Association of Healthy Lifestyle With Years Lived Without Major Chronic Diseases
Association of Healthy Lifestyle With Years Lived Without Major Chronic Diseases
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DOI：
10.1001/jamainternmed.2020.0618
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发表时间：
2020-05-01
影响因子：
39
通讯作者：
Kivimaki, Mika
中科院分区：
文献类型：
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作者：
Nyberg, Solja T.;Singh-Manoux, Archana;Kivimaki, Mika
这项队列研究探讨了不同生活方式风险因素组合的参与者的无病生命年。问题生活方式因素的不同组合是否与无慢性病的生存年相关？结果在116 043名参与者的多队列研究中，注意到总体健康生活方式评分与无病生命年数增加之间存在统计学显著相关性。在研究的16种不同的生活方式中，与最大无病生命年相关的4种包括体重指数低于25和3个因素中的至少2个：从不吸烟，体育活动和适度饮酒。各种健康的生活方式似乎与没有2型糖尿病、心血管和呼吸系统疾病和癌症的寿命延长有关。重要性已经确定，选定的生活方式因素与慢性病风险降低有关，但这些因素的组合如何与无病寿命年相关尚不清楚。目的探讨健康生活方式与无病生命年的关系。设计、设置和参与者进行了一项前瞻性多队列研究，包括12项欧洲研究，作为工作人群联盟个体参与者数据荟萃分析的一部分。参与者包括116043人，从1991年8月7日到2006年5月31日，基线时没有重大非传染性疾病。数据分析于2018年5月22日至2020年1月21日进行。四个基线生活方式因素（吸烟、体重指数、体力活动和饮酒）根据风险状态分别分配一个评分：最佳（2分）、中等（1分）或较差（0分），导致总体生活方式评分范围为0（最差）至8（最佳）。根据这些危险因素的组合构建了16种生活方式。主要结果和测量40至75岁之间没有慢性疾病的年数，包括2型糖尿病，冠心病，中风，癌症，哮喘和慢性阻塞性肺疾病。结果在纳入分析的116 043人中，平均（SD）年龄为43.7（10.1）岁，其中70 911人为女性（61.1%）。在145万人年的风险（平均随访，12.5年;范围，4.9-18.6年），17&x202f;383参与者发展至少1种慢性疾病。总体健康生活方式评分与无病年数之间存在线性相关性，因此评分改善1分与男性无病年数增加0.96（95%CI，0.83-1.08）和女性无病年数增加0.89（95%CI，0.75-1.02）相关。将最佳生活方式评分与最差生活方式评分进行比较，男性无慢性病的年数增加9.9（95%CI 6.7-13.1），女性无慢性病的年数增加9.4（95%CI 5.4-13.3）（剂量反应P <0.001）。所有与最高无病年数相关的4种生活方式包括体重指数小于25（计算方法为体重（公斤）除以身高（米）的平方）和以下因素中的至少2个：从不吸烟，体育活动和适度饮酒。具有这些生活方式之一的参与者达到70.3（95% CI，69.9-70.8）至71.4（95% CI，70.9-72.0）岁的无病年龄，取决于个人资料和性别。结论和相关性在这个多队列分析中，各种健康的生活方式似乎与无重大慢性疾病的生命年的增加有关。
This cohort study examines disease-free life-years in participants with varying combinations of lifestyle risk factors.Question Are different combinations of lifestyle factors associated with years lived without chronic diseases? Findings In a multicohort study of 116 & x202f;043 participants, a statistically significant association between overall healthy lifestyle score and an increased number of disease-free life-years was noted. Of 16 different lifestyle profiles studied, the 4 that were associated with the greatest disease-free life years included body mass index lower than 25 and at least 2 of 3 factors: never smoking, physical activity, and moderate alcohol consumption. Meaning Various healthy lifestyle profiles appear to be associated with extended gains in life lived without type 2 diabetes, cardiovascular and respiratory diseases, and cancer.Importance It is well established that selected lifestyle factors are individually associated with lower risk of chronic diseases, but how combinations of these factors are associated with disease-free life-years is unknown. Objective To estimate the association between healthy lifestyle and the number of disease-free life-years. Design, Setting, and Participants A prospective multicohort study, including 12 European studies as part of the Individual-Participant-Data Meta-analysis in Working Populations Consortium, was performed. Participants included 116 & x202f;043 people free of major noncommunicable disease at baseline from August 7, 1991, to May 31, 2006. Data analysis was conducted from May 22, 2018, to January 21, 2020. Exposures Four baseline lifestyle factors (smoking, body mass index, physical activity, and alcohol consumption) were each allocated a score based on risk status: optimal (2 points), intermediate (1 point), or poor (0 points) resulting in an aggregated lifestyle score ranging from 0 (worst) to 8 (best). Sixteen lifestyle profiles were constructed from combinations of these risk factors. Main Outcomes and Measures The number of years between ages 40 and 75 years without chronic disease, including type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease. Results Of the 116 & x202f;043 people included in the analysis, the mean (SD) age was 43.7 (10.1) years and 70 & x202f;911 were women (61.1%). During 1.45 million person-years at risk (mean follow-up, 12.5 years; range, 4.9-18.6 years), 17 & x202f;383 participants developed at least 1 chronic disease. There was a linear association between overall healthy lifestyle score and the number of disease-free years, such that a 1-point improvement in the score was associated with an increase of 0.96 (95% CI, 0.83-1.08) disease-free years in men and 0.89 (95% CI, 0.75-1.02) years in women. Comparing the best lifestyle score with the worst lifestyle score was associated with 9.9 (95% CI 6.7-13.1) additional years without chronic diseases in men and 9.4 (95% CI 5.4-13.3) additional years in women (P < .001 for dose-response). All of the 4 lifestyle profiles that were associated with the highest number of disease-free years included a body-mass index less than 25 (calculated as weight in kilograms divided by height in meters squared) and at least 2 of the following factors: never smoking, physical activity, and moderate alcohol consumption. Participants with 1 of these lifestyle profiles reached age 70.3 (95% CI, 69.9-70.8) to 71.4 (95% CI, 70.9-72.0) years disease free depending on the profile and sex. Conclusions and Relevance In this multicohort analysis, various healthy lifestyle profiles appeared to be associated with gains in life-years without major chronic diseases.