Quantifying the Association Between Physical Activity and Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis.
Quantifying the Association Between Physical Activity and Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis.
复制标题
量化体育活动与心血管疾病与糖尿病之间的关联：系统评价和荟萃分析。
DOI：
10.1161/jaha.115.002495
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发表时间：
2016-09-14
影响因子：
5.4
通讯作者：
Scarborough P
中科院分区：
文献类型：
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作者：
Wahid A;Manek N;Nichols M;Kelly P;Foster C;Webster P;Kaur A;Friedemann Smith C;Wilkins E;Rayner M;Roberts N;Scarborough P
体力活动（PA）与心血管疾病（CVD）和2型糖尿病（T2 DM）之间的关系主要使用PA的分类指标进行估计，掩盖了剂量反应关系的形状。在这项系统性综述和Meta分析中，我们首次能够推导出一个单一的连续PA指标，以比较PA和CVD/T2 DM之间的关联，包括调整体重测量值之前和之后。检索MEDLINE和EMBASE电子数据库中1981年1月至2014年3月发表的所有研究。共有36项研究（3439874例受试者和179393起事件，平均随访期为12.3年）被纳入分析（33项与CVD相关，3项与T2 DM相关）。从不活动增加到达到建议的PA水平（每周150分钟中等强度有氧运动）与CVD死亡率降低23%、CVD发病率降低17%和T2 DM发病率降低26%相关经体重校正后，分别为（相对危险度[RR]，0.77 [0.71-0.84]）、（RR，0.83 [0.77-0.89]）和（RR，0.74 [0.72-0.77]）。通过使用PA水平的单一连续指标，我们能够比较PA对CVD发病率和死亡率的影响，包括心肌梗死（MI）、卒中和心力衰竭以及T2 DM。CVD和T2 DM的效应量通常相似，并表明健康的最大收益与从不活动到少量PA的变化有关。
The relationships between physical activity (PA) and both cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) have predominantly been estimated using categorical measures of PA, masking the shape of the dose‐response relationship. In this systematic review and meta‐analysis, for the very first time we are able to derive a single continuous PA metric to compare the association between PA and CVD/T2DM, both before and after adjustment for a measure of body weight. The search was applied to MEDLINE and EMBASE electronic databases for all studies published from January 1981 to March 2014. A total of 36 studies (3 439 874 participants and 179 393 events, during an average follow‐up period of 12.3 years) were included in the analysis (33 pertaining to CVD and 3 to T2DM). An increase from being inactive to achieving recommended PA levels (150 minutes of moderate‐intensity aerobic activity per week) was associated with lower risk of CVD mortality by 23%, CVD incidence by 17%, and T2DM incidence by 26% (relative risk [RR], 0.77 [0.71–0.84]), (RR, 0.83 [0.77–0.89]), and (RR, 0.74 [0.72–0.77]), respectively, after adjustment for body weight. By using a single continuous metric for PA levels, we were able to make a comparison of the effect of PA on CVD incidence and mortality including myocardial infarct (MI), stroke, and heart failure, as well as T2DM. Effect sizes were generally similar for CVD and T2DM, and suggested that the greatest gain in health is associated with moving from inactivity to small amounts of PA.