[目的]探索常规循环肝功能标志物与结直肠癌发病风险的关系.[方法]采用巢式病例对照研究,剔除基线慢性结肠炎、肠息肉和恶性肿瘤患者及基本资料不全者,以金昌队列3次随访期间新发结直肠癌患者145例为病例组,以随访未发生结直肠癌的人群作为对照来源,根据同期随访、基线年龄±2岁和同性别进行1∶4个体匹配,获得对照组580名,最终纳入725名研究对象.通过条件Lo-gistic 回归分析探究常规循环肝功能标志物与结直肠癌发病风险的关系,计算比值比(odds ratio,OR)及其95％置信区间(confidence interval,CI),采用限制性立方样条分析相关因素与结直肠癌发病的剂量-反应关系.[结果]研究对象平均年龄为61.24岁,男性占比71.72％.多因素条件Logistic回归分析结果显示,在调整混杂因素后,发现总胆红素第2四分位数组研究对象发生结直肠癌的风险是第1四分位数组的0.490倍(OR=0.490,95％CI:0.273～0.879),处于白蛋白第2、3、4四分位数组的研究对象发生结直肠癌的风险分别较处于第1四分位数组的研究对象降低41.6％(OR=0.584,95％CI:0.342～0.996)、42.9％(OR=0.571,95％CI:0.337～0.970)和 42.7％(OR=0.573,95％CI:0.330～0.996).对结直肠癌发病部位进行分区,以白蛋白第1四分位数组为对照,第3、4四分位数组的个体发生结肠癌的风险分别降低 66.6％(OR=0.334,95％CI:0.139～0.804)和 80.7％(OR=0.193,95％CI:0.066～0.566).未发现白蛋白与直肠癌发病风险之间具有统计学意义.白蛋白与结直肠癌发病风险之间存在明显的负向线性剂量-反应关系(P总趋势＜0.050,P非线性=0.191),结直肠癌发病风险随白蛋白的升高而降低.[结论]白蛋白和总胆红素水平的升高与结直肠癌发病风险降低相关,且白蛋白与结直肠癌的发病风险存在剂量-反应关系.白蛋白与结肠癌发病风险存在较强的负相关性,而与直肠癌不存在关联.

Objective To evaluate the correlation between metabolic syndrome (MetS) and its components on the incidence of colorectal cancer (CRC) based on data from Jinchang Cohort. Methods This is a large prospective cohort study. Between 2011 and 2020, a total of 43 516 individuals from Jinchang Cohort were included for this study. Hazard ratios (HRs) with 95% confidence intervals (CIs) for CRC according to MetS were calculated with the Cox proportional hazard models. The restricted cubic spine models with four knots were conducted to fit the dose-response relationships. Results MetS was associated with increased risk of CRC (n = 141; HR: 1.64, 95% CI: 1.15–2.33) after adjusting for confounding factors (age, sex, education level, family history of CRC, smoking index and alcohol index). Participants with hyperglycemia had a significantly higher risk of developing incident CRC (HR: 1.70; 95% CI: 1.19–2.43). The positive association between MetS and CRC was observed in males (HR: 1.76; 95% CI: 1.17–2.63), but not in females (HR: 1.24; 95% CI: 0.59–2.64). Furthermore, linear dose-response relationship was found between fasting plasma glucose (FPG) and CRC risk in males ( P overall < 0.05, P non-linear = 0.35). When stratified by smoke and drink, MetS was found to increase the incidence of CRC only in the smoke (HR: 2.07, 95% CI: 1.35–3.18) and drink (HR: 2.93, 95% CI: 1.51–5.69) groups. Conclusion MetS was associated with a higher risk of CRC incidence. Hyperglycemia lended strong support to the role of MetS in new-onset CRC, especially in males. Other components of MetS were not found to be associated with increased risk of CRC.

