南方医科大学学报

南方医科大学学报 ›› 2017, Vol. 37 ›› Issue (02): 184-.

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健康促进生活方式对亚健康状态转化的影响

陈洁瑜，余克强，孙晓敏，陈泽伟，邝柳燕，姬彦兆，赵晓山，罗仁   

  • 出版日期:2017-02-20 发布日期:2017-02-20

Effect of health-promoting lifestyle on outcomes of suboptimal health status

  • Online:2017-02-20 Published:2017-02-20

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摘要： 目的探讨健康促进生活方式对亚健康状态转化的影响。方法在2013年3~5月，我们建立了一个5676人的前瞻性大学 生队列，进行基线的健康体检、健康状态评估和生活方式判别等，最终发现有2972名亚健康者，并对其进行了1.5年健康状态转 化的随访研究，观察不良生活方式对健康状态转化的影响。生活方式的评估使用《健康促进生活方式量表》（HPLP-Ⅱ），健康状 况的判定主要结合被调查者的体检报告及《亚健康评定量表》（SHMS V1.0）。结果2972名亚健康者经1.5年的随访，有422名 恢复到健康状态，而579名进展为疾病状态，1971名仍是亚健康状态。422名亚健康转化成健康者在健康状态评估SHMS V1.0 量表总分的平均分提高了8.75±6.95分，前后差异有统计学意义（t=-2.14，P=0.000），在生理维度、心理维度和社会维度等3个健 康维度的平均分均有显著的提高。HPLP-Ⅱ总分的平均分在1.5 年后较基线时增加了14.73 分（t=-15.34，P=0.000），同时， HPLP-Ⅱ的6个维度的得分也都明显增加。回归分析发现健康促进生活方式对健康状态有显著影响（P<0.05）。在校正一般人 口学资料的模型中，相对于优秀水平的促进健康生活方式（最小暴露者），差水平的生活方式（最高暴露者）发生亚健康的危险性 高达30 倍（OR：30.598，95% CI：3.928~238.331），一般水平的生活方式（较高暴露者）发生亚健康的危险性高达24 倍（OR： 23.988，95% CI：14.695~39.158），次优水平的生活方式发生亚健康的危险性为4倍（OR：4.306，95% CI：2.767~6.702）。结论亚 健康状态具有既可发展为疾病状态、又可逆转为健康状态的双向性转化特点。不良生活方式是诱导亚健康状态转化的重要因 素；预防和干预生活方式危险因素，是促进亚健康状态回归健康的重要途径。

Abstract: Objective To determine evaluate the effect of health-promoting lifestyle on the outcomes of suboptimal health status (SHS). Methods A prospective population cohort was conducted by consecutively enrolling 5676 college students who took routine health examination from March to May 2013. The participants were assessed for baseline health status and lifestyle and 2972 participants with SHS were followed up for 1.5 years. Exposure was defined as an unhealthy lifestyle. The health-promoting lifestyle was assessed via the Health-promoting Lifestyle Profile (HPLP-II). SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Results Among the 2972 students with SHS, 422 showed recovery of the healthy status at 1.5 year follow-up, 579 showed progression into disease conditions, and 1971 remained in SHS. The participants with recovered health status presented with significant increase of SHMS V1.0 scores by 8.75±6.95 points compared to the baseline assessment (t=-2.14, P=0.000) in physiological, psychological and social dimensions; they also showed a marked improvement of HPLP-II scores by 14.73 points in 6 dimensions (t=-15.34, P=0.000). Multivariable regression analyses with adjusted demographic variables revealed a significant association between health status and health-promoting lifestyle (P<0.05). Compared with a healthy lifestyle (minimal exposure), a ’poor’ lifestyle (the highest level of exposure) was associated with a 30 times higher risk of developing SHS (OR: 30.598, 95% CI: 3.928-238.331), while a ’moderate’ lifestyle (a relatively high-level exposure) had a 24 times higher risk of SHS (OR: 23.988, 95% CI: 14.695-39.158), and a suboptimal lifestyle had a nearly 4 times higher risk of SHS (OR: 4.306, 95% CI: 2.767-6.702). Conclusions SHS may evolve into either a healthy or a disease condition. A unhealthy lifestyle is the important risk factor contributing to the progression of SHS into a disease condition, suggesting the importance of intervention of unhealthy lifestyles in promoting good health.