Donneyong M M, Taylor K C, Kerber R A, Hornung C A, Scragg R
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02120, USA; Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, 40202, USA.
Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, 40202, USA.
Nutr Metab Cardiovasc Dis. 2016 Aug;26(8):735-42. doi: 10.1016/j.numecd.2016.02.008. Epub 2016 Mar 3.
To investigate if frequency of outdoor recreational activity (ORA) predicts cardiovascular disease (CVD) mortality, independent of serum 25(OH)D concentration.
Baseline data on ORA and serum 25(OH)D, collected from 11,746 participants aged 30-90 years in the Third National Health and Nutrition Examination Survey during 1988-1994, were linked to the National Death Index for assessment of CVD deaths from baseline through December 2006. CVD mortality as a primary cause of death was assessed during a mean follow up of 12.9 (SD, 4.2) years. There were 1519 CVD deaths during follow up. A strong positive association was observed between frequency of ORA in the last month and serum 25(OH)D (p < 0.001). Compared to participants who did no ORA in the last month, the hazard ratio (HR) of CVD mortality was 0.72 (95% confidence interval 0.58-0.90) for those doing ORA 1-4 times, 0.64 (0.47-0.89) for 5-12 times, 0.70 (0.56-0.89) for 13-30 times and 0.63 (0.47-0.84) for ≥30 times (p-trend < 0.001), in a Cox proportional hazards regression model which included 25(OH)D and CVD risk factors. Serum 25(OH)D was inversely associated with CVD mortality (p-trend, 0.01) in this same model.
An inverse association between ORA and CVD mortality was observed independent of 25(OH)D. The underlying mechanism for this association may not involve 25(OH)D hence, further studies are warranted to confirm and investigate the underlying mechanism.
探讨户外休闲活动（ORA）频率能否独立于血清25（OH）D浓度预测心血管疾病（CVD）死亡率。
从1988 - 1994年第三次全国健康与营养检查调查中收集的11746名30 - 90岁参与者的ORA和血清25（OH）D基线数据，与国家死亡指数相链接，以评估从基线到2006年12月期间的CVD死亡情况。在平均12.9（标准差，4.2）年的随访期间评估CVD死亡率作为主要死亡原因。随访期间有1519例CVD死亡。观察到上个月ORA频率与血清25（OH）D之间存在强正相关（p < 0.001）。在包含25（OH）D和CVD危险因素的Cox比例风险回归模型中，与上个月未进行ORA的参与者相比，进行ORA 1 - 4次的参与者CVD死亡率的风险比（HR）为0.72（95%置信区间0.58 - 0.90），5 - 12次为0.64（0.47 - 0.89），13 - 30次为0.70（0.56 - 0.89），≥30次为0.63（0.47 - 0.84）（p趋势< 0.001）。在同一模型中，血清25（OH）D与CVD死亡率呈负相关（p趋势，0.01）。
观察到ORA与CVD死亡率之间存在独立于25（OH）D的负相关。这种关联的潜在机制可能不涉及25（OH）D，因此，有必要进行进一步研究以确认和研究潜在机制。
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