Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
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DOI：
10.1371/journal.pmed.1003332
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发表时间：
2020-09
期刊：
影响因子：
15.8
通讯作者：
Zaccardi F
中科院分区：
文献类型：
--
作者：
Chudasama YV;Khunti K;Gillies CL;Dhalwani NN;Davies MJ;Yates T;Zaccardi F
健康的生活方式是否会影响多Morphine的寿命尚不清楚。我们调查了健康的生活方式和预期寿命之间的关联，在人们和没有多发性硬化症。在英国生物库中，共分析了480，940名中年成年人（中位年龄为58岁[范围38-73]，46%为男性，95%为白色）;这项纵向研究收集了2006年至2010年的数据，参与者随访至2016年。我们提取了36种慢性疾病，并将多发病定义为2种或2种以上的疾病。四种生活方式的因素，根据国家的指导方针，被用来：休闲时间的身体活动，吸烟，饮食和饮酒。一个综合加权评分被开发出来，并将参与者分为4类：非常不健康，不健康，健康和非常健康。生存模型用于预测预期寿命，调整种族，工作状态，剥夺，体重指数和久坐时间。共有93，746名（19.5%）参与者患有多发性硬化症。在平均7年（范围2-9年）的随访期间，发生了11，006例死亡。在45岁时，在患有多发性硬化症的男性中，不健康的评分与1.5的增加相关（95%置信区间[CI]-0.3至3.3; P = 0.102）与非常不健康的评分相比，额外的生命年，尽管相关性不显著，而健康的评分与4.5的增益显著相关（3.3 ~ 5.7; P < 0.001）寿命年，非常健康评分为6.3（5.0 ~ 7.7; P < 0.001）年。女性的相应估计值分别为3.5（95% CI 0.7 - 6.3; P = 0.016）、6.4（4.8 - 7.9; P < 0.001）和7.6（6.0 - 9.2; P < 0.001）年。结果是一致的，在那些没有多morphine和几个敏感性分析。就个人生活方式因素而言，目前不吸烟与最大的生存益处相关。主要的局限性是，我们不能探索我们的结果的一致性使用一个更严格的定义，多Morphine包括心脏代谢条件，参与者并不代表整个英国。在对英国生物银行数据的分析中，我们发现，无论是否存在多Morphine，从事更健康的生活方式与男性寿命延长6.3年和女性7.6年相关;然而，并非所有生活方式风险因素与预期寿命相关，吸烟明显比其他因素更糟。在一项纵向研究中，Yogini Chudasama及其同事在英国生物银行队列中调查了预期寿命和健康生活方式与多死亡率之间的关系。患有多发性硬化症（存在2种或2种以上慢性疾病）的人与没有多发性硬化症的人相比，健康状况较差，死亡风险较高。健康的生活方式与更长的预期寿命有关。据我们所知，迄今为止还没有研究调查这种关系的存在多morphine。大多数研究使用的是综合评分，没有考虑到每个生活方式因素对死亡风险的不同影响。我们调查了健康的生活方式和个体危险因素与预期寿命之间的关系，这些危险因素与多发病的存在有关。我们发现，整体健康的生活方式在很大程度上抵消了多发性硬化症和预期寿命之间的负相关。更健康的生活方式始终与各种个人风险的预期寿命延长相关，无论是否存在多种长期医疗条件。关于健康生活方式以减少发展慢性长期疾病风险的公共卫生建议同样适用于已经患有多发性硬化症的个人。
Whether a healthy lifestyle impacts longevity in the presence of multimorbidity is unclear. We investigated the associations between healthy lifestyle and life expectancy in people with and without multimorbidity. A total of 480,940 middle-aged adults (median age of 58 years [range 38–73], 46% male, 95% white) were analysed in the UK Biobank; this longitudinal study collected data between 2006 and 2010, and participants were followed up until 2016. We extracted 36 chronic conditions and defined multimorbidity as 2 or more conditions. Four lifestyle factors, based on national guidelines, were used: leisure-time physical activity, smoking, diet, and alcohol consumption. A combined weighted score was developed and grouped participants into 4 categories: very unhealthy, unhealthy, healthy, and very healthy. Survival models were applied to predict life expectancy, adjusting for ethnicity, working status, deprivation, body mass index, and sedentary time. A total of 93,746 (19.5%) participants had multimorbidity. During a mean follow-up of 7 (range 2–9) years, 11,006 deaths occurred. At 45 years, in men with multimorbidity an unhealthy score was associated with a gain of 1.5 (95% confidence interval [CI] −0.3 to 3.3; P = 0.102) additional life years compared to very unhealthy score, though the association was not significant, whilst a healthy score was significantly associated with a gain of 4.5 (3.3 to 5.7; P < 0.001) life years and a very healthy score with 6.3 (5.0 to 7.7; P < 0.001) years. Corresponding estimates in women were 3.5 (95% CI 0.7 to 6.3; P = 0.016), 6.4 (4.8 to 7.9; P < 0.001), and 7.6 (6.0 to 9.2; P < 0.001) years. Results were consistent in those without multimorbidity and in several sensitivity analyses. For individual lifestyle factors, no current smoking was associated with the largest survival benefit. The main limitations were that we could not explore the consistency of our results using a more restrictive definition of multimorbidity including only cardiometabolic conditions, and participants were not representative of the UK as a whole. In this analysis of data from the UK Biobank, we found that regardless of the presence of multimorbidity, engaging in a healthier lifestyle was associated with up to 6.3 years longer life for men and 7.6 years for women; however, not all lifestyle risk factors equally correlated with life expectancy, with smoking being significantly worse than others. In a longitudinal study, Yogini Chudasama and colleagues investigate associations between life expectancy and healthy lifestyles with multimorbidity in the UK Biobank cohort. People with multimorbidity (presence of 2 or more chronic conditions) have poorer health outcomes and a higher mortality risk compared to people without multimorbidity. A healthy lifestyle has been associated with a longer life expectancy. To our knowledge, no study to date has investigated this relationship in relation to the presence of multimorbidity. Most studies used a combined score that did not account for the differential impact of each lifestyle factor on the risk of death. We investigated the association between healthy lifestyle and individual risk factors with life expectancy in relation to the presence of multimorbidity. We found that an overall healthy lifestyle largely counterbalances the negative association between multimorbidity and life expectancy. A healthier lifestyle is consistently associated with a longer life expectancy across various individual risks and irrespective of the presence of multiple long-term medical conditions. Public health recommendations about a healthy lifestyle to reduce the risk of developing chronic long-term conditions equally apply to individuals who have already multimorbidity.
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影响因子：
5
作者：
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
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纠正：男性和女人的健康行为和死亡率的综合影响：
影响因子：
15.8
作者：
通讯作者：
--
影响因子：
9.3
作者：
Li K;Hüsing A;Kaaks R
通讯作者：
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