Risk Patterns and Mortality in Postmenopausal Women Using Latent Class Analysis.
Risk Patterns and Mortality in Postmenopausal Women Using Latent Class Analysis.
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DOI：
10.1016/j.amepre.2021.04.025
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发表时间：
2021-11
影响因子：
5.5
通讯作者：
Margolis KL
中科院分区：
文献类型：
--
作者：
Luo J;Dinh P;Hendryx M;Li W;Robinson J;Margolis KL
虽然风险因素往往共同发生，以前的研究检查生活方式或心理社会因素往往把这些因素作为个人的健康预测。本研究的目的是确定潜在的亚组妇女的特点是不同的生活方式和社会心理的风险模式，并调查风险模式和死亡率之间的前瞻性关联绝经后妇女。共有64，812名年龄在50-79岁之间的绝经后女性在基线（1993-1998）时没有糖尿病，心血管疾病和癌症，随访至2019年，平均随访时间为14.6（SD=6.4）年。潜在类别分析用于确定潜在类别的妇女同质组合的生活方式和社会心理变量，并测试类是否与死亡率的前瞻性相关。分析按人种╱种族分层，并于二零二零年进行。西班牙裔、黑人和白色女性有4个潜在类别（“健康的生活方式和心理社会”、“危险的心理社会”、“危险的生活方式”和“危险的生活方式和危险的心理社会”），美洲印第安人和亚洲女性有2个类别（“高风险”或“低风险”）。与健康生活方式和心理社会组相比，危险生活方式和危险心理社会组在所有种族/民族群体中研究的所有结果的风险比最高，其次是危险生活方式组。仅在黑人女性中，危险的心理社会等级与总体和心血管疾病死亡率的风险升高显著相关。与低风险参考组相比，同时存在危险生活方式和心理社会因素的类别传达了所有类型死亡率的最大风险。健康促进应同时解决行为和心理社会风险。
Although risk factors often co-occur, previous studies examining lifestyle or psychosocial factors often treat these factors as individual predictors of health. This study aims to identify underlying subgroups of women characterized by distinct lifestyle and psychosocial risk patterns, and investigate prospective associations between risk patterns and mortality among postmenopausal women. A total of 64,812 postmenopausal women aged 50–79 years without prevalent diabetes, cardiovascular disease, and cancer at baseline (1993–1998) were followed until 2019 with a mean follow-up of 14.6 (SD=6.4) years. Latent class analysis was used to identify latent classes of women with homogeneous combinations of lifestyle and psychosocial variables and test whether the classes were prospectively associated with mortality. Analyses were stratified by race/ethnicity and performed in 2020. Four latent classes (“Healthy Lifestyle and Psychosocial,” “Risky Psychosocial,” “Risky Lifestyle,” and “Risky Lifestyle and Risky Psychosocial”) were identified for Hispanic, Black, and White Women, and 2 classes (“High Risk” or “Low Risk”) for American Indian and Asian women. Compared with the Healthy Lifestyle and Psychosocial group, the Risky Lifestyle and Risky Psychosocial group had the highest hazard ratios for all outcomes studied for all race/ethnicity groups, followed by the Risky Lifestyle group. Risky Psychosocial class was significantly associated with elevated risk of overall and cardiovascular disease mortality only in Black women. The class with concurrent risky lifestyle and psychosocial factors conveyed greatest risk of all types of mortality compared with a low-risk ref group. Health promotion should address both behavioral and psychosocial risks concurrently.
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影响因子：
12.7
作者：
Jackson JS;Knight KM;Rafferty JA
通讯作者：
Rafferty JA
影响因子：
2.3
作者：
Johnson-Kozlow, Marilyn;Rock, Cheryl L.;Pierce, John P.
通讯作者：
Pierce, John P.
影响因子：
3.6
作者：
Levine, DW;Kaplan, RM;Shumaker, SA
通讯作者：
Shumaker, SA
影响因子：
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作者：
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影响因子：
2.1
作者：
Lanza, Stephanie T.;Rhoades, Brittany L.;Cox, Martha
通讯作者：
Cox, Martha