代谢综合征人群中新兴健康生活方式与全因死亡结局的关系

The Relationship between Emerging Healthy Lifestyles and All-Cause Mortality in People with Metabolic Syndrome

摘要: 目的：本研究旨在探讨新兴健康生活方式是否以及在多大程度上降低具有代谢综合征和代谢综合征样特征的个体的全因死亡风险。方法：共选取2007~2014年全国健康与营养调查(NHANES)的6934名参与者，我们根据以下标准评估了参与者的生活方式，即吸烟、饮酒、体力活动、饮食、睡眠时间和久坐行为信息。采用广义线性回归模型分析健康生活方式评分与全因死亡结局的关系。结果与结论：与健康生活方式评分较低的参与者相比，代谢综合征人群中健康生活方式评分中等组的风险比为0.51 (RR = 0.51, 95% CI 0.30~0.88)，健康生活方式评分较高组的风险比为0.26 (RR = 0.26, 95% CI 0.15~0.48)。性别差异仍然存在，女性的中、高分组的风险比分别为0.47 (RR = 0.47, 95% CI 0.23~0.96)和0.21 (RR = 0.21, 95% CI 0.09~0.46)。相比之下，在男性中，健康生活方式的保护作用只在高分组中更为显著(RR = 0.33, 95% CI 0.13~0.83)。无论参与者具有一项代谢综合征的特征，还是多项特征的组合，较高的生活方式评分均与较显著的保护作用相关。在具有代谢综合征及代谢综合征样特征的人群中，坚持新型健康生活方式可降低全因死亡风险，且得分越高，作用越明显。

Abstract: Aims: To explore whether and to what extent emerging healthy lifestyles reduce the risk of all-cause mortality in individuals with metabolic syndrome and metabolic syndrome-like charac-teristics. Methods: A total of 6934 participants from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) were included. We evaluated participants’ lifestyles according to the following criteria: smoking, alcohol consumption, physical activity, diet, sleep duration, and seden-tary behavior information. Generalized linear regression models were used to analyze the associa-tion between healthy lifestyle scores and all-cause mortality. Results and Conclusions: Among par-ticipants with metabolic syndrome, compared to low healthy lifestyle scores group, the risk ratio (RR) was 0.51 (RR = 0.51, 95% CI 0.30~0.88) and 0.26 (RR = 0.26, 95% CI 0.15~0.48) for people with middle and high lifestyle scores respectively. The difference in gender persists. In females, the RRs of the middle and high score groups were 0.47 (RR = 0.47, 95% CI 0.23~0.96) and 0.21 (RR = 0.21, 95% CI 0.09~0.46), respectively. Compared to males, the protective effect of a healthy lifestyle was more pronounced only in the high score group (RR = 0.33, 95% CI 0.13~0.83). Higher lifestyle scores were associated with more prominent protective effects, regardless of the presence of a sin-gle metabolic syndrome factor or a combination of several factors. As a conclusion, sticking to an emerging healthy lifestyle can reduce the risk of all-cause mortality in people with metabolic syn-drome and metabolic syndrome-like characteristics; the higher the score, the more obvious the protective effect.