Rosique-Esteban Nuria, Díaz-López Andrés, Martínez-González Miguel A, Corella Dolores, Goday Albert, Martínez J Alfredo, Romaguera Dora, Vioque Jesus, Arós Fernando, Garcia-Rios Antonio, Tinahones Francisco, Estruch Ramon, Fernández-García José Carlos, Lapetra José, Serra-Majem Luís, Pinto Xavier, Tur Josep A, Bueno-Cavanillas Aurora, Vidal Josep, Delgado-Rodríguez Miguel, Daimiel Lidia, Vázquez Clotilde, Rubio Miguel Ángel, Ros Emilio, Salas-Salvadó Jordi
Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain.
CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
PLoS One. 2017 Mar 8;12(3):e0172253. doi: 10.1371/journal.pone.0172253. eCollection 2017.
Limited data exists on the interrelationships between physical activity (PA), sedentary behaviors and sleep concerning cardiometabolic risk factors in aged adults at high cardiovascular disease risk. Our aim was to examine independent and joint associations between time spent in leisure-time PA, sedentary behaviors and sleep on the prevalence of obesity, type 2 diabetes (T2D) and components of the metabolic syndrome (MetS) in Mediterranean individuals at high cardiovascular risk. Cross-sectional analyses were performed on baseline data from 5776 Spanish adults (aged 55-75y in men; 60-75y in women) with overweight/obesity and MetS, from October 2013 to October 2016, in the PREDIMED-PLUS trial. Employing multivariable-adjusted Cox regression with robust variance and constant time (given the cross-sectional design), higher prevalence of obesity, T2D and abdominal obesity as component of the MetS were associated with greater time in TV-viewing (Relative Risk, RR: 1.02, 95%CI: 1.01, 1.03; RR:1.04, 95%CI: 1.02, 1.06 and RR: 1.01 95%CI: 1.00, 1.02; respectively, all P < .01). Conversely, greater time in moderate-vigorous PA (MVPA) was associated with lower prevalence of obesity, T2D, abdominal obesity and low HDL-cholesterol (RR: 0.95, 95%CI: 0.93, 0.97; RR: 0.94, 95%CI: 0.89, 0.99; RR: 0.97, 95%CI: 0.96, 0.98; and RR: 0.95, 95%CI: 0.91, 0.99, respectively, all P < .05). For these outcomes, theoretically substituting 1-h/day of MVPA for 1-h/day TV-viewing was also significantly associated with lower prevalence (RR 0.91 to 0.97, all P < .05). Similar lower RR in these outcomes was observed when substituting 1-h/day of MVPA for 1-h/day of sleeping. Longer time watching TV and not meeting MVPA recommendations were jointly associated with higher RR of the prevalence of obesity and T2D. We concluded that, in senior individuals at high cardiovascular risk, greater time spent on MVPA and fewer on sedentary behaviors was inversely associated with prevalence of obesity, T2D, and some of the components of MetS.
关于身体活动（PA）、久坐行为和睡眠之间的相互关系，在心血管疾病高风险的老年成年人中，与心血管代谢风险因素相关的数据有限。我们的目的是研究休闲时间PA、久坐行为和睡眠时长与肥胖、2型糖尿病（T2D）患病率以及心血管高风险地中海人群代谢综合征（MetS）各组分之间的独立和联合关联。在2013年10月至2016年10月的PREDIMED-PLUS试验中，对5776名超重/肥胖且患有MetS的西班牙成年人（男性年龄55 - 75岁；女性年龄60 - 75岁）的基线数据进行横断面分析。采用具有稳健方差和固定时间的多变量调整Cox回归（鉴于横断面设计），肥胖、T2D以及作为MetS组分的腹型肥胖的较高患病率与看电视时间较长相关（相对风险，RR：1.02，95%置信区间：1.01，1.03；RR：1.04，95%置信区间：1.02，1.06；RR：1.01，95%置信区间：1.00，1.02；P均 < 0.01）。相反，中等强度至剧烈强度PA（MVPA）时间较长与肥胖、T2D、腹型肥胖和低高密度脂蛋白胆固醇的较低患病率相关（RR：0.95，95%置信区间：0.93，0.97；RR：0.94，95%置信区间：0.89，0.99；RR：0.97，95%置信区间：0.96，0.98；RR：0.95，95%置信区间：0.91，0.99；P均 < 0.05）。对于这些结果，理论上用每天1小时的MVPA替代1小时看电视时间也与较低患病率显著相关（RR 0.91至0.97，P均 < 0.05）。当用每天1小时的MVPA替代1小时睡眠时间时，在这些结果中也观察到类似的较低RR。看电视时间较长且未达到MVPA建议与肥胖和T2D患病率的较高RR共同相关。我们得出结论，在心血管高风险的老年人中，MVPA时间较长且久坐行为时间较少与肥胖、T2D以及MetS的一些组分的患病率呈负相关。
