Department of Cardiovascular Sciences, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
Diabetologia. 2012 Nov;55(11):2895-905. doi: 10.1007/s00125-012-2677-z. Epub 2012 Aug 14.
AIMS/HYPOTHESIS: Sedentary (sitting) behaviours are ubiquitous in modern society. We conducted a systematic review and meta-analysis to examine the association of sedentary time with diabetes, cardiovascular disease and cardiovascular and all-cause mortality.
Medline, Embase and the Cochrane Library databases were searched for terms related to sedentary time and health outcomes. Cross-sectional and prospective studies were included. RR/HR and 95% CIs were extracted by two independent reviewers. Data were adjusted for baseline event rate and pooled using a random-effects model. Bayesian predictive effects and intervals were calculated to indicate the variance in outcomes that would be expected if new studies were conducted in the future.
Eighteen studies (16 prospective, two cross-sectional) were included, with 794,577 participants. Fifteen of these studies were moderate to high quality. The greatest sedentary time compared with the lowest was associated with a 112% increase in the RR of diabetes (RR 2.12; 95% credible interval [CrI] 1.61, 2.78), a 147% increase in the RR of cardiovascular events (RR 2.47; 95% CI 1.44, 4.24), a 90% increase in the risk of cardiovascular mortality (HR 1.90; 95% CrI 1.36, 2.66) and a 49% increase in the risk of all-cause mortality (HR 1.49; 95% CrI 1.14, 2.03). The predictive effects and intervals were only significant for diabetes.
CONCLUSIONS/INTERPRETATION: Sedentary time is associated with an increased risk of diabetes, cardiovascular disease and cardiovascular and all-cause mortality; the strength of the association is most consistent for diabetes.
目的/假设：久坐（坐立）行为在现代社会中普遍存在。我们进行了系统评价和荟萃分析，以研究久坐时间与糖尿病、心血管疾病以及心血管和全因死亡率之间的关系。
使用 Medline、Embase 和 Cochrane 图书馆数据库搜索与久坐时间和健康结果相关的术语。纳入了横断面和前瞻性研究。由两位独立审查员提取 RR/HR 和 95%置信区间（CI）。数据根据基线事件发生率进行调整，并使用随机效应模型进行汇总。计算贝叶斯预测效应和区间，以指示如果未来进行新的研究，预期结果的变异性。
共纳入 18 项研究（16 项前瞻性研究，2 项横断面研究），共有 794577 名参与者。其中 15 项研究为中高度质量。与最低久坐时间相比，最高久坐时间与糖尿病 RR 增加 112%（RR 2.12；95%可信区间 [CrI] 1.61, 2.78）、心血管事件 RR 增加 147%（RR 2.47；95% CI 1.44, 4.24）、心血管死亡率风险增加 90%（HR 1.90；95% CrI 1.36, 2.66）和全因死亡率风险增加 49%（HR 1.49；95% CrI 1.14, 2.03）。预测效应和区间仅对糖尿病具有显著意义。
结论/解释：久坐时间与糖尿病、心血管疾病以及心血管和全因死亡率的风险增加相关；这种关联的强度对糖尿病最为一致。
