Associations of long-term physical activity trajectories with coronary artery calcium progression and cardiovascular disease events: results from the CARDIA study
Associations of long-term physical activity trajectories with coronary artery calcium progression and cardiovascular disease events: results from the CARDIA study
复制标题
长期体力活动轨迹与冠状动脉钙进展和心血管疾病事件的关联：CARDIA 研究结果
DOI：
10.1136/bjsports-2021-105092
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发表时间：
2022-03-13
影响因子：
18.4
通讯作者：
Liu, Pin-Ming
中科院分区：
文献类型：
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作者：
Gao, Jing-Wei;Hao, Qing-Yun;Liu, Pin-Ming
目的本研究旨在评估25年时间跨度内身体活动（PA）轨迹与冠状动脉钙化（CAC）进展以及随后心血管疾病（CVD）事件风险的相关性。方法：我们纳入了2497名来自年轻人冠状动脉疾病风险发展研究的参与者，他们在基线（15年：2000-2001年）和随访（20年或25年）时进行了CAC的计算机断层扫描评估，并从0年到25年进行了至少三次PA测量。长期PA轨迹确定潜在类建模使用验证问卷。结果在纳入的参与者中，1120人（44.9%）是男性，1418人（56.8%）是白色，平均（SD）年龄为40.4（3.6）岁。我们根据PA平均水平和变化模式确定了三种不同的PA轨迹：低（低于PA指南，n=1332; 53.3%）;中度（符合和略高于PA指南，n=919; 36.8%）和高（约为PA指南的三倍或更多，n=246; 9.9%）。在平均（SD）8.9（2.1）年的随访期间，640（25.6%）例参与者发生CAC进展。校正传统心血管危险因素后，高PA轨迹组的参与者CAC进展风险高于低PA轨迹组（HR 1.51; 95% CI 1.18 - 1.94）。然而，高PA轨迹与CVD事件发生风险增加无关（HR 1.01; 95% CI 0.44 - 2.31），所有3个PA轨迹组中CAC进展受试者的CVD事件发生率相似（p=0.736）。结论：长期PA约为指南的3倍或更多与CAC进展独立相关;然而，未检测到额外的CVD事件风险。
Objective The study aimed to assess the associations of physical activity (PA) trajectories across a 25-year span with coronary artery calcium (CAC) progression, and subsequent risk of cardiovascular disease (CVD) events. Methods We included 2497 participants from the Coronary Artery Disease Risk Development in Young Adults study who had computed tomography-assessment of CAC at baseline (year 15: 2000-2001) and follow-up (year 20 or 25) and at least three measures of PA from year 0 to year 25. Long-term PA trajectories were determined by latent class modelling using a validated questionnaire. Results Among the included participants, 1120 (44.9%) were men, 1418 (56.8%) were white, and the mean (SD) age was 40.4 (3.6) years. We identified three distinct PA trajectories based on PA average levels and change patterns: low (below PA guidelines, n=1332; 53.3%); moderate (meeting and slightly over PA guidelines, n=919; 36.8%) and high (about three times PA guidelines or more, n=246; 9.9%). During a mean (SD) follow-up of 8.9 (2.1) years, 640 (25.6%) participants had CAC progression. Participants in the high PA trajectory group had a higher risk of CAC progression than those in the low PA trajectory group after adjustment for traditional cardiovascular risk factors (HR 1.51; 95% CI 1.18 to 1.94). However, high PA trajectory was not associated with an increased risk of incident CVD events (HR 1.01; 95% CI 0.44 to 2.31) and the incidence of CVD events in participants with CAC progression was similar across all three PA trajectory groups (p=0.736). Conclusion Long-term PA about three times the guidelines or more is independently associated with CAC progression; however, no additional risk of incident CVD events could be detected.