青年人群累积生命八要素评分与脑卒中的关联

Association between cumulative life's essential 8 score and stroke in young adults

摘要

目的 探讨青年人群累积生命八要素评分（cumLE8）与脑卒中的关联。方法 本研究为回顾性队列研究。选取连续参加开滦研究 2006 至 2012 年度 4 次体检的 9 303 例观察对象，观察对象按照 cumLE8 的三分位数分为三组（T1、T2、T3），以 2012 年度体检的时间点作为基线时间并进行随访。采用 Cox 风险比例模型，评估 cumLE8 与脑卒中风险的关系。结果 在中位随访 9.94（9.61，10.15）年期间，共发生 168 例脑卒中，其中 T1 组 106 例（3.42%），T2 组 44 例（1.42%），T3 组 18 例（0.58%）。多因素 Cox 比例风险回归分析结果显示，与 T1 组相比，T2 组和 T3 组发生脑卒中风险的 HR（95%CI）分别为 0.60（0.41～0.88）和 0.43（0.24～0.79）。当将 cumLE8 作为连续性变量分析时，cumLE8 每增加一个标准差（6.58），脑卒中的发生风险下降 4%（HR=0.96，95%CI：0.94～0.99）。在脑卒中亚型分析中，cumLE8 与缺血性脑卒中风险呈负向关联，而与出血性脑卒中风险的关联无统计学意义。结论 青年人群的 cumLE8 与总体脑卒中风险呈负相关，这种关联主要见于缺血性脑卒中，而非出血性脑卒中。

Abstract

Objective To explore the association between cumulative life's essential 8 (cumLE8) score and stroke in young adults. Methods This is a retrospective cohort study. A total of 9 303 participants who consecutively attended 4 physical examinations in the Kailuan Study from 2006 to 2012 were selected. The participants were divided into three groups (T1, T2, T3) according to the tertiles of cumLE8 scores. The physical examination in 2012 was set as the baseline, and follow-up was conducted. The Cox proportional hazards model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) of the association between cumLE8 and stroke risk. Results During a mean follow-up of 9.94 (9.61, 10.15) years, a total of 168 stroke events occurred, among which 106 cases (3.42%) were in Group T1, 44 cases (1.42%) in Group T2, and 18 cases (0.58%) in Group T3. Multivariate Cox proportional hazards regression analysis showed that compared with the Group T1, the HR (95%CI) for stroke in the Group T2 and Group T3 were 0.60 (0.41 to 0.88) and 0.43 (0.24 to 0.79), respectively. When cumLE8 was analyzed as a continuous variable, each increase of 1 standard deviation (6.58) in cumLE8 was associated with a 4% reduction in stroke risk (HR = 0.96, 95%CI: 0.94 to 0.99). In the subtype analysis of stroke, cumLE8 was inversely associated with ischemic stroke, whereas no statistically significant association was observed with hemorrhagic stroke. Conclusion In the young population, cumLE8 was inversely associated with overall stroke risk, and this association was primarily observed for ischemic stroke rather than hemorrhagic stroke.

关键词

生命八要素 / 脑卒中 / 青年人群 / 开滦研究

Key words

life's essential 8 / stroke / young adults / Kailuan study

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基金资助

河北省医学科学研究课题计划项目(20251171)