Koolhaas Chantal M, Dhana Klodian, Schoufour Josje D, Ikram M Arfan, Kavousi Maryam, Franco Oscar H
Department of Epidemiology, Erasmus Medical Center, The Netherlands.
Eur J Prev Cardiol. 2017 Jun;24(9):934-941. doi: 10.1177/2047487317693952. Epub 2017 Jan 1.
Background Being overweight or obese is associated with an increased risk of cardiovascular disease (CVD). Physical activity might reduce the risk associated with overweight and obesity. We examined the association between overweight and obesity and CVD risk as a function of physical activity levels in a middle-aged and elderly population. Design The study was a prospective cohort study. Methods The study included 5344 participants aged 55 years or older from the population-based Rotterdam Study. Participants were classified as having high or low physical activity based on the median of the population. Normal weight (18.5-24.9 kg/m), overweight (25.0-29.9 kg/m) and obese participants (≥30 kg/m) were categorized as having high or low physical activity to form six categories. We assessed the association of the six categories with CVD risk using Cox proportional hazard models adjusted for confounders. High physical activity and normal weight was used as the reference group. Results During 15 years of follow-up (median 10.3 years, interquartile range 8.2-11.7 years), 866 (16.2%) participants experienced a CVD event. Overweight and obese participants with low physical activity had a higher CVD risk than normal weight participants with high physical activity. The HRs and 95% confidence intervals (CIs) were 1.33 (1.07-1.66) and 1.35 (1.04-1.75), respectively. Overweight and obese participants with high physical activity did not show a higher CVD risk (HRs (95%CIs) 1.03 (0.82-1.29) and 1.12 (0.83-1.52), respectively). Conclusions Our findings suggest that the beneficial impact of physical activity on CVD might outweigh the negative impact of body mass index among middle-aged and elderly people. This emphasizes the importance of physical activity for everyone across all body mass index strata, while highlighting the risk associated with inactivity even among normal weight people.
超重或肥胖与心血管疾病（CVD）风险增加相关。体育活动可能会降低与超重和肥胖相关的风险。我们在中老年人群中研究了超重、肥胖与CVD风险之间的关联，并将其作为体育活动水平的函数。设计：该研究为前瞻性队列研究。方法：该研究纳入了基于人群的鹿特丹研究中5344名年龄在55岁及以上的参与者。根据人群中位数将参与者分为体育活动水平高或低两类。体重正常（18.5 - 24.9 kg/m）、超重（25.0 - 29.9 kg/m）和肥胖参与者（≥30 kg/m）根据体育活动水平高或低进行分类，形成六类。我们使用经混杂因素调整的Cox比例风险模型评估这六类与CVD风险的关联。以体育活动水平高且体重正常作为参照组。结果：在15年的随访期间（中位数10.3年，四分位间距8.2 - 11.7年），866名（16.2%）参与者发生了CVD事件。体育活动水平低的超重和肥胖参与者比体育活动水平高的体重正常参与者具有更高的CVD风险。风险比（HRs）和95%置信区间（CIs）分别为1.33（1.07 - 1.66）和1.35（1.04 - 1.75）。体育活动水平高的超重和肥胖参与者未显示出更高的CVD风险（HRs（95%CIs）分别为1.
