生活方式对中国妇女死亡率产生影响

一项对上海妇女的健康调查结果显示了与生活方式相关的因素对该组中国妇女的死亡率产生的影响——这肯定了其它西方相关研究的结果。这项研究成果刊登在本周出版的《科学公共图书馆医药分刊》（PLoS Medicine）上。

这项大型的前瞻性组群研究由Wei Zheng及其同事（来自范德比特大学（Vanderbilt University）和上海肿瘤研究所）主持。研究发现，主动吸烟和饮酒之外的生活方式会对整体的死亡率产生重大的综合影响，其程度堪比吸烟带来的影响。

比如，那些更为健康的生活方式因素，包括正常的体重、较小的腰臀比例、参与运动、配偶不吸烟或从未吸到配偶的二手烟，以及每天摄取大量的水果和蔬菜，都分别与较低的整体死亡率和死因别死亡率紧密相关。

原文摘要：

PLoS Med  doi:10.1371/journal.pmed.1000339

Combined Impact of Lifestyle-Related Factors on Total and Cause-Specific Mortality among Chinese Women: Prospective Cohort Study

Sarah J. Nechuta1, Xiao-Ou Shu1, Hong-Lan Li2, Gong Yang1, Yong-Bing Xiang2, Hui Cai1, Wong-Ho Chow3, Butian Ji3, Xianglan Zhang1, Wanqing Wen1, Yu-Tang Gao2, Wei Zheng1*

Abstract

Background

Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese and other non-Western populations. The objective of this study was to quantify the overall impact of lifestyle-related factors beyond that of active cigarette smoking and alcohol consumption on all-cause and cause-specific mortality in Chinese women.

Methods and Findings

We used data from the Shanghai Women's Health Study, an ongoing population-based prospective cohort study in China. Participants included 71,243 women aged 40 to 70 years enrolled during 1996–2000 who never smoked or drank alcohol regularly. A healthy lifestyle score was created on the basis of five lifestyle-related factors shown to be independently associated with mortality outcomes (normal weight, lower waist-hip ratio, daily exercise, never exposed to spouse's smoking, higher daily fruit and vegetable intake). The score ranged from zero (least healthy) to five (most healthy) points. During an average follow-up of 9 years, 2,860 deaths occurred, including 775 from cardiovascular disease (CVD) and 1,351 from cancer. Adjusted hazard ratios for mortality decreased progressively with an increasing number of healthy lifestyle factors. Compared to women with a score of zero, hazard ratios (95% confidence intervals) for women with four to five factors were 0.57 (0.44–0.74) for total mortality, 0.29 (0.16–0.54) for CVD mortality, and 0.76 (0.54–1.06) for cancer mortality. The inverse association between the healthy lifestyle score and mortality was seen consistently regardless of chronic disease status at baseline. The population attributable risks for not having 4–5 healthy lifestyle factors were 33% for total deaths, 59% for CVD deaths, and 19% for cancer deaths.

Conclusions

In this first study, to our knowledge, to quantify the combined impact of lifestyle-related factors on mortality outcomes in Chinese women, a healthier lifestyle pattern—including being of normal weight, lower central adiposity, participation in physical activity, nonexposure to spousal smoking, and higher fruit and vegetable intake—was associated with reductions in total and cause-specific mortality among lifetime nonsmoking and nondrinking women, supporting the importance of overall lifestyle modification in disease prevention.