O'Donovan Gary, Stensel David, Hamer Mark, Stamatakis Emmanuel
School of Sport, Exercise and Health Sciences, National Centre for Sport & Exercise Medicine-East Midlands, Loughborough University, Loughborough, LE11 3TU, UK.
Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
Eur J Epidemiol. 2017 Jul;32(7):559-566. doi: 10.1007/s10654-017-0280-9. Epub 2017 Jun 30.
The objective of this study was to investigate associations between leisure-time physical activity, low high-density lipoprotein cholesterol (HDL-C) and mortality. Self-reported leisure-time physical activity, HDL-C concentration, and mortality were assessed in 37,059 adults in Health Survey for England and Scottish Health Survey. Meeting physical activity guidelines was defined as ≥150 min wk of moderate-intensity activity, ≥75 min wk of vigorous-intensity activity, or equivalent combinations. Low HDL-C was defined as <1.03 mmol L. Cox proportional hazard models were adjusted for age, sex, smoking, total cholesterol, systolic blood pressure, body mass index, longstanding illness, and socioeconomic status. There were 2250 deaths during 326,016 person-years of follow-up. Compared with those who met physical activity guidelines and whose HDL-C was normal (reference group), all-cause mortality risk was not elevated in those who met physical activity guidelines and whose HDL-C concentration was low (hazard ratio: 1.07; 95% confidence interval: 0.75, 1.53). Compared with the reference group, all-cause mortality risk was elevated in those who did not meet physical activity guidelines and whose HDL-C was normal (1.37; 1.16, 1.61), and in those who did not meet physical activity guidelines and whose HDL-C was low (1.65; 1.37, 1.98). Cardiovascular disease mortality hazard ratios were similar, although confidence intervals were wider. There was no statistically significant evidence of biological interaction between physical inactivity and low HDL-C. This novel study supports the notion that leisure-time physical activity be recommended in those with low HDL-C concentration who may be resistant to the HDL-raising effect of exercise training.
本研究的目的是调查休闲时间身体活动、低高密度脂蛋白胆固醇（HDL-C）与死亡率之间的关联。在英格兰健康调查和苏格兰健康调查的37059名成年人中，对自我报告的休闲时间身体活动、HDL-C浓度和死亡率进行了评估。达到身体活动指南的标准定义为每周进行≥150分钟的中等强度活动、≥75分钟的高强度活动或同等组合。低HDL-C定义为<1.03 mmol/L。Cox比例风险模型根据年龄、性别、吸烟、总胆固醇、收缩压、体重指数、长期疾病和社会经济状况进行了调整。在326016人年的随访期间，有2250人死亡。与达到身体活动指南且HDL-C正常的人群（参照组）相比，达到身体活动指南但HDL-C浓度低的人群全因死亡风险并未升高（风险比：1.07；95%置信区间：0.75，1.53）。与参照组相比，未达到身体活动指南但HDL-C正常的人群全因死亡风险升高（1.37；1.16，1.61），未达到身体活动指南且HDL-C低的人群全因死亡风险也升高（1.65；1.37，1.98）。心血管疾病死亡率风险比相似，尽管置信区间更宽。身体不活动与低HDL-C之间没有统计学上显著的生物学相互作用证据。这项新研究支持了以下观点，即对于HDL-C浓度低且可能对运动训练提高HDL的作用有抵抗性的人群，建议进行休闲时间身体活动。
