Objective: To explore the gender-specific risk factors of new-onset cerebral hemorrhage. Methods: In this prospective cohort study,a total of 98 961 participants((51.1±12.6)years old), who underwent the 2006 to 2007 physical examination and met the inclusion criteria, were enrolled from the Kailuanstudy cohort. There were 78 908 (79.7%) male,and 20 053 (20.3%) female.The incidence of cerebral hemorrhage was observed once per year until December 31, 2016.The difference on the incidence of cerebral hemorrhage between male and female was compared. Multivariate Cox regression analysis was applied to analyze therisk factors of cerebral hemorrhage events among different genders. Results: The participants were followed up for(10.00±0.73) years,and 860 cerebral hemorrhage events were recorded during follow up. The incidence of cerebral hemorrhage in the population was 86.90/10 million person years (standardized incidence rate of 47.85/10 million person years). The incidence of cerebral hemorrhage was significantly higher in male (49.61/10 million person years) than in female (34.07/10 million person years, P<0.05). Multivariate Cox regression analysis showed that 45-59 years old, ≥ 60 years old, diabetes,and waist-hip ratio were more strongly related to new-onset of cerebral hemorrhage events in female than in male, and the hazard ratios(95%CI) were 2.33 (1.23-4.43) ,2.71 (1.30-5.66) ,2.16 (1.24-3.74) and 8.79 (1.42-54.32) in female versus 1.55 (1.21-1.97) ,2.16 (1.68-2.78) ,1.19 (0.93-1.53) and 3.21 (1.09-9.41) in male, respectively. The risk of male cerebral hemorrhage increased by 29% (HR=1.29, 95%CI 1.19-1.40) in male and 24% (HR=1.24, 95%CI 1.20-1.28) in female,when the systolic blood pressure increased 10 mmHg (1 mmHg=0.133 kPa). Conclusions: The incidence of cerebral hemorrhage is higher in male than in female in this cohort.The association between systolic blood pressure and cerebral hemorrhage is stronger in male than that in female.The associations between age, waist-hip ratio, diabetes and cerebral hemorrhage are stronger in female than in male. Trial Registration: Chinese Clinical Trail Registry, ChiCTR-TNC-11001489.
目的： 探讨不同性别人群脑出血发病的影响因素。 方法： 采用前瞻性队列研究方法，在参加2006至2007年健康体检的开滦研究队列中纳入研究对象98 961名。研究对象年龄（51.1±12.6）岁；男性78 908名（79.7%）,女性20 053名（20.3%）。每年记录1次研究对象的脑出血发病情况，随访至2016年12月31日。随访结束后比较男性脑出血与女性脑出血发病率的差异，采用Cox比例风险模型分析不同性别人群脑出血发病的影响因素。 结果： 随访（10.00±0.73）年后，研究对象共发生脑出血事件860例，脑出血发病率为86.90/10万人年（标化发病率为47.85/10万人年），男性人群脑出血标化发病率（49.61/10万人年）高于女性人群（34.07/10万人年）。多因素Cox回归分析显示，45~59岁、≥60岁、糖尿病和腰臀比与女性脑出血发病的关联性[HR（95%CI）分别是2.33（1.23~4.43）、2.71（1.30~5.66）、2.16（1.24~3.74）和8.79（1.42~54.32）]高于男性[HR（95%CI）分别为1.55（1.21~1.97）、2.16（1.68~2.78）、1.19（0.93~1.53）和3.21（1.09~9.41）]；收缩压每升高10 mmHg（1 mmHg=0.133 kPa）,男性脑出血的发生风险增加29%（HR=1.29，95%CI 1.19~1.40），女性脑出血的发生风险增加24%（HR=1.24，95%CI 1.20~1.28）。 结论： 男性脑出血发病率高于女性。收缩压与男性脑出血发病的关联性更强，年龄、腰臀比和糖尿病与女性脑出血发病的关联性更强。 临床试验注册： 中国临床试验注册中心，注册号为ChiCTR-TNC-11001489。.
Keywords: Cerebral hemorrhage; Risk factors; Sex factors.