目的 基于队列入群研究心源性猝死(sudden cardiac death,SCD)的影响因素,为SCD的预防和病因学研究提供科学依据.方法 采用巢式病例对照研究的方法,以金昌队列2011-2019年三次随访新发52例SCD者为病例组,按照年龄(±2岁)及同性别1∶4个体匹配的方法,以同期随访未发生SCD者的208例为对照组.用条件logistic回归分析模型分析金昌队列人群发生SCD的影响因素,并通过限制性立方样条(restricted cubic spline,RCS)模型拟合SCD发病风险的剂量-反应关系曲线.结果 多因素条件logistic回归分析模型分析结果显示:三酰甘油(triglycerides,TG)(OR=2.94,95％CI:1.15～7.51)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)(OR=2.70,95％CI:1.18～6.22)、糖尿病(OR=5.59,95％CI:1.79～17.46)和心电图异常(OR=5.54,95％CI:2.11～14.56)是SCD的危险因素;文化程度在高中及以上(OR=0.33,95％CI:0.12～0.88)是SCD的保护因素.RCS结果显示:空腹血糖(fasting plasma glucose,FPG)、TG与SCD发病风险间呈正向线性剂量-反应关系(P总趋势＜0.05,P非线性＞0.05).结论 TG、LDL-C、糖尿病、心电图异常和文化程度与SCD的发生有关且FPG、TG与SCD的发生风险间存在线性剂量-反应关系.

目的 探索女性人群乳腺癌发病的影响因素,为乳腺癌的防治提供科学依据.方法 基于金昌队列,以2014-2020年中3次随访新发乳腺癌者96例为病例组,按照年龄(±2岁)1∶2个体匹配的方法,以同期随访未发生癌症的192例为对照组.采用条件Logistic回归模型、限制性立方样条模型及相乘和相加交互模型探讨乳腺癌发病的影响因素及因素间的交互作用.结果 多因素条件Logistic回归模型结果显示体重指数(BMI)≥24kg.m-2、血清低密度脂蛋白胆固醇(LDL-C)水平异常的人群乳腺癌发病风险增加,分别是BMI＜24kg·m-2组、LDL-C水平正常组的1.87倍(OR=1.87,95％CI:[1.05,3.34])、2.66倍(OR=2.66,95％CI:[1.39,5.08]),且LDL-C及BMI水平与乳腺癌发病风险间存在正向线性剂量-反应关系(LDL-C:总趋势P=0.001,非线性P=0.413;BMI:总趋势P＜0.001,非线性P=0.376),但未发现两者的交互作用.结论 超重/肥胖和LDL-C异常是乳腺癌发病的危险因素,且BMI、LDL-C和乳腺癌的发病风险间存在正向线性剂量-反应关系.

Background: The risk of hepatocellular carcinoma (HCC) is associated with a variety of factors. However, the possible association between the abnormal metabolism of fasting plasma glucose (FPG) and alanine aminotransferase (ALT) and the risk of HCC has not been widely studied. We examined this relationship based on a prospective cohort study.Methods: 162 first-attack HCC cases during three follow-up periods (2014-2020) were selected as the case group. A control group of 648 participants was obtained by 1:4 matching of age (+/- 2 years) and sex with noncancer participants in the same period. Conditional logistic regression models, restricted cubic spline models, additive interaction models, and generalized additive models were used to explore the effects of FPG and ALT on the risk of HCC.Results: After correction for confounding factors, we found that abnormal FPG and elevated ALT increased the risk of HCC, respectively. Compared with the normal FPG group, the risk of HCC was significantly increased in the impaired fasting glucose (IFG) (OR = 1.91, 95 %CI: 1.04, 3.50) and diabetes groups (OR = 2.12, 95 %CI: 1.24, 3.63). Compared with the lowest quartile of ALT, subjects in the fourth quartile had an 84 % increased risk of HCC (OR = 1.84, 95 %CI: 1.05-3.21). Moreover, there was an interaction between FPG and ALT on the risk of HCC, and 74 % of the HCC risk could be attributed to their synergistic effect (AP = 0.74, 95 %CI: 0.56-0.92).Conclusion: Abnormal FPG and elevated ALT are independent risk factors for HCC, and they have a synergistic effect on the risk of HCC. Therefore, serum FPG and ALT levels should be monitored to prevent the development of HCC.

