0.419 0.339 1.520 0.218 1.520 (0.781~2.956)
    高血压 Hypertension
      有 Yes 无 No 0.082 0.161 0.258 0.611 1.085 (0.791~1.489)
    糖尿病 Diabetes
      有 Yes 无 No 0.263 0.210 1.563 0.211 1.300 (0.861~1.963)
    冠心病 Coronary heart disease
      有 Yes 无 No 0.284 0.238 1.426 0.232 1.328 (0.833~2.117)
    脑卒中 Stroke
      有 Yes 无 No 0.462 0.219 4.469 0.035 1.587 (1.034~2.436)
    恶性肿瘤 Malignant tumor
      有 Yes 无 No 0.673 0.366 3.388 0.066 1.961 (0.957~4.017)
    静坐时间/(h·d-1) Sedentary time/(h·d-1)
      4~<6 0~<4 0.103 0.183 0.316 0.574 1.108 (0.774~1.587)
      6~<8 0.471 0.237 3.963 0.047 1.602 (1.007~2.548)
      ≥8 0.513 0.213 5.783 0.016 1.670 (1.100~2.538)
    下载: 导出CSV
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  • 收稿日期:  2024-03-11
  • 修回日期:  2024-05-27
  • 网络出版日期:  2024-07-13
  • 刊出日期:  2024-06-10

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