School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
Am J Cardiol. 2011 Nov 15;108(10):1426-31. doi: 10.1016/j.amjcard.2011.07.005. Epub 2011 Aug 17.
Physical activity can improve several metabolic risk factors associated with cardiovascular disease (CVD) and is associated with a lower risk of CVD mortality. We sought to evaluate the extent to which metabolic risk factors mediate the association between physical activity and CVD mortality and whether physical activity provides protective effects against CVD mortality in healthy adults and those with metabolic risk factors. A sample of 10,261 adults from the Third National Health and Nutrition Examination Survey with public-access mortality data linkage (follow-up 13.4 ± 3.9 years) was used. Physical activity was assessed by questionnaire and classified into inactive, light, and moderate/vigorous activity categories. Metabolic risk factors (dyslipidemia, type 2 diabetes mellitus, obesity, hypertension, inflammation, and insulin resistance) were categorized using clinical thresholds. After adjusting for basic confounders, engaging in light or moderate/vigorous physical activity was associated with a lower risk of CVD mortality (p < 0.05). Adjustment for each risk-factor set only slightly attenuated this relation. When all risk-factor sets were added to the model simultaneously, light (hazard ratio 0.72, 0.62 to 0.84) and moderate/vigorous (hazard ratio 0.72, 0.62 to 0.85) activity remained at lower risk of CVD mortality. In addition, physical activity provided protective effects for CVD mortality in healthy subjects and those with metabolic risk factors in isolation or in clusters. In conclusion, physical activity was associated with a lower risk of CVD mortality independent of traditional and inflammatory risk factors. Taken together these results suggest that physical activity may protect against CVD mortality regardless of the presence of metabolic risk factors.
身体活动可以改善与心血管疾病（CVD）相关的多种代谢风险因素，并且与 CVD 死亡率降低相关。我们试图评估代谢风险因素在多大程度上调节身体活动与 CVD 死亡率之间的关联，以及身体活动是否为健康成年人和存在代谢风险因素的成年人提供对 CVD 死亡率的保护作用。使用了来自第三次国家健康和营养检查调查的 10261 名成年人样本，这些成年人具有公共访问死亡率数据链接（随访 13.4±3.9 年）。身体活动通过问卷进行评估，并分为不活动、轻度和中度/剧烈活动类别。使用临床阈值对代谢风险因素（血脂异常、2 型糖尿病、肥胖、高血压、炎症和胰岛素抵抗）进行分类。在调整基本混杂因素后，进行轻度或中度/剧烈身体活动与 CVD 死亡率降低相关（p<0.05）。仅调整每个风险因素集，这种关系略有减弱。当同时将所有风险因素集添加到模型中时，轻度（风险比 0.72，0.62 至 0.84）和中度/剧烈（风险比 0.72，0.62 至 0.85）活动仍然处于较低的 CVD 死亡率风险中。此外，身体活动为健康受试者和单独或成组存在代谢风险因素的受试者提供了对 CVD 死亡率的保护作用。总之，身体活动与 CVD 死亡率降低独立于传统和炎症风险因素相关。总之，这些结果表明，无论是否存在代谢风险因素，身体活动都可能预防 CVD 死亡率。
