Williams Paul T, Franklin Barry
Ernest Orlando Lawrence Berkeley National Laboratory, Life Sciences Division, Berkeley, CA 94720, USA.
Med Sci Sports Exerc. 2007 Nov;39(11):1933-41. doi: 10.1249/mss.0b013e318145b337.
The prevalences of diabetes, hypertension, and high cholesterol all decrease with increased levels of physical activity and cardiorespiratory fitness. Whether these reductions extend beyond contemporary guideline activity levels and whether fitness affects medication use independent of activity, remains unclear.
Cross-sectional analyses of 62,291 male and 45,041 female runners, of whom 496 used antidiabetic, 3738 used antihypertension, and 2360 used low-density lipoprotein cholesterol (LDL-C)-lowering medications. Cardiorespiratory fitness was reported as speed (m x s(-1)) during a 10-km foot race.
Medication use was significantly inversely associated with activity and fitness (P < 0.001, except LDL-C-lowering versus women's fitness). Compared with < or = 16 km x wk(-1) (guideline levels), the odds in men and women who ran > 64 km x wk(-1) were, respectively, 69% and 55% lower for antidiabetic, 48% and 52% lower for antihypertension, and 64% and 51% lower for LDL-C-lowering medication use. Compared with the least-fit men (< 3.25 m x s(-1)) and women (< 2.8 m x s(-1)), the odds for those who were most fit (men > 4.75 m x s(-1); women > 4.0 m x s(-1)) were 58% and 65% lower for antidiabetic, and 76% and 55% lower for antihypertensive medication use. Odds for LDL-C-lowering medication use were 87% lower in the fittest versus the least-fit men. Adjustment for activity only moderately diminished the inverse relationships of fitness with medication use.
Among individuals who exceed current guideline levels, antidiabetic, antihypertension, and LDL-C-lowering medications are inversely related to vigorous physical activity and cardiorespiratory fitness. Lower odds of medication use with higher fitness occur independently of physical activity.
糖尿病、高血压和高胆固醇的患病率均随着体力活动水平和心肺适能的提高而降低。这些患病率的降低是否超出当代指南所规定的活动水平，以及适能是否独立于活动而影响药物使用，目前尚不清楚。
对62291名男性和45041名女性跑步者进行横断面分析，其中496人使用抗糖尿病药物，3738人使用抗高血压药物，2360人使用降低低密度脂蛋白胆固醇（LDL-C）的药物。心肺适能以10公里赛跑时的速度（米×秒⁻¹）表示。
药物使用与活动和适能呈显著负相关（P < 0.001，降低LDL-C的药物与女性适能的相关性除外）。与每周跑步≤16公里（指南规定水平）相比，每周跑步>64公里的男性和女性使用抗糖尿病药物的几率分别低69%和55%，使用抗高血压药物的几率分别低48%和52%，使用降低LDL-C药物的几率分别低64%和51%。与适能最差的男性（<3.25米×秒⁻¹）和女性（<2.8米×秒⁻¹）相比，适能最佳的男性（>4.75米×秒⁻¹）和女性（>4.0米×秒⁻¹）使用抗糖尿病药物的几率分别低58%和65%，使用抗高血压药物的几率分别低76%和55%。适能最佳的男性与适能最差的男性相比，使用降低LDL-C药物的几率低87%。仅对活动进行调整，适度减弱了适能与药物使用之间的负相关关系。
在超过当前指南规定水平的个体中，抗糖尿病、抗高血压和降低LDL-C的药物使用与剧烈体力活动和心肺适能呈负相关。较高适能状态下药物使用几率较低，这一情况独立于体力活动而出现。
