目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例...目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例风险回归模型分析饮食质量评分与不同性别糖尿病患者全因死亡的关系。分层分析评估其他因素是否与饮食模式评分有相互作用。结果在74个月的中位随访期内,有512例死亡记录,男性311例,女性201例。饮食评分较高的糖尿病患者组对比较低组调整风险比如下:饮食炎症指数[男性:风险比(hazard ratio,HR)=1.22,P=0.084;女性HR=1.00,P=0.818];地中海饮食评分(男性:HR=0.99,P=0.873;女性HR=0.79,P=0.027);健康饮食指数-2020(男性HR=1.00,P=0.956;女性HR=0.83,P=0.046)。饮食评分对糖尿病患者死亡风险的影响是独立的,未发现饮食评分与其他变量存在内在的相互作用。结论糖尿病人群中,地中海饮食和健康饮食指数-2020与女性较低的死亡风险相关,而在男性未发现明显的关联。展开更多
Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases...Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.展开更多
Objective： To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease （CHD） mortality, cardiovascular mortality or all-cause mortality in the general population by a m...Objective： To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease （CHD） mortality, cardiovascular mortality or all-cause mortality in the general population by a meta- analysis. Methods： In a systematic search conducted in the databases of PubMed and Embase prior to October 2013, we identified relevant prospective observational studies evaluating the association between baseline homocysteine levels and CHD mortality, cardiovascular or all-cause mortality in the general population. Pooled adjust risk ratio （RR） and corresponding 95% confidence interval （CI） were calculated separately for categorical risk estimates and con- tinuous risk estimates. Results： Twelve studies with 23 623 subjects were included in the meta-analysis. Comparing the highest to lowest homocysteine level categories, CHD mortality increased by 66% （RR 1.66; 95% CI 1.12-2.47; P=-0.012）, cardiovascular mortality increased by 68% （RR 1.68; 95% CI 1.04-2.70; P=0.033）, and all-cause mortality increased by 93% （RR 1.93; 95% CI 1.54-2.43; P〈0.001）. Moreover, for each 5 pmol/L homocysteine increment, the pooled RR was 1.52 （95% CI 1.26-1.84; ,〈0.001） for CHD mortality, 1.32 （95% CI 1.08-1.61; P=0.006） for cardio- vascular mortality, and 1.27 （95% CI 1.03-1.55; P=-0.023） for all-cause mortality. Conclusions： Elevated homocysteine levels are an independent predictor for subsequent cardiovascular mortality or all-cause mortality, and the risks were more pronounced among elderly persons.展开更多
文摘目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例风险回归模型分析饮食质量评分与不同性别糖尿病患者全因死亡的关系。分层分析评估其他因素是否与饮食模式评分有相互作用。结果在74个月的中位随访期内,有512例死亡记录,男性311例,女性201例。饮食评分较高的糖尿病患者组对比较低组调整风险比如下:饮食炎症指数[男性:风险比(hazard ratio,HR)=1.22,P=0.084;女性HR=1.00,P=0.818];地中海饮食评分(男性:HR=0.99,P=0.873;女性HR=0.79,P=0.027);健康饮食指数-2020(男性HR=1.00,P=0.956;女性HR=0.83,P=0.046)。饮食评分对糖尿病患者死亡风险的影响是独立的,未发现饮食评分与其他变量存在内在的相互作用。结论糖尿病人群中,地中海饮食和健康饮食指数-2020与女性较低的死亡风险相关,而在男性未发现明显的关联。
基金This project is supported by China Roche Pharmaceuticals.
文摘Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.
文摘Objective： To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease （CHD） mortality, cardiovascular mortality or all-cause mortality in the general population by a meta- analysis. Methods： In a systematic search conducted in the databases of PubMed and Embase prior to October 2013, we identified relevant prospective observational studies evaluating the association between baseline homocysteine levels and CHD mortality, cardiovascular or all-cause mortality in the general population. Pooled adjust risk ratio （RR） and corresponding 95% confidence interval （CI） were calculated separately for categorical risk estimates and con- tinuous risk estimates. Results： Twelve studies with 23 623 subjects were included in the meta-analysis. Comparing the highest to lowest homocysteine level categories, CHD mortality increased by 66% （RR 1.66; 95% CI 1.12-2.47; P=-0.012）, cardiovascular mortality increased by 68% （RR 1.68; 95% CI 1.04-2.70; P=0.033）, and all-cause mortality increased by 93% （RR 1.93; 95% CI 1.54-2.43; P〈0.001）. Moreover, for each 5 pmol/L homocysteine increment, the pooled RR was 1.52 （95% CI 1.26-1.84; ,〈0.001） for CHD mortality, 1.32 （95% CI 1.08-1.61; P=0.006） for cardio- vascular mortality, and 1.27 （95% CI 1.03-1.55; P=-0.023） for all-cause mortality. Conclusions： Elevated homocysteine levels are an independent predictor for subsequent cardiovascular mortality or all-cause mortality, and the risks were more pronounced among elderly persons.
