Dose-response relationship of physical activity to premature and total all-cause and cardiovascular disease mortality in walkers.
Dose-response relationship of physical activity to premature and total all-cause and cardiovascular disease mortality in walkers.
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DOI：
10.1371/journal.pone.0078777
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Williams PT
中科院分区：
文献类型：
--
作者：
Williams PT
在一个前瞻性的步行者流行病学队列中评估病因特异性死亡率和运动能量消耗之间的剂量反应关系。样本包括8，436名男性和33，586名女性参加了全国步行者健康研究。以代谢当量（MET，1 MET = 3.5 ml O2/kg/min）计算步行能量消耗，用于将队列分为4个运动类别：第1类（≤1.07 MET-小时/d）、第2类（1.07 - 1.8 MET-小时/d）、第3类（1.8 - 3.6 MET-小时/d）和第4类（≥3.6 MET-小时/d）。 使用竞争风险回归分析计算第2、3和4类相对于第1类的死亡风险。22.9%的受试者属于1类，16.1%属于2类，33.3%属于3类，27.7%属于4类。在平均9.6年的随访期间，有2,448人死亡。与第1类相比，第2类总死亡率低11.2%（P = 0.04），第3类低32.4%（P<10−12），第4类低32.9%（P =10−11）。 对于潜在死亡原因，与第1类相比，第2类、第3类和第4类的心血管疾病死亡风险分别降低了23.6%（P = 0.008）、35.2%（P<10−5）和34.9%（P = 0.0001）;缺血性心脏病死亡风险分别降低了27.8%（P= 0.18）、20.6%（P = 0.07）和31.4%（P = 0.009）;糖尿病死亡风险分别降低了39.4%（P =0.18）、63.8%（P=0.005）和90.6%（P=0.002）。 对于所有相关死亡率（即，合并潜在和促成死亡原因），第2、3和4类的风险分别降低18.7%（P = 0.22），42.5%（P = 0.001），57.5%（P = 0.0001）心力衰竭; 9.4%（P = 0.56），44.3%（P = 0.0004）和33.5%（P = 0.02）高血压疾病; 11.5%（P = 0.38），41.0%（P<10−4），35.5%（P = 0.001）节律障碍：脑血管疾病组分别为23.2%（P= 0.13）、45.8%（P = 0.0002）和41.1%（P =0.005）。 超过目前的锻炼指南对健康有很大的好处。
To assess the dose-response relationships between cause-specific mortality and exercise energy expenditure in a prospective epidemiological cohort of walkers. The sample consisted of the 8,436 male and 33,586 female participants of the National Walkers' Health Study. Walking energy expenditure was calculated in metabolic equivalents (METs, 1 MET = 3.5 ml O2/kg/min), which were used to divide the cohort into four exercise categories: category 1 (≤1.07 MET-hours/d), category 2 (1.07 to 1.8 MET-hours/d), category 3 (1.8 to 3.6 MET-hours/d), and category 4 (≥3.6 MET-hours/d). Competing risk regression analyses were use to calculate the risk of mortality for categories 2, 3 and 4 relative to category 1. 22.9% of the subjects were in category 1, 16.1% in category 2, 33.3% in category 3, and 27.7% in category 4. There were 2,448 deaths during the 9.6 average years of follow-up. Total mortality was 11.2% lower in category 2 (P = 0.04), 32.4% lower in category 3 (P<10−12) and 32.9% lower in category 4 (P = 10−11) than in category 1. For underlying causes of death, the respective risk reductions for categories 2, 3 and 4 were 23.6% (P = 0.008), 35.2% (P<10−5), and 34.9% (P = 0.0001) for cardiovascular disease mortality; 27.8% (P = 0.18), 20.6% (P = 0.07), and 31.4% (P = 0.009) for ischemic heart disease mortality; and 39.4% (P = 0.18), 63.8% (P = 0.005), and 90.6% (P = 0.002) for diabetes mortality when compared to category 1. For all related mortality (i.e., underlying and contributing causes of death combined), the respective risk reductions for categories 2, 3 and 4 were 18.7% (P = 0.22), 42.5% (P = 0.001), and 57.5% (P = 0.0001) for heart failure; 9.4% (P = 0.56), 44.3% (P = 0.0004), and 33.5% (P = 0.02) for hypertensive diseases; 11.5% (P = 0.38), 41.0% (P<10−4), and 35.5% (P = 0.001) for dysrhythmias: and 23.2% (P = 0.13), 45.8% (P = 0.0002), and 41.1% (P = 0.005) for cerebrovascular diseases when compared to category 1. There are substantial health benefits to exceeding the current exercise guidelines.
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