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[BMJ圣诞专刊]:美国女性出生月份、出生季节与总死亡率和心血管疾病死亡率的相关性:前瞻队列研究
2019年12月29日 时讯速递, 进展交流 暂无评论

Research Christmas 2019: Let it Be

Birth month, birth season, and overall and cardiovascular disease mortality in US women: prospective cohort study

Yin Zhang,  Elizabeth E Devore, Susanne Strohmaier, et al

BMJ 2019;367:l6058 doi: https://doi.org/10.1136/bmj.l6058 (Published 18 December 2019)

Abstract

Objectives 目的

To evaluate the associations between birth month, birth season, and overall and cardiovascular disease mortality, and to examine the role of familial and socioeconomic factors in these associations.

评价出生月份、出生季节与总死亡率及心血管疾病死亡率的相关性,并研究家庭与社会经济因素在上述相关性中的作用。

Design 试验设计

Prospective cohort study.

前瞻队列研究

Setting 场景

Nurses’ Health Study, established in 1976, an ongoing prospective cohort study in the United States.

始于1976年的护士健康研究是美国一项前瞻性队列研究

Participants 研究对象

Female registered nurses who reported information on date of birth at study enrolment (n=116 911, 1976-2014, followed for 38 years).

在纳入研究时报告出生日期的女性注册护士 (n=116 911, 1976-2014, 随访 38 年)。

Exposure 暴露因素

Birth month and astronomical birth season (based on solstices and equinoxes as boundaries of the season categories).

出生月份与天文出生季节(根据分至点区分季节)。

Main outcome measures 主要预后指标

Age and various multivariable adjusted hazard ratios and 95% confidence intervals for the association between birth months (using November as the reference), astronomical birth season (using autumn as the reference), and overall and cardiovascular disease specific mortality were assessed using Cox proportional hazards models.

根据年龄及多种因素进行校正后,采用Cox比例风险模型计算出生月份 (以11月作为参照)和天文出生季节 (以秋季作为参照)与总死亡率及心血管疾病死亡率之间的相关性。

Results 结果

Among study participants, 43 248 overall deaths were documented during 4 136 364 person years of follow-up since enrolment, including 8360 cardiovascular disease related deaths. In fully adjusted multivariable analyses, no significant association was observed between birth month, birth season, and overall mortality. Compared with women born in November, increased cardiovascular disease mortality was observed among those born from March to July (hazard ratio for March, 1.09, 95% confidence interval 0.98 to 1.21; April, 1.12, 1.00 to 1.24; May, 1.08, 0.98 to 1.20; June, 1.07, 0.96 to 1.19; and July 1.08, 0.98 to 1.20). Those born in April had the highest cardiovascular disease mortality, and those born in December had the lowest (December, 0.95, 0.85 to 1.06). The relative difference between the lowest and highest risk month was 17.89%. Women born in spring (1.10, 1.04 to 1.17) and summer (1.09, 1.03 to 1.16) had a higher cardiovascular disease mortality than women born in the autumn. Adjustment for familial and socioeconomic factors did not change these results. The relative difference between the lowest and highest risk season was 10.00%.

所有参研对象纳入研究后,在随访的4 136 364 人年间,共有43 248 例死亡,其中包括 8360 例心血管相关死亡。通过多因素分析进行校正后,出生月份、出生季节与总死亡率之间无显著相关性。与11月出生的女性相比,3月至7月出生者心血管疾病死亡率增加 (3月份风险比, 1.09, 95% 可信区间 0.98 to 1.21; 4月份, 1.12, 1.00 to 1.24; 5月份, 1.08, 0.98 to 1.20; 6月份, 1.07, 0.96 to 1.19; 和7月份 1.08, 0.98 to 1.20)。4月出生者心血管疾病死亡率最高,12月出生者最低 (12月份, 0.95, 0.85 to 1.06)。风险最低与最高月份相对差异为 17.89%。春季(1.10, 1.04 to 1.17) 和夏季(1.09, 1.03 to 1.16)出生的女性心血管疾病死亡率高于秋季出生者。对家庭及社会经济因素进行校正,并不改善上述结果。风险最低与最高季节的相对差异为 10.00%。

Conclusion 结论

Participants born in the spring and summer (especially those born in March-July) had a slight but significant increase in cardiovascular disease specific mortality. However, no seasonal birth month effect was observed among women for overall mortality. Familial and socioeconomic factors did not appear to alter these associations. Further studies are required to confirm these findings and reveal mechanisms of these seasonal birth month effects in cardiovascular disease mortality.

春季与夏季出生者(特别是3月至7月出生者)心血管疾病死亡率轻度且显著增加。然而,女性出生季节和月份与总死亡率没有相关性。家庭与社会经济因素并不改变上述相关性。需要进一步研究确定这一结果,并揭示出生季节与月份对心血管死亡率产生影响的机制。

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