Aims To quantify the trajectories from normoglycaemia to pre-diabetes, subsequently to type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and cardiovascular death, and the effects of risk factors on the rates of transition. Methods and results We used data from the Jinchang Cohort of 42 585 adults aged 20-88 free of coronary heart disease (CHD) and stroke at baseline. A multistate model was applied for analysing the progression of CVD and its relation to various risk factors. During a median follow-up of 7 years, 7498 participants developed pre-diabetes, 2307 developed T2DM, 2499 developed CVD, and 324 died from CVD. Among 15 postulated transitions, transition from comorbid CHD and stroke to cardiovascular death had the highest rate (157.21/1000 person-years), followed by transition from stroke alone to cardiovascular death (69.31/1000 person-years) and transition from pre-diabetes to normoglycaemia (46.51/1000 person-years). Pre-diabetes had a sojourn time of 6.77 years, and controlling weight, blood lipids, blood pressure, and uric acid within normal limits may promote reversion to normoglycaemia. Among transitions to CHD alone and stroke alone, transition from T2DM had the highest rate (12.21/1000 and 12.16/1000 person-years), followed by transition from pre-diabetes (6.81/1000 and 4.93/1000 person-years) and normoglycaemia (3.28/1000 and 2.39/1000 person-years). Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidaemia, and hyperuricaemia played crucial but different roles in transitions. Conclusion Pre-diabetes was the optimal intervention stage in the disease trajectory. The derived transition rates, sojourn time, and influence factors could provide scientific support for the primary prevention of both T2DM and CVD. Lay summary Former single-outcome studies on the relationship between glycaemia and cardiovascular disease (CVD) may ignore the complexity and multi-transformations across the multiple stages from normoglycaemia to CVD in real-world setting. We aimed to quantify the trajectories from normoglycaemia to pre-diabetes, subsequently to type 2 diabetes, CVD, and cardiovascular death.Pre-diabetes was the optimal intervention stage in the disease trajectory.Transitions from CVD to death had much higher rates than other transitions.Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidaemia, and hyperuricaemia played crucial but different roles in transitions.

Background and aims: Studies have shown that elevated serum uric acid (SUA) may increase the risk of coronary heart disease (CHD). However, it is still disputable how mediate ef-fects between metabolic diseases and hyperuricemia affect the incidence of CHD. This study aimed to explore whether metabolic diseases may mediate the connection from hyperuricemia at baseline to the elevated incidence risk of CHD during follow-ups. Methods and Results: Based on the Jinchang cohort, 48 001 subjects were followed for 9 years be-tween June 2011 and December 2019. Multivariate-adjusted Cox regression models were applied to estimate hazard ratios (HRs) of CHD with 95% confidence intervals (CIs). Significantly increased risks of CHD were observed in hyperuricemia (HR:1.46, 95%CI:1.2 8, 1.67) when compared with normouricemia population. The mediating effect model further demonstrated that metabolic diseases could mediate the association between hyperuricemia and CHD patho-genesis, partially for the combined metabolic diseases with mediation effects of 45.12%, 25.24% for hypertension, 28.58% for overweight or obese status, 29.05% for hypertriglyceridemia, 6.70% for hypercholesterolemia, 3.52% for low high density lipoprotein cholesterol (HDL-C), and 6.51% for high low density lipoprotein cholesterol (LDL-C), respectively. Conclusions: Hyperuricemia significantly increased the risk of incident CHD, and this association was partly mediated by metabolic diseases. & COPY; 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Ital-ian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

