A Threshold of Objectively-Assessed Daily Sedentary Time for All-Cause Mortality in Older Adults: A Meta-Regression of Prospective Cohort Studies
A Threshold of Objectively-Assessed Daily Sedentary Time for All-Cause Mortality in Older Adults: A Meta-Regression of Prospective Cohort Studies
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DOI：
10.3390/jcm8040564
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发表时间：
2019-04-01
影响因子：
3.9
通讯作者：
Chen, Li-Jung
中科院分区：
文献类型：
--
作者：
Ku, Po-Wen;Steptoe, Andrew;Chen, Li-Jung
背景：本荟萃分析旨在估计客观评估的每日久坐时间（ST）与全因死亡率之间的剂量反应关系，并探讨是否存在ST阈值，超过该阈值，老年人的死亡风险就会增加。方法：在截至2019年3月31日的五个数据库中检索前瞻性队列研究，提供每日ST（暴露）对全因死亡率（结果）的影响估计。采用随机效应元回归模型量化每日ST与全因死亡率之间的剂量-反应关系。还进行了敏感性分析以检验结果的稳定性。结果：我们对11项符合条件的研究的汇总数据的分析没有揭示ST和死亡率之间一致的关联形式。在排除了3项可能存在混杂偏倚的研究后，每日ST与全因死亡率之间存在对数线性剂量反应关系。总的来说，久坐的时间越长，老年人的死亡率就越高。基于meta回归分析的剂量-反应关系目视评估表明，当总ST超过约9小时/天时，死亡风险显著增加。结论：基于有限数量的研究，这项荟萃分析为考虑每天久坐时间的截止时间提供了一个起点，表明老年人每天坐着的时间更少。
Background: This meta-analysis aimed to estimate the shape of the dose-response association between objectively-assessed daily sedentary time (ST) and all-cause mortality, and to explore whether there is a threshold of ST above which there is an increase in mortality risk in older adults. Methods: Searches for prospective cohort studies providing effect estimates of daily ST (exposure) on all-cause mortality (outcome) were undertaken in five databases up to 31 March 2019. A random-effects meta-regression model was conducted to quantify the dose-response relationship between daily ST and all-cause mortality. Sensitivity analyses were also performed to test the stability of the results. Results: Our analysis of pooled data from 11 eligible studies did not reveal a consistent shape of association between ST and mortality. After excluding three studies with potential confounding bias, there was a log-linear dose-response relationship between daily ST and all-cause mortality. Overall, higher amounts of time spent in sedentary behaviors were associated with elevated mortality risks in older adults. Visual assessments of dose-response relationships based on meta-regression analyses indicated that increased mortality risks became significant when total ST exceeded approximately 9 h/day. Conclusions: Based on a limited number of studies, this meta-analysis provides a starting point for considering a cut-off of daily sedentary time, suggesting older adults spend less time in daily sitting.