Sedentary Behavior and Cardiovascular Disease in Older Women The OPACH Study
Sedentary Behavior and Cardiovascular Disease in Older Women The OPACH Study
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DOI：
10.1161/circulationaha.118.035312
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发表时间：
2019-02-19
期刊：
影响因子：
37.8
通讯作者：
LaCroix, Andrea Z.
中科院分区：
文献类型：
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作者：
Bellettiere, John;LaMonte, Michael J.;LaCroix, Andrea Z.
背景技术背景：久坐时间长与心血管疾病（CVD）风险高相关的证据主要基于自我报告的测量。很少有研究探讨久坐时间的模式是否与较高的风险为cVD.METHODS：妇女从OPACH研究（客观的体力活动和心血管健康; n=5638，年龄63-97岁，平均年龄79 +/- 7岁），没有心肌梗死或中风的历史，戴加速度计4至7天，并随访长达4.9年的心血管事件。平均每日久坐时间和平均久坐回合持续时间是感兴趣的暴露。使用考克斯回归模型估计CVD的风险比（HR）和95% CI，模型校正了协变量，随后校正了潜在介质（体重指数、糖尿病、高血压和CVD风险生物标志物[空腹血糖、高密度脂蛋白、甘油三酯和收缩压]）。结果：在19350人-年中有545例CVD事件。调整协变量后，久坐时间最长（约11小时/天或更长）的女性与久坐时间最短（约9小时/天或更短）的女性相比，CVD风险更高（HR，1.62; 95%CI，1.21-2.17; P趋势< 0.001）。进一步调整潜在的介质减弱了这些关联的显著性，但没有消除这些关联的显著性（P趋势均< 0.05）。校正协变量后，久坐发作时间越长与CVD风险越高相关（HR，1.54; 95%CI，1.27-2.02; P趋势=0.003）。CVD风险生物标志物的额外调整减弱了相关性，导致四分位数4与四分位数1的HR为1.36（95% CI，1.01-1.83; P趋势=0.10）。久坐时间和发作持续时间与CVD的剂量反应相关性是线性的（P非线性均> 0.05）。与久坐时间较短且发作持续时间较短的女性相比，久坐时间较长且发作持续时间较长的女性发生CVD的风险显著更高（HR，1.34; 95%CI，1.08-1.65）。所有的分析重复事件冠心病（心肌梗死或心血管疾病死亡），和协会是相似的，有显着更强的HRs.CONCLUSIONS：高久坐时间和长的平均回合持续时间与剂量反应的方式增加心血管疾病的风险在老年妇女，这表明，努力减少心血管疾病的负担可能受益于解决久坐行为的一个或两个组件。
BACKGROUND: Evidence that higher sedentary time is associated with higher risk for cardiovascular disease (CVD) is based mainly on self-reported measures. Few studies have examined whether patterns of sedentary time are associated with higher risk for CVD.METHODS: Women from the OPACH Study (Objective Physical Activity and Cardiovascular Health; n=5638, aged 63-97 years, mean age 79 +/- 7 years) with no history of myocardial infarction or stroke wore accelerometers for 4 to 7 days and were followed up for up to 4.9 years for CVD events. Average daily sedentary time and mean sedentary bout duration were the exposures of interest. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs for CVD using models adjusted for covariates and subsequently adjusted for potential mediators (body mass index, diabetes mellitus, hypertension, and CVD risk biomarkers [ fasting glucose, high-density lipoprotein, triglycerides, and systolic blood pressure]). Restricted cubic spline regression characterized dose-response relationships.RESULTS: There were 545 CVD events during 19 350 person-years. With adjustment for covariates, women in the highest (approximate to 11 h/d or more) versus the lowest (approximate to 9 h/d or less) quartile of sedentary time had higher risk for CVD (HR, 1.62; 95% CI, 1.21-2.17; P trend < 0.001). Further adjustment for potential mediators attenuated but did not eliminate significance of these associations (P trend < 0.05, each). Longer versus shorter mean sedentary bout duration was associated with higher risks for CVD (HR, 1.54; 95% CI, 1.27-2.02; P trend=0.003) after adjustment for covariates. Additional adjustment for CVD risk biomarkers attenuated associations, resulting in a quartile 4 versus quartile 1 HR of 1.36 (95% CI, 1.01-1.83; P trend=0.10). Dose-response associations of sedentary time and bout duration with CVD were linear (P nonlinear > 0.05, each). Women jointly classified as having both high sedentary time and long bout durations had significantly higher risk for CVD (HR, 1.34; 95% CI, 1.08-1.65) than women with low sedentary time and short bout duration. All analyses were repeated for incident coronary heart disease (myocardial infarction or CVD death), and associations were similar, with notably stronger HRs.CONCLUSIONS: Both high sedentary time and long mean bout durations were associated in a dose-response manner with increased CVD risk in older women, which suggests that efforts to reduce CVD burden might benefit from addressing either or both components of sedentary behavior.