Impact of Individual and Combined Health Behaviors on All Causes of Premature Mortality Among Middle Aged Men in Korea: The Seoul Male Cohort Study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives: The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea. Methods: In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score. Results: Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively. Conclusions: Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.
Abstract
Objectives: The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea. Methods: In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score. Results: Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively. Conclusions: Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.
참고문헌 (28)
- Jong-Myon Bae, "Cigarette Smoking and Risk of Lung Cancer in Korean Men: The Seoul Male Cancer Cohort Study", Journal of Korean Medical Science, 22(3), pp.508~512 (2007), 대한의학회
- Kim MK, "Alcohol consumption and mortality from all-cause and cancers among 1.34 million Koreans: the results from the Korea national health insurance corporation’s health examinee cohort in 2000", Cancer Causes Control, 21(12), pp.2295~2302 (2010)
- Kim DS, "A cohort study of physical activity and all cause mortality in middle-aged men in Seoul", Korean J Prev Med, 31(4), pp.604~615 (1998)
- Doll R, "Mortality from cancer in relation to smoking: 50 years observations on British doctors", Br J Cancer, 92(3), pp.426~429 (2005)
- Warburton DE, "Health benefits of physical activity: the evidence", CMAJ, 174(6), pp.801~809 (2006)
- Van den Brandt PA, "The impact of a Mediterranean diet and healthy lifestyle on premature mortality in men and women", Am J Clin Nutr, 94(3), pp.913~920 (2011)
- Katz DL, "Life and death, knowledge and power: why knowing what matters is not what’s the matter", Arch Intern Med, 169(15), pp.1362~1363 (2009)
- Yoo KY, "Cancer epidemiology and prevention", Korean J Epidemiol, 25(1), pp.1~15 (2003)
- Khaw KT, "Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study", PLoS Med, 5(1), pp.12~ (2008)
- Knoops KT, "Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project", JAMA, 292(12), pp.1433~1439 (2004)
- Van Dam RM, "Combined impact of lifestyle factors on mortality: prospective cohort study in US women", BMJ, 337, pp.1440~ (2008)
- Kvaavik E, "Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey", Arch Intern Med, 170(8), pp.711~718 (2010)
- Centers for Disease Control, "Premature mortality in the United States: public health issues in the use of years of potential life lost", MMWR Morb Mortal Wkly Rep, 35(2 Suppl), pp.1~11 (1986)
- Shin MH, "The effect of coffee consumption on serum total cholesterol level in healthy middle-aged men", Korean J Prev Med, 27(2), pp.200~216 (1994)
- Jong-MyonBae, "A Nested Case-Control Study on the High-Normal Blood Pressure as a Risk Factor of Hypertension in Korean Middle-Aged Men", Journal of Korean Medical Science, 17(3), pp.328~336 (2002), 대한의학회
- Lee MS, "Methodologic considerations on the cohort study of risk factors of stomach cancer: on the incompleteness of case ascertainment", Korean J Epidemiol, 19(2), pp.152~160 (1997)
- WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies", Lancet, 363(9403), pp.157~163 (2004)
- "Lifetable from1970-2009"[URL]
- Sullivan LM, "Presentation of multivariate data for clinical use: the Framingham Study risk score functions", Stat Med, 23(10), pp.1631~1660 (2004)
- 이은하, "한국인의 흡연과 사망 위험에 관한 코호트 연구", 예방의학회지, 43(2), pp.151~158 (2010), 대한예방의학회
- Jee SH, "Smoking-attributable mortality among Korean adults: 1981-2003", Korean J Epidemiol, 28(1), pp.92~99 (2006)
- Seongho Min, "Alcohol Dependence, Mortality, and Chronic Health Conditions in a Rural Population in Korea", Journal of Korean Medical Science, 23(1), pp.1~9 (2008), 대한의학회
- 박민선, "Physical Activity and Physical Fitness as Predictors of All-Cause Mortality in Korean Men", Journal of Korean Medical Science, 24(1), pp.13~19 (2009), 대한의학회
- Rassi A Jr, "Development and validation of a risk score for predicting death in Chagas’ heart disease", N Engl J Med, 355(8), pp.799~808 (2006)
- Lewis EF, "Predictors of heart failure in patients with stable coronary artery disease: a PEACE study", Circ Heart Fail, 2(3), pp.209~216 (2009)
- Schnabel RB, "Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study", Lancet, 373(9665), pp.739~745 (2009)
- Wannamethee SG, "Changes in physical activity, mortality, and incidence of coronary heart disease in older men", Lancet, 351(9116), pp.1603~1608 (1998)
- Paffenbarger RS Jr, "The association of changes in physicalactivity level and other lifestyle characteristics with mortality among men", N Engl J Med, 328(8), pp.538~545 (1993)