Association of physical activity and body mass index with novel and traditional cardiovascular biomarkers in women
Association of physical activity and body mass index with novel and traditional cardiovascular biomarkers in women
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DOI：
10.1001/jama.295.12.1412
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发表时间：
2006-03-22
影响因子：
120.7
通讯作者：
Ridker, PM
中科院分区：
文献类型：
--
作者：
Mora, S;Lee, IM;Ridker, PM
研究背景：直接比较体力活动和体重对心血管生物标志物影响的数据很少。目的探讨体力活动与体重指数之间的关系（BMI，定义为以千克为单位的体重除以以米为单位的身高的平方）单独和与心血管生物标志物组合。对27158名表面健康的美国女性进行横断面分析（平均年龄，54.7岁）（1992-1995）在妇女健康研究中，一项随机、双盲、安慰剂对照试验，剂量阿司匹林和维生素E在心血管疾病和癌症的一级预防中的作用。主要结果指标BMI和高敏C反应蛋白（CRP）、纤维蛋白原、可溶性细胞内粘附分子1（ICAM-1）、同型半胱氨酸、低密度脂蛋白和高密度脂蛋白（低密度脂蛋白和高密度脂蛋白）胆固醇、总胆固醇、载脂蛋白A-1和B-100、脂蛋白（a）、结果低水平的体力活动和高水平的BMI是独立相关的（P趋势<0.001），几乎所有脂质和炎症生物标志物的水平都不利。高BMI与这些生物标志物的相关性比缺乏身体活动更强。例如，使用身体活动的参考组，正常体重的女性（能量消耗>= 1000千卡/周; BMI，18.5-24.9）并调整年龄、种族、吸烟、血压、糖尿病、绝经状态和激素使用，CRP > 3 mg/L的95%可信区间（CI）为：不活动、体重正常的女性为1.26（1.15-1.37）;活动，超重2.68（2.41-2.98）;不活动，超重3.11（2.84-3.41）;活动，肥胖8.25（7.15-9.51）;不活动，肥胖9.86（8.84-10.99）。在类似的分析中，HDL胆固醇< 50 mg/dL的95% CI为1.20（1.11-1.30）; 2.25（2.04-2.49）; 2.62（2.41-2.85）; 4.21（3.68-4.81）;和5.27载脂蛋白B-100 > 120 mg/dL者为1.21（1.11-1.33）; 1.86（1.66-2.08）; 2.06（1.88-2.67）; 2.35（2.04-2.70）;和2.33（2.09-2.59）。纤维蛋白原、ICAM-1、载脂蛋白A1、总胆固醇和LDL胆固醇显示出类似的相关性。相比之下，同型半胱氨酸，脂蛋白（a），肌酐表现出弱或nonsignificantassociation.Conclusions高BMI是更强烈的不良心血管生物标志物水平比缺乏体力活动。然而，在BMI类别中，体力活动通常比不活动与更有利的心血管生物标志物水平相关。
Context There are few data directly comparing the effects of physical activity and body weight on cardiovascular biomarkers.Objective To examine the association of physical activity and body mass index (BMI, defined as weight in kilograms divided by the square of height in meters) alone and in combination with cardiovascular biomarkers.Design, Setting, and Participants Cross-sectional analysis of 27 158 apparently healthy US women ( mean age, 54.7 years) at the time of enrollment (1992-1995) in the Women's Health Study, a randomized, double-blind, placebo-controlled trial of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer.Main Outcome Measures The association of physical activity and BMI with high-sensitivity C-reactive protein (CRP), fibrinogen, soluble intracellular adhesion molecule 1 (ICAM-1), homocysteine, low- and high-density lipoprotein (LDL and HDL) cholesterol, total cholesterol, apolipoprotein A-1 and B-100, lipoprotein( a), and creatinine.Results Lower levels of physical activity and higher levels of BMI were independently associated ( P for trend < .001) with adverse levels of nearly all lipid and inflammatory biomarkers. High BMI showed stronger associations with these biomarkers than physical inactivity. For example, using the reference group of physically active, normal weight women ( energy expenditure >= 1000 kcal/week; BMI, 18.5-24.9) and adjusting for age, race, smoking, blood pressure, diabetes, menopausal status, and hormone use, the odds ratios (95% confidence intervals [CIs]) for having CRP > 3 mg/L were: for inactive, normal weight women 1.26 (1.15-1.37); active, overweight 2.68 (2.41-2.98); inactive, overweight 3.11 (2.84-3.41); active, obese 8.25 (7.15-9.51); and inactive, obese 9.86 (8.84-10.99). In similar analyses, the odds ratios ( 95% CIs) for having HDL cholesterol < 50 mg/dL were 1.20 (1.11-1.30); 2.25 (2.04-2.49); 2.62 (2.41-2.85); 4.21 (3.68-4.81); and 5.27 (4.77-5.84), respectively, and for having apolipoprotein B-100 > 120 mg/dL they were 1.21 (1.11-1.33); 1.86 (1.66-2.08); 2.06 (1.88-2.67); 2.35 (2.04-2.70); and 2.33 (2.09-2.59). Fibrinogen, ICAM-1, apolipoprotein A1, total cholesterol, and LDL cholesterol showed similar associations. By contrast, homocysteine, lipoprotein ( a), and creatinine showed weak or nonsignificant associations.Conclusions High BMI was more strongly related to adverse cardiovascular biomarker levels than physical inactivity. However, within BMI categories, physical activity was generally associated with more favorable cardiovascular biomarker levels than inactivity.