Department of Health Sciences, University of Jyväskylä, Finland.
Eur J Epidemiol. 2010 Oct;25(10):731-9. doi: 10.1007/s10654-010-9493-x. Epub 2010 Aug 3.
The aim of this study was to find out whether persistent leisure-time physical activity, adjusted for genetic liability and childhood experiences, protect against occurrence of specific chronic diseases and all-cause mortality. Study design was a 24-year prospective follow-up after 6-year physical activity discordance in twin pairs. From 5,663 healthy adult twin pairs, 146 pairs (including 29 mozygotic) discordant for both intensity and volume of leisure physical activity at baseline in both 1975 and 1981 were systematically identified. Mortality and occurrence of chronic diseases (diabetes, hypertension, coronary heart disease defined according to reimbursable medication status) were followed for the period 1.1.1983-31.12.2006 for mortality and 1.1.1983-31.12.2004 for diseases. By end of follow-up, 19 inactive and 10 active co-twins had died. In the whole sample, HR of death adjusted for social class was 2.08 (95% CI 1.06-4.09) for inactive vs. active co-twins, the HR being 2.67 (95% CI 1.15-6.20) among DZ pairs with no mortality difference among the smaller number of discordant MZ pairs. The reimbursable medication analyses showed a tendency of higher risk for inactive vs. active co-twins. Among DZ pairs, HR of diabetes medication adjusted for social class was 2.73 (95% CI 0.62-12.00) and HR of hypertension medication was 2.14 (95% CI 0.94-4.89). This study supports the earlier findings that physical activity is associated with reduced mortality. However the difference was seen only in DZ pairs and therefore some residual genetic confounding effects on mortality cannot be excluded.
本研究旨在探究经过遗传易感性和儿童时期经历调整后，持续的休闲时间体力活动是否能预防特定慢性病和全因死亡率的发生。研究设计为双胞胎对在 6 年体力活动不一致后进行 24 年前瞻性随访。从 5663 对健康的成年双胞胎中，系统地确定了在基线时 1975 年和 1981 年同时存在体力活动强度和量不一致的 146 对（包括 29 对同卵双胞胎）。从 1983 年 1 月 1 日至 2006 年 12 月 31 日，对死亡率进行了随访，从 1983 年 1 月 1 日至 2004 年 12 月 31 日，对疾病进行了随访。随访结束时，19 名不活跃的同卵双胞胎和 10 名活跃的同卵双胞胎死亡。在整个样本中，调整社会阶层后，不活跃的同卵双胞胎死亡的 HR 为 2.08（95%CI 1.06-4.09），DZ 对的 HR 为 2.67（95%CI 1.15-6.20），但 MZ 对中没有死亡率差异。可报销药物分析显示，不活跃的同卵双胞胎比活跃的同卵双胞胎有更高的风险。在 DZ 对中，调整社会阶层后的糖尿病药物 HR 为 2.73（95%CI 0.62-12.00），高血压药物 HR 为 2.14（95%CI 0.94-4.89）。本研究支持了早期的发现，即体力活动与降低死亡率有关。然而，这种差异仅在 DZ 对中可见，因此不能排除对死亡率有一些残余的遗传混杂影响。
