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一项减少工人久坐时间的聚类 RCT:对心血管代谢生物标志物的影响。

A Cluster RCT to Reduce Workers' Sitting Time: Impact on Cardiometabolic Biomarkers.

机构信息

1The University of Queensland, School of Public Health, Brisbane, AUSTRALIA; 2Baker IDI Heart and Diabetes Institute, Melbourne, AUSTRALIA; 3School of Physiotherapy, Faculty of Health Sciences, Curtin University, Perth, AUSTRALIA; 4Swinburne University of Technology, Melbourne, AUSTRALIA; 5School of Population and Global Health, The University of Melbourne, Melbourne, AUSTRALIA; 6School of Medicine, Monash University, Melbourne, AUSTRALIA; 7Centre for Population Health Research, Deakin University, Geelong, Australia, AUSTRALIA; and 8Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, AUSTRALIA.

出版信息

Med Sci Sports Exerc. 2017 Oct;49(10):2032-2039. doi: 10.1249/MSS.0000000000001328.

DOI:10.1249/MSS.0000000000001328
PMID:28538025
Abstract

PURPOSE

To evaluate the initial and long-term impacts on cardiometabolic health indicators of the Stand Up Victoria intervention-a 12-month, multicomponent workplace-delivered intervention that successfully reduced overall sitting time, primarily by increasing standing time.

METHODS

Office worksites (≥1 km apart) from a single organization were cluster randomized to intervention (n = 7) or control (n = 7). Participants were 136 intervention and 95 control desk-based workers (5-39 per worksite; 68% women; mean ± SD age = 45.6 ± 9.4 yr). Outcomes, assessed at baseline (0 months), 3, and 12 months, were 14 individual biomarkers of body composition, blood pressure, glucose metabolism, lipid metabolism, and a composite overall cardiometabolic risk score. Intervention effects were assessed by linear mixed models, accounting for repeated measures and clustering, baseline values, and potential confounders. Missing data were multiply imputed. Significance was set at P < 0.05, two-tailed.

RESULTS

No significant intervention effects were observed at 3 months. Significant effects, favoring intervention, were observed at 12 months for fasting glucose (-0.34; 95% confidence interval [CI], -0.65 to -0.03; P = 0.028 mmol·L) and the overall cardiometabolic risk score (-0.11, 95% CI, -0.29 to -0.00; P = 0.046). Other intervention effects were typically weakly in favor of the intervention group, but were nonsignificant and estimated with wide CI.

CONCLUSIONS

In "healthy" workers (not selected as having any specific health condition), a workplace intervention showed a small benefit for improving biomarkers of cardiometabolic risk, but only with 12 months of intervention and not for all biomarkers. Long-term facilitation of movement and standing at work may be a useful approach to reducing cardiovascular disease risk in the working population. The potential benefits for workers at high risk for cardiovascular disease (e.g., with diabetes) may be even greater and merit investigation.

摘要

目的

评估站立维多利亚干预措施对心血管代谢健康指标的初始和长期影响-一项为期 12 个月的多组分工作场所干预措施,通过增加站立时间,成功地减少了总体久坐时间。

方法

从一个组织中选择相隔至少 1 公里的办公室工作场所进行集群随机分组,分为干预组(n = 7)和对照组(n = 7)。参与者为 136 名干预组和 95 名对照组的办公桌工作人员(每个工作场所 5-39 人;68%为女性;平均±标准差年龄为 45.6 ± 9.4 岁)。在基线(0 个月)、3 个月和 12 个月时评估了 14 项个体身体成分、血压、葡萄糖代谢、脂质代谢和综合整体心血管代谢风险评分的生物标志物。通过线性混合模型评估干预效果,该模型考虑了重复测量和聚类、基线值和潜在混杂因素。缺失数据采用多重插补法。设双侧 P < 0.05 为差异有统计学意义。

结果

在 3 个月时未观察到显著的干预效果。在 12 个月时,干预组空腹血糖(-0.34;95%置信区间[CI],-0.65 至-0.03;P = 0.028 mmol·L)和整体心血管代谢风险评分(-0.11,95%CI,-0.29 至-0.00;P = 0.046)有显著的干预效果。其他干预效果通常对干预组略有优势,但无统计学意义,且估计值的置信区间较宽。

结论

在“健康”的工人(未选择患有任何特定健康状况的工人)中,工作场所干预措施对改善心血管代谢风险的生物标志物显示出较小的益处,但仅在 12 个月的干预后才有效果,且并非对所有生物标志物都有效。长期促进工作中的运动和站立可能是减少工作人群心血管疾病风险的有效方法。对于心血管疾病风险较高的工人(例如患有糖尿病的工人),其潜在益处可能更大,值得进一步研究。

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