| 孙风清,谢谊博,郭运达,等.孤独感对心脑血管疾病及死亡的影响[J].中国临床保健杂志,2025,28(5):700-705. |
| 孤独感对心脑血管疾病及死亡的影响 |
| The impact of loneliness on cardiovascular and cerebrovascular diseases and death |
| 投稿时间：2025-05-22 |
| DOI：10.3969/J.issn.1672-6790.2025.05.023 |
| 中文关键词: 孤独 血管疾病 衰弱 死亡 早期干预 |
| 英文关键词: Loneliness Vascular diseases Frailty Death Early intervention 〖FL |
| 基金项目:国家科技重大专项(2023ZD0509800) |
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| 摘要点击次数: 39 |
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| 中文摘要: |
| 目的 探讨孤独感通过衰弱和三酰甘油葡萄糖-体重指数(TyG-BMI)的链式路径影响心脑血管病及全因死亡的作用机制与风险轨迹。方法 基于中国健康与养老追踪调查2011—2020年数据,纳入7 320例≥45岁基线无心脑血管疾病人群。采用链式中介模型分析孤独感经衰弱、TyG-BMI影响脑卒中、心血管病和死亡的路径；应用多状态模型量化不同健康状态转移风险。结果 链式中介路径:衰弱在链式中介模型中起核心作用；孤独感对脑卒中、心血管病和死亡风险的正向影响,分别有55.6%、71.5%和74.2%是通过衰弱这一途径实现的；TyG-BMI在疾病发生阶段负向调节孤独感效应(脑卒中:贡献度-27.0%；心血管病:贡献度-15.8%),但在死亡中呈正向作用(贡献度15.7%)；孤独感→衰弱→TyG-BMI→心脑血管病的链式协同路径显著(脑卒中贡献度4.8%,心血管病贡献度2.4%)。多状态模型:衰弱显著增加所有状态转移风险(健康→死亡HR=1.66,心血管病→死亡HR=2.09)；孤独感仅升高健康→心血管病(HR=1.22)和健康→死亡(HR=1.24)风险；TyG-BMI高水平增加健康→脑卒中风险(HR=2.46),但降低心血管病→死亡风险(HR=0.38)。结论 孤独感通过衰弱主导的病理通路增加心脑血管病及死亡风险,TyG-BMI在不同疾病阶段呈现的双向调节作用。 |
| 英文摘要: |
| Objective To explore the mechanism and risk trajectory through which loneliness affects cardiovascular/cerebrovascular diseases and all-cause mortality via the chain pathways of frailty and TyG-BMI.Methods Utilizing data from the China Health and Retirement Longitudinal Study 2011—2020,7,320 participants aged ≥45 years without baseline cardiovascular/cerebrovascular diseases were included.Chain mediation models analyzed the pathways of loneliness affecting stroke,cardiovascular disease (CVD),and death via frailty and TyG-BMI.Multi-state models quantified transition risks between different health states.Results Chain mediation pathways:Frailty was the core mediator,contributing significantly to the positive effects of loneliness on the risk of stroke (contribution degree:55.6%),CVD (71.5%),and death (74.2%).TyG-BMI negatively regulated the effect of loneliness in the disease onset phase (stroke:contribution degree -27.0%;CVD:contribution degree -15.8%) but showed a positive effect on death (contribution degree:15.7%).The chain synergistic pathway Loneliness→Frailty→TyG-BMI→CCVD was significant (stroke contribution degree:4.8%,CVD:contribution degree 2.4%).Multi-state models:Frailty significantly increased the risk of all state transitions (Healthy→Death HR=1.66,CVD→Death HR=2.09).Loneliness only increased the risk of Healthy→CVD (HR=1.22) and Healthy→Death (HR=1.24).High TyG-BMI levels increased the Healthy→Stroke risk (HR=2.46) but decreased the CVD→Death risk (HR=0.38).Conclusions Loneliness increases the risk of CCVD and death primarily through frailty-dominated pathological pathways,with TyG-BMI exhibiting bidirectional regulation at different disease stages. |
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