身体活动可改善精神分裂症住院患者久坐行为与心血管代谢风险之间的关联：与使用加速度计的对照组相比。

Physical activity ameliorates the association between sedentary behavior and cardiometabolic risk among inpatients with schizophrenia: A comparison versus controls using accelerometry.

机构信息

Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.

Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City 404, Taiwan; Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.

出版信息

Compr Psychiatry. 2017 Apr;74:144-150. doi: 10.1016/j.comppsych.2017.01.010. Epub 2017 Jan 20.

DOI:10.1016/j.comppsych.2017.01.010

PMID:28167327

Abstract

OBJECTIVE

A lack of clarity exists regarding the relationship between objectively measured physical activity (PA) and sedentary behavior (SB) and cardiometabolic outcomes in people with schizophrenia. We conducted a large study investigating the independent relationships of PA and SB among inpatients with schizophrenia versus healthy controls (HCs).

METHODS

A cross sectional study including 199 inpatients with schizophrenia (mean age 44.0years, mean illness duration 23.8years) versus 60 age/sex/body mass index matched HCs. Participants wore accelerometers for 7days to capture SB and daily steps. Cardiometabolic outcomes included blood pressure, fasting blood glucose (FBG), triglycerides, high-density lipoprotein cholesterol (HDL-C) and waist circumference (WC). Multivariate regression analyses adjusting for multiple confounders were undertaken.

RESULTS

Compared to HCs, patients engaged in more sedentary behavior and less daily steps versus HCs (p<0.001). Patients with higher levels of SB (n=89) had increased fasting glucose compared to patients with low levels of SB (105.2 vs. 96.3mg/dl, p<0.05). In the multivariate analysis, sedentary behavior was associated with higher FBG (β = .146, p=.041) but this was ameliorated when daily steps were inserted in to the model (β = .141, p=.059). In the final model, higher daily steps were associated with more favorable HDL-C (β=-.226, p=.004), independent of SB and other confounders.

CONCLUSIONS

Our data suggest that higher than while sedentary behavior is related to worse fasting glucose, this relationship is attenuated when PA is taken into account. Physical activity is also associated with favorable HDL-C. Interventions targeting replacing sedentary behavior with PA may improve metabolic risk.

摘要

目的

在精神分裂症患者中，客观测量的身体活动（PA）与久坐行为（SB）与心血管代谢结局之间的关系尚不清楚。我们进行了一项大型研究，调查了精神分裂症住院患者与健康对照者（HCs）中 PA 和 SB 的独立关系。

方法

这是一项横断面研究，纳入了 199 名精神分裂症住院患者（平均年龄 44.0 岁，平均病程 23.8 年）和 60 名年龄/性别/体重指数匹配的 HCs。参与者佩戴加速度计 7 天以捕捉 SB 和日常步数。心血管代谢结局包括血压、空腹血糖（FBG）、甘油三酯、高密度脂蛋白胆固醇（HDL-C）和腰围（WC）。进行了多元回归分析，以调整多种混杂因素。

结果

与 HCs 相比，患者的久坐行为更多，日常步数更少（p<0.001）。与 SB 水平较低的患者相比（105.2 与 96.3mg/dl，p<0.05），SB 水平较高的患者（n=89）的空腹血糖更高。在多元分析中，久坐行为与较高的 FBG 相关（β=0.146，p=0.041），但当将日常步数纳入模型时，这种相关性减弱（β=0.141，p=0.059）。在最终模型中，较高的日常步数与更有利的 HDL-C 相关（β=-0.226，p=0.004），独立于 SB 和其他混杂因素。