Association of Educational Attainment With Chronic Disease and Mortality: The Kidney Early Evaluation Program (KEEP)
Association of Educational Attainment With Chronic Disease and Mortality: The Kidney Early Evaluation Program (KEEP)
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DOI：
10.1053/j.ajkd.2011.02.388
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发表时间：
2011-08-01
影响因子：
13.2
通讯作者：
Shlipak, Michael G.
中科院分区：
文献类型：
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作者：
Choi, Andy I.;Weekley, Cristin C.;Shlipak, Michael G.
背景：最近的报告表明，在美国，教育与健康（包括死亡率）之间存在密切关系。研究设计：观察性队列。环境和参与者：我们研究了61457名参加国家健康筛查倡议，国家肾脏基金会肾脏早期评估计划（KEEP）的参与者。预测指标：自我报告的受教育程度。结果：慢性疾病（高血压、糖尿病、心血管疾病、肾功能下降和蛋白尿）和死亡率。测量方法：我们使用逻辑回归模型评估了自我报告的受教育程度与所列慢性疾病之间的横断面关联，该模型对人口统计学、获得护理、行为和合并症进行了调整。使用多变量Cox比例风险回归确定受教育程度与生存的关系。结果：较高的教育程度与所列每种慢性疾病的患病率较低有关。在多变量模型中，与未完成高中学业的人相比，大学毕业生患各种慢性疾病的风险较低，从肾功能下降的几率降低11%到心血管疾病的几率降低37%不等。在平均3.9年（中位3.7年）的随访期间，发生了2384例（4%）死亡。在完全调整后的Cox模型中，那些完成大学学业的人的死亡率比那些至少完成了一些高中学业的人低24%。局限性：由于缺乏收入数据，我们无法将教育与收入的独立影响区分开来。结论：在这个多样化的当代队列中，在所有年龄和种族/民族群体中，较高的教育程度与较低的慢性病患病率和短期死亡率独立相关。[J]中华肾脏病杂志，2016,31(2):344 - 344。由爱思唯尔公司代表国家肾脏基金会出版。这是美国政府的工作。它的使用没有限制。
Background: Recent reports have suggested a close relationship between education and health, including mortality, in the United States.Study Design: Observational cohort.Setting & Participants: We studied 61,457 participants enrolled in a national health screening initiative, the National Kidney Foundation's Kidney Early Evaluation Program (KEEP).Predictor: Self-reported educational attainment.Outcomes: Chronic diseases (hypertension, diabetes, cardiovascular disease, reduced kidney function, and albuminuria) and mortality.Measurements: We evaluated cross-sectional associations between self-reported educational attainment with the chronic diseases listed using logistic regression models adjusted for demographics, access to care, behaviors, and comorbid conditions. The association of educational attainment with survival was determined using multivariable Cox proportional hazards regression.Results: Higher educational attainment was associated with a lower prevalence of each of the chronic conditions listed. In multivariable models, compared with persons not completing high school, college graduates had a lower risk of each chronic condition, ranging from 11% lower odds of decreased kidney function to 37% lower odds of cardiovascular disease. During a mean follow-up of 3.9 (median, 3.7) years, 2,384 (4%) deaths occurred. In the fully adjusted Cox model, those who had completed college had 24% lower mortality compared with participants who had completed at least some high school.Limitations: Lack of income data does not allow us to disentangle the independent effects of education from income.Conclusions: In this diverse contemporary cohort, higher educational attainment was associated independently with a lower prevalence of chronic diseases and short-term mortality in all age and race/ethnicity groups. Am J Kidney Dis. 58(2): 228-234. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is a US Government Work. There are no restrictions on its use.