健康生活方式评分与类风湿关节炎风险的联合效应分析

doi:10.12183/j.scjpm.2026.1022

摘要/Abstract

摘要： 目的探讨健康生活方式评分与类风湿关节炎（RA）发病风险的关联。方法采用病例对照研究,选取临泉县人民医院2022年5月至2025年9月收治的150例RA患者为病例组,同期选取该院体检中心及非风湿免疫科门诊150例非RA人群为对照组。构建健康生活方式评分（范围0~5分,含吸烟、饮酒、BMI、体力活动及饮食5个维度）,采用单因素及多因素logistic回归、趋势检验等方法分析评分与RA风险的关联。结果病例组与对照组健康生活方式单项评分及总分差异均有统计学意义（均P< 0.05）。多因素logistic回归显示,教育程度高中/中专以下（OR=2.620,95% CI：1.601~4.289）、RA家族史（OR=2.907,95% CI：1.250~6.759）及健康生活方式评分0~1分（OR=4.223,95% CI：2.140~8.332）是RA的独立危险因素。趋势检验显示,随着评分下降,RA风险呈显著上升趋势（P for trend< 0.001）。亚组分析显示,该保护效应在不同年龄、性别亚组中具有一致性（均P for interaction > 0.05）。人群归因分数（PAF）为32.10%,提示若全体人群采纳健康生活方式,预计可预防32.10%的RA病例。结论不吸烟、限制饮酒、维持正常体重、坚持规律运动及健康饮食等健康生活方式与RA发病风险降低相关,具有重要的公共卫生意义。

关键词: 类风湿关节炎, 健康生活方式, 病例对照研究, 人群归因分数

Abstract: Objective To investigate the association between a healthy lifestyle score and the incident risk of rheumatoid arthritis (RA). Methods A case-control study design was employed, comprising 150 patients with RA admitted to Linquan County Hospital between May 2022 and September 2025 as the case cohort. Concurrently, a control cohort of 150 non-RA individuals was recruited from the hospital's physical examination center and non-rheumatology outpatient clinics. A healthy lifestyle score (ranging from 0 to 5) was constructed, encompassing five dimensions: smoking status, alcohol consumption, body mass index, physical activity, and dietary habits. The association between this composite score and RA risk was evaluated utilizing univariate and multivariate logistic regression models, alongside trend tests. Results Statistically significant differences were observed between the case and control cohorts regarding both individual domain scores and the aggregate healthy lifestyle score (both P<0.05). Multivariate logistic regression analysis identified an educational attainment below the high school/vocational level (OR=2.620, 95% CI: 1.601-4.289), a family history of RA (OR=2.907, 95% CI: 1.250-6.759), and a healthy lifestyle score of 0-1 (OR=4.223, 95% CI: 2.140-8.332) as independent risk factors for RA. Trend analysis demonstrated a significant progressive escalation in RA risk concomitant with a decline in the lifestyle score (P for trend <0.001). Subgroup analyses indicated that this protective effect remained consistent across diverse age and sex strata (all P for interaction >0.05). The population attributable fraction (PAF) was determined to be 32.10%, suggesting that universal adherence to a healthy lifestyle could theoretically prevent 32.10% of incident RA cases. Conclusion Adherence to healthy lifestyle behaviors—specifically smoking abstinence, alcohol restriction, maintenance of normoweight, sustained regular physical activity, and the consumption of a healthy diet—is inversely associated with the risk of developing RA, thereby presenting substantial implications for public health prevention strategies.

Key words: Rheumatoid arthritis, Healthy lifestyle, Case-control study, Population attributable fraction

中图分类号:

R163

张婧, 吴芳, 郭李霞. 健康生活方式评分与类风湿关节炎风险的联合效应分析[J]. 华南预防医学, 2026, 52(9): 1022-1027.

Zhang Jing, Wu Fang, Guo Lixia. Joint effects of a healthy lifestyle score on the risk of rheumatoid arthritis[J]. South China Journal of Preventive Medicine, 2026, 52(9): 1022-1027.

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