目的 了解血压水平及其不同组合对金昌队列入群脑卒中发病的影响,为人群血压管理和脑卒中的防控提供参考依据.方法 收集金昌队列2011年6月-2015年12月完成基线调查和随访调查的32736名金昌队列人群的相关数据,应用单因素和多因素Cox比例风险回归模型分析不同血压水平及其组合对脑卒中发病风险的影响.结果 金昌队列入群随访期间脑卒中发病率为0.88％,男性和女性人群发病率分别为1.03％和0.65％.调整性别、年龄、文化程度、吸烟情况、饮酒情况、有无糖尿病和脑卒中家族史等混杂因素后,多因素Cox比例风险回归分析结果显示,金昌队列入群收缩压为120～139、140～159和≥160 mm Hg时发生脑卒中的风险分别为＜120 mm Hg时的1.53、2.65和3.09倍,舒张压为80～89、90～99和≥100mmHg时发生脑卒中的风险分别为＜80mmHg时的1.42、2.17 和 2.79 倍;收缩压/舒张压为 120～139/80～89、140～159/＜80、140～159/80～89、140～159/90～99、140～159/≥100、≥160/＜100 和≥160/≥100mmHg 时发生脑卒中的风险分别为＜120/＜80mmHg 时的 1.83、2.55、1.81、3.21、3.34、2.28和3.97倍.在调整了年龄、文化程度、吸烟情况、饮酒情况、有无糖尿病和有无脑卒中家族史等混杂因素后,多因素Cox回归分析结果显示,金昌队列男性人群收缩压为140～159和≥160 mm Hg时发生脑卒中的风险分别为＜120 mm Hg时的2.44和2.86倍,舒张压为90～99和≥100 mm Hg时发生脑卒中的风险分别为＜80 mm Hg时的2.02和2.95倍;金昌队列女性人群收缩压为120～139、140～159和≥160mmHg时发生脑卒中的风险分别为＜120mmHg时的2.03、2.55和2.83倍,舒张压为90～99mmHg时发生脑卒中的风险为＜80mmHg时的2.34倍.结论 不同血压水平及其组合金昌队列入群脑卒中发病风险不同,在血压管理和脑卒中的防控工作中应予以综合考量.

目的 了解金昌队列随访人群2011-2020年循环系统疾病死亡率及早死概率的变化趋势,为制定循环系统疾病的防控策略提供依据.方法 收集金昌队列随访人群2011年1月1日-2020年12月31日死于循环系统疾病的相关数据,通过计算粗死亡率(CDR)、年龄标化死亡率(ASMR)、早死概率等指标分析该人群循环系统疾病的10年死亡率和早死概率的变化趋势.结果 金昌队列随访人群2011-2020年因循环系统疾病死亡1 387例,CDR 为 283.22/10 万,ASMR 为 161.80/10 万,循环系统疾病 10 年 CDR 呈上升趋势(APC=10.02％,t=5.80,P＜0.01).金昌队列随访人群2011-2020年循环系统疾病核心病种为脑卒中和冠心病,CDR分别为128.44/10万和84.33/10万,ASMR分别为73.02/10万和47.88/10万,此2种疾病死亡数占循环系统疾病死亡数的75.13％,其中冠心病10年CDR呈上升趋势(APC=17.90％,t=5.83,P＜0.01).金昌队列随访人群2011-2020年循环系统疾病的早死概率为1.46％,其中脑卒中为1.21％,冠心病为1.03％.结论 金昌队列随访人群2011-2020年循环系统疾病死亡率有所上升,核心病种为脑卒中和冠心病,其中冠心病的死亡率及早死概率上升明显.

Abstract Purpose The association of lipid metabolism linked the risk of gastric cancer (GC) was widely debated. We aimed to explore the longitudinal associations between total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) with the incident risk of GC. Methods The serum lipids were quarterly stratified based on the distribution of GC-free populations. The Cox proportional hazard models and restricted cubic spline models were applied to estimate the hazard ratios (HRs) and dose-response association of GC under different sub-analyses. The interactions of serum lipids on GC incidence were tested by generalized additive models. Results After average 7.2±1.2 years follow-up, 248 primary GCincident cases were collected among 45,642 cancer-free baseline individuals.In total population, the hazard risks (HRs) with 95% confidence interval (CI) of TG (HR=1.53, 95% CI: 1.02-2.29) and LDL-C (HR=2.21, 95% CI: 1.51-3.24) were significantly increased when the Q4 stratum compared with Q1. While decreased HR was found in the Q4 stratum of HDL-C (HR=0.42, 95% CI: 0.26-0.67). Further sub-analyses testified these associations in males solely. The highest GC incident risk was plainly visible when both HDL-C and LDL-C were abnormal (HR=5.38, 95% CI: 3.43-8.45), followed by excess TG and hypo-HDL-C group (HR=2.75, 95% CI: 1.89-4.00) and excess TG and LDL-C group (HR=2.55, 95% CI: 1.78- 3.64) compared with normal lipid group. Conclusion Lipid metabolism abnormalities could be important risk factors for GC. Additionally, a combination of any abnormalities among TG, HDL-C, and LDL-C would interactively elevate the incidence risk of GC.

