Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Med Sci Sports Exerc. 2011 Oct;43(10):1884-90. doi: 10.1249/MSS.0b013e31821b4d0a.
The effects of physical activity on risk of myocardial infarction (MI) are well documented and may include beneficial changes in blood lipids, inflammatory markers, and insulin sensitivity. The degree to which these and other traditional and nontraditional cardiovascular biomarkers mediate the inverse association between physical activity and risk of MI in men remains unclear.
We conducted a nested case-control study among 18,225 men in the Health Professionals Follow-up Study followed from 1994 to 2004. A total of 412 men with incident MI were matched 1:2 with control participants on age and smoking status using risk-set sampling. From detailed responses to a modified Paffenbarger physical activity questionnaire, we determined the association between average hours of vigorous-intensity activity (activities requiring METs ≥ 6) and MI risk.
For a 3-h·wk(-1) increase in vigorous-intensity activity, the multivariate relative risk (RR) of MI was 0.78 (95% confidence interval (CI) = 0.61-0.98). In models including preexisting CVD-related conditions, further adjustment for HDL-C, vitamin D, apolipoprotein B, and hemoglobin A1c attenuated the RR by 70% (95% CI = 12%-127%) to an RR of 0.93 (95% CI = 0.72-1.19).
Participating in 3 h·wk(-1) of vigorous-intensity activity is associated with a 22% lower risk of MI among men. This inverse association can be partially explained by the beneficial effects of physical activity on HDL-C, vitamin D, apolipoprotein B, and hemoglobin A1c. Although the inverse association attributable to these biomarkers is substantial, future research should explore benefits of exercise beyond these biomarkers of risk.
有大量文献证明，身体活动可降低心肌梗死（MI）风险，其机制可能包括改善血脂、炎症标志物和胰岛素敏感性。但目前尚不清楚这些以及其他传统和非传统心血管生物标志物在多大程度上介导了身体活动与男性 MI 风险之间的负相关关系。
我们在参加 1994 年至 2004 年随访的健康专业人员随访研究的 18225 名男性中进行了一项巢式病例对照研究。通过风险集抽样，根据年龄和吸烟状况，将 412 名新发 MI 患者与对照参与者进行 1:2 配对。通过对改良的 Paffenbarger 体力活动问卷的详细回答，我们确定了平均剧烈强度活动（代谢当量≥6）时间与 MI 风险之间的关系。
剧烈强度活动每增加 3 小时/周，MI 的多变量相对风险（RR）为 0.78（95%置信区间[CI]，0.61-0.98）。在包括预先存在的 CVD 相关疾病的模型中，进一步调整高密度脂蛋白胆固醇（HDL-C）、维生素 D、载脂蛋白 B 和糖化血红蛋白 A1c 后，RR 降低了 70%（95%CI，12%-127%），RR 为 0.93（95%CI，0.72-1.19）。
男性每周进行 3 小时剧烈强度活动与 MI 风险降低 22%相关。这种负相关关系部分可以通过身体活动对 HDL-C、维生素 D、载脂蛋白 B 和糖化血红蛋白 A1c 的有益影响来解释。尽管归因于这些生物标志物的负相关关系很大，但未来的研究应该探索运动对这些风险生物标志物以外的益处。
