青岛市成年人水果摄入与脑卒中发病关联的前瞻性研究

目的 了解青岛市居民的水果摄入情况，探讨水果摄入与脑卒中发病的关联。方法 利用中国慢性病前瞻性研究项目（CKB）青岛项目点30～79岁调查对象的基线信息和随访获得的脑卒中发病事件，采用Cox比例风险回归模型，评估水果摄入与脑卒中发病风险之间的关联。结果 基线共调查35 509人，男女性别比为1∶1.27，年龄（50.3±10.2）岁。水果摄入频率较高的研究对象更年轻，更多的是女性、文化程度高和家庭收入高的人群（均P<0.05）。本研究随访过程共观察到脑卒中发病事件1 011例，脑卒中发病密度为387.63/10万人年。多因素Cox回归分析结果显示，在调整了相关混杂因素之后，增加水果的摄入频率对脑卒中发病具有保护作用。与几乎不吃水果的研究对象相比，≥4次/周频率组的研究对象脑卒中发病的风险降低了44%（HR=0.56，95% CI：0.50～0.62，P<0.05），在男性和女性中分别降低了46%（HR=0.54，95% CI：0.46～0.64）和42%（HR=0.58，95% CI：0.52～0.69）（均P<0.05）。进一步调整研究对象的腰围、BMI、SBP和随机血糖，没有改变水果摄入对于脑卒中发病的保护作用。结论 增加水果摄入能降低脑卒中的发病风险，我国居民应增加水果摄入，建立更健康合理的饮食习惯。

Association between fruit consumption and stroke in adults in Qingdao:a prospective study

Objective To understand the fruit consumption of adults of Qingdao and examine the association between fruit consumption and stroke. Methods We analyzed baseline data and stroke incidence of the participants who were aged 30-79 years and had been enrolled into the China Kadoorie Biobank (CKB) study from Qingdao city. Cox proportional hazards regression model was conducted to estimate the association of fruit consumption with risk of stroke. Results A total of 35 509 participants were investgated in the baseline survey. Ratio of male to female was 1:1.27, and the average age was (50.3±10.2) years. Respondents with higher frequency of fruit consumption were younger, more women, with higher education level and higher income (P<0.05). A total of 1 011 new cases of stroke were observed, with a stroke incidence of 387.63/100 000 person-years. Multivariate Cox regression analysis showed that fruit consumption had a protective effect on stroke incidence. Compared to the respondents who never consumed fruit, respondents who consumed fruit more than 4 days per week had a 44% lower risk of stroke incidence (HR=0.56, 95%CI:0.50-0.62, P<0.05), and the risk reduced by 46% (HR=0.54, 95%CI:0.46-0.64, P<0.05) and 42% (HR=0.58, 95%CI:0.52-0.69, P<0.05) in male and female, respectively. Further adjustment for WC, BMI, SBP and random blood glucose did not change the association. Conclusion Increasing fruit consumption can effectively decrease the risk of stroke. People should increase fruit consumption advisably to set up reasonable and healthy dietary habits.