目的 了解金昌队列人群脑卒中的发病状况,探讨糖尿病及FPG与脑卒中发病之间的联系,为有效控制糖尿病、预防脑卒中的发生提供科学依据.方法 以金昌队列为研究平台,采用前瞻性队列研究的方法分析糖尿病及FPG水平与脑卒中发病风险间的关系,运用限制样条法拟合FPG水平与脑卒中发病风险间的剂量反应关系.结果 本研究共纳入32736例研究对象,平均随访2.2年后,脑卒中累积发病率为8.77‰,其中糖尿病组脑卒中发病率为23.38‰,高于对照组发病率6.67‰.调整混杂因素后,糖尿病患者和空腹血糖受损人群中脑卒中的发病风险分别是对照组的2.257倍(HR=2.257,95％ CI:1.658～3.072,P＜0.001)和1.396倍(HR=1.396,95％CI:1.039～1.877,P=0.027).以FPG＜ 5.6 mmol/L作为对照组,控制混杂因素后,总人群中FPG≥5.6 mmol/L组和FPG≥6.1 mmol/L组脑卒中的发病风险分别增加48.1％(HR=1.481,95％CI:1.040～2.108,P=0.030)和49.3％(HR=1.493,95％ CI:1.044～2.136,P=0.028);当FPG≥7.0 mmol/L时,男性和女性脑卒中的发病风险分别是对照组的1.614倍(HR=1.614,95％ CI:1.068～2.438)和2.742倍(HR=2.742,95％ CI:1.355～5.547).在总人群和女性中FPG与脑卒中发病风险间呈非线性剂量反应关系,男性中FPG与脑卒中发病风险间呈线性剂量反应关系.结论 糖尿病是脑卒中的独立危险因素,且FPG水平与脑卒中的发病风险间存在剂量反应关系.

目的 分析金昌队列人群2011-2020年四种主要慢性病的死亡率、早死概率及变化趋势,锁定影响人群健康的核心病种,为人群慢性病防治提供基础数据.方法 以金昌队列为平台,纳入基线全部人群48 001人,连续10年追踪随访其结局,应用简略寿命表法与joinpoint回归法计算死因构成比、粗死亡率、标化死亡率、早死概率及年度变化百分比(annual percent change,APC)等指标.结果 2011-2020年金昌队列人群4类主要慢性病平均死亡构成比为80.26％,4类主要慢性病粗死亡率呈上升趋势(APC=6.48％),心脑血管疾病粗死亡率呈上升趋势(APC=10.02％),其他三类疾病粗死亡率与标化死亡率均无变化趋势.除女性心脑血管疾病早死概率呈上升趋势外(APC=12.92％),其他主要慢性病早死概率均无变化趋势.男性主要慢性病死亡率及早死概率高于女性.主要慢性病不同病种平均死亡率前3位为肺癌、脑卒中、冠心病.结论 4类主要慢性病是导致金昌队列人群死亡的主要疾病,肺癌、脑卒中为核心病种.男性为慢性病防治的重点人群,同时还应重点关注女性心脑血管疾病的防治,降低慢性病早死概率.

