Sedentary Behavior and Cardiovascular Health in Young Women

年轻女性的久坐行为与心血管健康

• 批准号: 10623317
• 负责人: Bethany Barone Gibbs
• 金额: $ 60.65万
• 依托单位: WEST VIRGINIA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-20 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10623317
• 关键词: Acceleration; Accelerometer; Activity Cycles; Acute; Address; Adverse event; Age; Ancillary Study; Autonomic Dysfunction; Behavior; Behavior Therapy; Behavior assessment; Behavioral; Blood Pressure; Body mass index; Calibration; Cardiac health; Cardiovascular Diseases; Cardiovascular system; Cholesterol; Clinical; Data; Development; Disease Outcome; Epidemiology; Exposure to; Female; Glucose; Guidelines; High Risk Woman; Indiana; Intervention; Laboratories; Leisures; Life Style; Link; Lipids; Longitudinal cohort; Measurement; Measures; Modality; Monitor; Mothers; Nature; Nulliparity; Outcome Study; Patient Self-Report; Pattern; Persons; Physical activity; Physiologic pulse; Posture; Pregnancy; Pregnancy Outcome; Recommendation; Recording of previous events; Reporting; Research; Resources; Risk; Risk Factors; Role; Self Correction; Sex Differences; Statistical Methods; Sum; Testing; Thigh structure; Time; United States National Institutes of Health; Woman; adverse pregnancy outcome; arterial stiffness; behavior measurement; blood pressure elevation; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; clinical development; cohort; critical period; design; fasting glucose; heart rate variability; high risk; high risk population; improved; innovation; light intensity; men; middle age; modifiable risk; novel; novel strategies; post pregnancy; prospective; response; sedentary lifestyle; sex; standard measure; therapy development; vigorous intensity; young adult; young woman

ABSTRACT Women have more rapid cardiovascular disease (CVD) risk development compared to men during young adulthood; yet, little research has studied factors that could curtail CVD risk development during this critical period for young women. The Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-Be Heart Health Study (nuMoM2b HHS) is a unique, multi-center, longitudinal cohort, originating during the first pregnancy, that is now studying associations between adverse pregnancy outcomes (APO) and modifiable CVD risk in women. This ancillary application to nuMoM2b HHS aims to test our hypotheses that sedentary behavior (SED) is a key, modifiable risk factor for CVD risk development in young women, including those with APO. SED is low-intensity behavior in a seated, reclining, or lying posture and has recently been identified as a CVD risk factor that is distinct from insufficient moderate-to-vigorous intensity activity (MVPA). Acute prolonged sitting results in marked, adverse responses such as increased blood pressure (BP), glucose, and lipids. Yet, major research gaps preclude the development and testing of specific SED-reduction interventions, especially for young women. Most studies measure SED poorly (e.g., by self-report) and do not statistically consider that SED is part of an all-day activity pattern (or composition). Further, mechanisms of how SED leads to CVD are unclear, further limiting intervention development. Last, almost no studies focus on young women. Our preliminary data suggest that SED is strongly associated with APOs and reduced cardiovascular health (e.g., BP) in young women post-pregnancy. Further, our laboratory has recently demonstrated novel associations between SED and mechanistic CVD measures, including greater arterial stiffness (higher pulse wave velocity [PWV]) and worse autonomic function (lower heart rate variability [HRV]). Collectively, SED is a novel, understudied risk factor for reduced cardiovascular health that our data suggest is highly relevant for young women. We have a unique, efficient, and time-sensitive opportunity to address these gaps by adding gold standard SED assessment via activPAL thigh-mounted accelerometer to the upcoming HHS2 exam. In this contemporary and diverse female cohort (n=4,050, age=36±6 years), we aim to quantify cross-sectional and longitudinal associations of SED with the clinical components of idea cardiovascular health (BP, BMI, total cholesterol, fasting glucose) by using state-of-the-art statistical methods that consider the compositional nature of SED and 24-hr activity and can correct existing, longitudinal self-reported SED via regression calibration. Also, we add HRV and PWV in Pittsburgh and Indiana (n=950) to efficiently study associations between SED and subclinical, mechanistic CVD outcomes in young women. Aim 3 will study interrelationships of SED, APO history, and ideal cardiovascular health to identify novel risk reductions strategies in this high-risk group with limited treatment options. This research will provide critical data to rigorously link SED, CVD risk, and contributing mechanisms and will inform age- and sex-specific SED interventions to test in young women, including those with APO.

摘要 在年轻时期，女性比男性有更快的心血管疾病(CVD)风险发展 然而，很少有研究研究在这一关键时期可能减少心血管疾病风险发展的因素 年轻女性的时期。监测准妈妈心脏健康的未产妇妊娠结局研究 研究(NuMoM2B HHS)是一项独特的、多中心的纵向队列研究，起源于第一次怀孕期间， 目前正在研究不良妊娠结局(APO)和可改变的女性心血管疾病风险之间的关系。 NuMoM2B HHS的这一辅助应用旨在测试我们的假设，即久坐行为(SED)是关键， 年轻女性，包括APO患者心血管疾病风险发展的可改变的危险因素。 SED是指坐着、靠着或躺着时的低强度行为，最近被确认为脑血管病 不同于中等到剧烈强度活动不足(MVPA)的危险因素。急性久坐 结果出现显著的不良反应，如血压(BP)、血糖和血脂升高。然而，少校 研究差距阻碍了特定SED减少干预措施的开发和测试，特别是针对 年轻女性。大多数研究对SED的测量很差(例如，通过自我报告)，并且没有从统计上认为SED 是全天活动模式(或作文)的一部分。此外，SED如何导致心血管疾病的机制尚不清楚， 进一步限制干预发展。最后，几乎没有研究关注年轻女性。我们的初步数据 提示SED与APOS和年轻女性心血管健康状况下降(如BP)密切相关 怀孕后。此外，我们的实验室最近证明了SED和 机械性心血管疾病措施，包括更大的动脉僵硬(更高的脉搏波速度[PWV])和更差 自主神经功能(降低心率变异性[HRV])。总体而言，SED是一种新的、未被研究的风险因素 我们的数据表明，心血管健康状况的下降与年轻女性高度相关。 我们有一个独特、高效且对时间敏感的机会，可以通过添加黄金标准来弥补这些差距 通过ACTIVPAL大腿安装的加速度计对即将到来的HHS2考试进行SED评估。在这个当代 和不同的女性队列(n=4,050，年龄=36±6岁)，我们的目标是量化横截面和纵向 SED与IDEA心血管健康临床指标(BP、BMI、总胆固醇、空腹)的关系 葡萄糖)，使用最先进的统计方法，考虑SED和24小时的组成性质 并且可以通过回归校正来纠正现有的纵向自我报告的SED。此外，我们还添加了HRV和 匹兹堡和印第安纳州的PWV(n=950)，以有效地研究SED和亚临床之间的关联， 年轻女性心血管疾病的机械性结局。目标3将研究SED、APO病史和IDEA的相互关系 心血管健康：在这一治疗有限的高危人群中确定新的降低风险策略 选择。这项研究将提供关键数据，将SED、心血管疾病风险和致病机制严格联系起来 并将通知针对年龄和性别的SED干预措施，以在年轻女性中进行测试，包括那些患有APO的女性。