摘要
目的:分析浙江省舟山市中老年人群生命历程多重因素与生理失调的关联,并分析生活方式和心理健康状况在以上关联中的中介作用。方法:基于浙江代谢综合征队列舟山六横子队列,纳入1553名45岁及以上海岛居民的人口学信息、生命历程信息、生活方式和心理健康信息,并采集血液标本。通过生理失调计算模型对老化状态进行评估。采用夏普利值分解法评估生命历程多重因素对生理失调差异的累积和相对贡献度;采用主成分分析和层次聚类分析相结合的方法确定四个亚群,采用一般线性回归模型评估生命历程亚群与生理失调之间的关联,根据以上分析结果确定与老化相关的关键因素。采用Logistic回归模型、一般线性回归模型和中介分析模型评估生命历程亚群及关键因素、不健康生活方式、心理健康和老化之间的复杂关联。结果:夏普利值分解法结果表明,八类生命历程多重因素可以解释6.63%(SE=0.0008)的个体生理失调差异,其中成年时期逆境经历的相对贡献度最大(2.78%)。将研究对象聚类为四个亚群后发现,经历较多成年逆境且受教育程度低或经历较多儿童创伤和较差儿童关系的亚群的生理失调水平显著较高。生命历程亚群及关键因素儿童时期创伤、儿童时期健康、成年时期逆境经历和较低的教育程度与不健康生活方式呈显著正向关联(β=0.12~0.41,均P<0.05);生命历程亚群及关键因素成年时期逆境经历与心理健康状况呈显著正向关联(OR=2.14~4.68,均P<0.05)。不健康生活方式评分与生理失调呈边缘显著正向关联(β=0.03,P=0.055)。未发现心理健康状况与生理失调之间存在关联(β=0.03,P=0.748)。中介分析模型结果显示,不健康生活方式可能部分介导了生命历程亚群、成年时期逆境经历与生理失调之间的关联(中介效应占比为3.9%~6.8%)。结论:浙江省舟山市中老年人群中生命历程多重因素贡献了约6.63%的生理失调差异,生命历程不良经历亚群的老化程度更高,且该关联可能部分由不健康生活方式所介导。
Objective:To analyze the associations between factors in life course and physiological dysregulation in the middle-aged and elderly population in Zhoushan city of Zhejiang province,and the mediating roles of lifestyle and mental health.Methods:A total of 1553 island residents aged≥45 years were enrolled from the Zhejiang Metabolic Syndrome Cohort Zhoushan Liuheng Sub-cohort.The demographic information,life course information,lifestyle,and mental health information of the participants were documented and blood samples were collected.The status of aging was evaluated by physiological dysregulation calculation model previously developed by the authors.The Shapley value decomposition method was used to assess the cumulative and relative contribution of multiple factors in life course to the aging.Principal component analysis and hierarchical clustering analysis were used to classify subgroups.General linear regression model was used to assess associations between the life course subgroups and physiological dysregulation,and the key factors associated with aging were finally identified.Logistic regression model,general linear regression model,and mediation analysis model were used to assess the complex associations between life course subgroups,key factors,unhealthy lifestyle,mental health,and aging.Results:Shapley value decomposition method indicated that eight types of life course factors explained 6.63%(SE=0.0008)of the individual physiological dysregulation variance,with the greatest relative contribution(2.78%)from adversity experiences in adulthood.The study participants were clustered into 4 subgroups,and subgroups experiencing more adversity in adulthood and having low educational attainment or experiencing more trauma and having poorer relationships in childhood had significantly higher levels of physiological dysregulation.Life course subgroups and key factors childhood trauma and health,adversity experience in adulthood,and lower education were positively associated with unhealthy lifestyles(β=0.12-0.41,all P<0.05).In addition,life course subgroups and key factor adversity experience in adulthood were positively associated with psychological problems(OR=2.14-4.68,all P<0.05).Unhealthy lifestyle scores showed a marginal significant association with physiological dysregulation(β=0.03,P=0.055).However,no significant association was found between psychological problems and physiological dysregulation(β=0.03,P=0.748).The results of the mediation analysis model suggested that unhealthy lifestyles partially mediated the associations between the life course subgroups,adversity experience in adulthood and physiological dysregulation,with the proportions mediating ranging from 3.9%-6.8%.Conclusion:Multiple life course factors contribute about 6.63%of the variance in physiological dysregulation in the middle aged and elderly population of the study area;subgroups with adverse life course experiences have higher levels of aging;and the association may be partially mediated by unhealthy lifestyles.
作者
曹星琦
赖章博
李嘉
邵伟
刘成国
贺迪
张静芸
林永兴
朱益民
刘足云
CAO Xingqi;LUA Cedric Zhang Bo;LI Jia;SHAO Wei;LIU Chengguo;HE Di;ZHANG Jingyun;LIN Yongxing;ZHU Yimin;LIU Zuyun(Center for Clinical Big Data and Analytics,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;School of Public Health,Zhejiang University School of Medicine,Hangzhou 310058,China;Zhejiang Key Laboratory of Intelligent Preventive Medicine,Hangzhou 310058,China;Department of Endocrinology,Zhoushan Putuo District People’s Hospital,Zhoushan 316100,Zhejiang Province,China;Department of Cardiology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Department of Intergrated Support,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Department of Respiratory Disease,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)
出处
《浙江大学学报(医学版)》
北大核心
2025年第1期39-48,I0025-I0031,共17页
Journal of Zhejiang University(Medical Sciences)
基金
国家自然科学基金(72374180)
浙江省医药卫生科技计划(2023KY639)
浙江省“尖兵”“领雁”研发攻关计划项目(2023C03163)
浙江大学医学院老化病防治研究中心项目(2022010002)
全省智能预防医学重点实验室(2020E10004)
中央高校基本科研业务费专项资金
浙江大学公共卫生学院交叉研究创新团队建设项目。
关键词
老化
生理失调
生命历程
生活方式
心理健康
Aging
Physiological dysregulation
Life course
Lifestyle
Mental health