目的 了解2011-2020年金昌队列人群冠心病死亡率变化趋势与寿命损失,为制定冠心病防治措施提供依据.方法 从金川集团有限公司获取2011-2020年职工死亡数据,计算粗死亡率、标化死亡率、潜在减寿年数(PYLL)、人均潜在减寿年数(AYLL)、潜在工作损失年(WYPLL)、人均潜在工作损失年(AWYPLL).采用Joinpoint回归分析趋势.结果 2011-2020年金昌队列人群冠心病粗死亡率为18.38/10万,标化死亡率为47.88/10万,随年份变化呈上升趋势(P＜0.05),70岁以上人群冠心病死亡率较高;PYLL为1011.46人年,AYLL为10.88 a,WPYLL为504.76人年,AW-PYLL为9.35 a.结论 金昌队列2011-2020年冠心病死亡率呈上升趋势,男性负担较重,应加强重点人群的防治.

BACKGROUND AND AIMS:There is still inconsistent evidence over the protective effect of total bilirubin on the development of coronary heart disease (CHD). Therefore, we aimed to investigate the association between bilirubin in population subtypes and the risks of CHD between different gender and menstruation subgroups.METHODS AND RESULTS:In this prospective cohort study, 29,750 participants free of CHD with an average age of 47 ± 14 years were recruited at baseline; of these, 720 CHD first-attack cases were collected after 7-years of follow up. The covariate-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) of CHD with 95% confidence intervals (CIs). The serum bilirubin concentration was quarterly stratified based on the distribution of healthy population without CHD onset. The HRs of incident CHD decreased with elevated bilirubin in females (ρ trend<0.05), but not males. In postmenopausal females, compared with the lowest quartile of total bilirubin, the adjusted HRs for the third and fourth quartiles were 0.64 (95% CI: 0.45, 0.93) and 0.59 (95% CI: 0.42, 0.86), the adjusted HRs in the third and fourth quartiles of direct bilirubin were 0.56 (0.39, 0.82) and 0.56 (0.38, 0.81), and for indirect bilirubin, corresponding HR in the highest quartile was 0.56 (0.38, 0.83).CONCLUSION:Elevated serum bilirubin was inversely associated with adjusted HRs of CHD in females, especially postmenopausal females. The relationship between elevated direct bilirubin and reduced HRs of CHD may be closer than indirect bilirubin in postmenopausal females.

The Jinchang Cohort was an ongoing 20-year ambispective cohort with unique metal exposures to an occupational population. From January 2014 to December 2019, the Jinchang Cohort has completed three phases of follow-up. The baseline cohort was completed from June 2011 to December 2013, and a total of 48 001 people were included. Three phases of follow-ups included 46 713, 41 888, and 40 530 participants, respectively. The death data were collected from 2001 to 2020. The epidemiological, physical examination, physiological, and biochemical data of the cohort were collected at baseline and during follow-up. Biological specimens were collected on the baseline to establish a biological specimen bank. The concentrations of metals in urine and serum were detected by inductively coupled plasma mass spectrometry (ICP-MS). The new areas of research aim to study the all-cases mortality, the burden of diseases, heavy metals and diseases, and the course of the chain from disease to high-risk outcomes using a combination of macro and micro means, which provided a scientific basis to explore the pathogenesis of multi-etiology and multi-disease and to evaluate the effects of the intervention measures in the population.

目的 掌握金昌队列人群恶性肿瘤的死亡趋势及其造成的疾病负担,确定肿瘤防治的高危人群和核心病种,为肿瘤防治和健康干预提供基础数据.方法 随访队列人群近10a的恶性肿瘤死因,利用职工唯一识别码构建用于分析恶性肿瘤死亡率和疾病负担的数据库,分析恶性肿瘤死亡率、潜在减寿年数(PYLL)和潜在工作损失年数(WYPLL)近10a的变化趋势.结果 2011-2020年,金昌队列人群恶性肿瘤粗死亡率为252.19/10万,标化死亡率为131.18/10万,其变化趋势差异均无统计学意义(P＞0.05);恶性肿瘤造成的男性PYLL(4272.40人年)是女性(2147.64人年)的1.99倍,女性平均潜在减寿年数(AYLL) (14.91 a)是男性(9.52 a)的1.57倍;恶性肿瘤导致的男性WYPLL(2485.00人年)是女性(1035.00人年)的2.40倍,女性平均潜在工作损失年数(AWYPLL) (10.78 a)是男性(10.02 a)的1.08倍,男、女性恶性肿瘤造成的疾病负担近10a变化趋势差异均无统计学意义;总人群中首位恶性肿瘤PYLL和WYPLL是肺癌,其次是肝癌、胃癌、食管癌和结直肠癌,男性恶性肿瘤AYLL和AWYPLL首位均是肝癌,女性恶性肿瘤AYLL和AWPYLL首位分别是食管癌和胃癌.结论 金昌队列人群近10a恶性肿瘤死亡率和疾病负担呈相对稳定状态,疾病负担较重的恶性肿瘤前5位分别为肺癌、肝癌、胃癌、食管癌和结直肠癌.

