The danger of sedenterism: endothelium at risk.
The danger of sedenterism: endothelium at risk.
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久坐的危险：内皮细胞处于危险之中。
DOI：
10.1152/ajpheart.00505.2010
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Widlansky,MichaelE
中科院分区：
文献类型：
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作者：
Widlansky,MichaelE
习惯性身体不活动，也称为久坐症，是过度和可预防的心血管风险的主要原因（4）。2007年，不到一半的美国成年人达到了推荐的身体活动标准，2008年，近四分之一的美国人口报告说没有休闲时间的身体活动，65岁以上的人的久坐率超过30%（3）。虽然久坐不动的社会成本的确切幅度很难量化，但估计表明，久坐不动的个人的直接医疗成本比身体活跃的人高出近三分之一，今天可能至少相当于1000亿美元的额外医疗成本（10）。缺乏身体活动的大部分风险归因于继发于相对于能量需求的过量热量摄入的肥胖症的发作。肥胖是公认的血脂异常、全身性炎症、高血压和胰岛素抵抗的危险因素。在这种情况下，血管内皮变得功能障碍。内皮功能障碍的特征在于促炎、促血栓形成和血管收缩表型，并且是已知的不良心血管事件的先兆（13）。虽然肥胖与内皮功能障碍和胰岛素抵抗有关，并且体力活动已被证明可以改善高危人群的这两项指标，但久坐症和肥胖的强烈共线性使确定单独体力活动对内皮功能障碍和胰岛素抵抗的贡献的尝试显着复杂化。
HABITUAL PHYSICAL inactivity, otherwise known as sedenterism, is a leading cause of excessive and preventable cardiovascular risk (4). Less than half of US adults met recommended physical activity standards in 2007, and nearly one-quarter of the US population reported no leisure time physical activity in 2008 with rates of sedenterism above 30% for those over the age of 65 (3). While the exact magnitude of the societal cost of sedenterism is difficult to quantify, estimates suggest that the direct medical costs of sedentary individuals are nearly onethird higher than those of their physically active counterparts and likely amounts to at least 100 billion US dollars of excess healthcare costs today (10).Sedentarism’s deleterious mechanisms of action remain unclear. Much of the risk of physical inactivity has been attributed to the onset of obesity secondary to excessive caloric intake relative to energy requirements. Obesity is a wellrecognized risk factor for the development of dyslipidemia, systemic inflammation, hypertension, and insulin resistance. In this setting, the vascular endothelium becomes dysfunctional. Endothelial dysfunction is characterized by a proinflammatory, prothrombotic, and vasoconstrictive phenotype and is a known harbinger of adverse cardiovascular events (13). While obesity has been linked to endothelial dysfunction and insulin resistance and physical activity has been shown to improve both measures in at-risk populations, the strong colinearity of sedenterism and obesity significantly complicates attempts to determine the contribution of physical inactivity alone to both endothelial dysfunction and insulin resistance.