低心肺适能男性的死亡率风险是否存在梯度？
Is There a Gradient of Mortality Risk among Men with Low Cardiorespiratory Fitness?
机构信息
1Research Division, Cooper Institute, Dallas, TX; 2Department of Medicine, Stanford University, Palo Alto, CA; and 3Center for Human Nutrition, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
出版信息
Med Sci Sports Exerc. 2015 Sep;47(9):1825-32. doi: 10.1249/MSS.0000000000000608.
PURPOSE
A low level of cardiorespiratory fitness (CRF) is a strong and independent predictor of all-cause mortality in men; however, it is unknown whether a gradient of mortality risk exists within the lowest CRF category.
METHODS
A total of 6251 apparently healthy men (mean age, 48.7 ± 6.3 yr) completed a comprehensive baseline clinical examination, including a maximal treadmill exercise test at Cooper Clinic between 1971 and 2006. In accord with previous studies using this cohort, low CRF was defined as a treadmill time in the first quintile within each age category of 40-49, 50-59, and 60-69 yr. The low CRF cohort was then grouped by tertiles (low/low, LL; mid/low, ML; and high/low, HL) using the same age categories.
RESULTS
After a mean follow-up period of 19.1 ± 10.4 yr, 1259 deaths occurred. Adjusted all-cause mortality rates were 57.0, 31.1, and 34.4 deaths per 10,000 man-years across LL, ML, and HL CRF categories for the 40- to 49-yr-old age group (P trend = 0.007). Similar trends were seen across low CRF categories for the 50- to 59-yr-old and 60- to 69-yr-old age groups (P trend = 0.02 and 0.09, respectively). When using treadmill time as a continuous variable, each 1-min increment in treadmill time was associated with a 9%, 11%, and 15% reduction in risk of all-cause mortality among low-CRF men in the 40-49, 50-59, and 60-69 age groups, respectively.
CONCLUSIONS
An inverse trend in all-cause mortality exists among men across LL, ML, and HL CRF groups. Although all low-fit men should be targeted for physical activity intervention, it is especially important to target the LL CRF group.
目的
心肺功能（CRF）水平较低是男性全因死亡率的一个强有力且独立的预测因素；然而，在最低 CRF 类别中是否存在死亡率风险的梯度尚不清楚。
方法
共有 6251 名看似健康的男性（平均年龄，48.7±6.3 岁）在 1971 年至 2006 年期间在库珀诊所完成了全面的基线临床检查，包括最大跑步机运动测试。根据使用该队列的先前研究，低 CRF 定义为每个年龄组（40-49、50-59 和 60-69 岁）的前五分位跑步机时间。然后，使用相同的年龄组，根据三分位数（低/低，LL；中/低，ML；高/低，HL）将低 CRF 队列分组。
结果
平均随访 19.1±10.4 年后，发生 1259 例死亡。调整后的全因死亡率在 40-49 岁年龄组的 LL、ML 和 HL CRF 类别中分别为每 10000 人年 57.0、31.1 和 34.4 例死亡（趋势 P=0.007）。在 50-59 岁和 60-69 岁年龄组中，低 CRF 类别也呈现出类似的趋势（趋势 P=0.02 和 0.09）。当使用跑步机时间作为连续变量时，在 40-49 岁、50-59 岁和 60-69 岁的低 CRF 男性中，跑步机时间每增加 1 分钟，全因死亡率的风险分别降低 9%、11%和 15%。
结论
在 LL、ML 和 HL CRF 组中，男性的全因死亡率呈反比趋势。虽然所有低适应能力的男性都应该作为体力活动干预的目标，但尤其重要的是要针对 LL CRF 组。
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