目的 分析金昌队列人群2011-2020年糖尿病的死亡率、疾病负担及变化趋势,评价该队列人群糖尿病的死亡特征及疾病负担情况,为糖尿病的防治提供基础数据.方法 以金昌队列为平台,以基线48001人为研究对象,连续随访10a,应用Joinpoint回归法计算粗死亡率、标化死亡率、疾病负担及年度变化百分比等指标.结果 2011-2020年金昌队列人群糖尿病粗死亡率为27.16/10万,标化死亡率为15.04/10万,其中男性粗死亡率为35.86/10万,标化死亡率为17.74/10万;女性粗死亡率为12.92/10万,标化死亡率为6.41/10万,男性高于女性,变化趋势均无统计学意义(P＞0.05).70岁及以上人群糖尿病死亡率最高(156.26/10万),在总死亡人数中占比最高(88.24％).糖尿病造成的潜在减寿年数为451.89 a,平均潜在减寿年数为10.51a/人,潜在工作损失年数为212.50 a,平均潜在工作损失年数为9.24 a/人.结论 金昌队列人群糖尿病死亡率相对较高,且集中在高年龄段人群,男性糖尿病死亡率与疾病负担较重,应重点关注并尽早给予相应的预防措施,降低死亡率.

[目的]揭示金昌队列人群恶性肿瘤死亡率、早死概率及其变化趋势,确定肿瘤防治的高危人群和核心疾病,为健康干预提供重要依据.[方法]通过前瞻性研究,对金昌队列人群近10年的肿瘤死因随访,从人力资源部、退休管理中心、各二级单位工会、医保中心及医院获取死因数据,通过ID号构建用于分析恶性肿瘤死亡率和早死概率的数据库.[结果]2011-2020年金昌队列人群恶性肿瘤死亡率为252.19/10万,中国人口标化死亡率为131.18/10万.总人群恶性肿瘤死亡率前5位肿瘤依次为肺癌(88.83/10万)、胃癌(37.37/10万)、肝癌(30.43/10万)、食管癌(18.38/10万)、结直肠癌(17.56/10万).男性恶性肿瘤死亡率前5位肿瘤依次为肺癌(125.36/10万)、胃癌(52.31/10万)、肝癌(41.79/10万)、食管癌(26.32/10万)、结直肠癌(23.03/10万);女性恶性肿瘤死亡率前5位肿瘤依次为肺癌(29.07/10万)、胃癌(12.92/10万)、肝癌(11.84/10万)、结直肠癌(8.61/10万)、乳腺癌(8.07/10万);男性、女性和总人群首位死因均为肺癌,在恶性肿瘤全死因中占比分别为37.35％、25.12％、35.22％.该人群近10年恶性肿瘤早死概率为6.39％,男性(2.76％)和女性(0.81％)恶性肿瘤早死概率首位均是肺癌.近10年该人群恶性肿瘤死亡率和早死概率变化趋势在男、女性和总人群中差异均无统计学意义.[结论]金昌队列人群恶性肿瘤死亡率前5位分别为肺癌、胃癌、肝癌、食管癌和结直肠癌,肺癌是导致男性和女性死亡的首位肿瘤,近10年恶性肿瘤死亡率和早死概率呈相对稳定状态.