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心肺适能评估在预防保健检查中的效果:一项随机对照试验。

The effect of cardiorespiratory fitness assessment in preventive health checks: a randomised controlled trial.

机构信息

Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.

Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Aarhus, Denmark.

出版信息

Eur J Public Health. 2018 Feb 1;28(1):173-179. doi: 10.1093/eurpub/ckx108.

Abstract

BACKGROUND

Poor cardiorespiratory fitness (CRF) increases morbidity and mortality risks. Routine CRF assessment in clinical practice has thus been advocated, but little is known about the effect. In this study, we investigated the effect of CRF assessment on CRF in a preventive health check programme.

METHODS

We used a randomised design, in which we invited 4153 middle-aged adults and included 2201 participants who received a preventive health check with CRF assessment (intervention) or without CRF assessment (control). After 1 year, participants were examined. The primary outcomes were adjusted absolute (l/min), relative (ml/kg/min), and poor (%) CRF assessed by the Astrand-Ryhming test. We adjusted for baseline physical activity and intra-cluster correlation within general practices.

RESULTS

A total of 901 attended the 1-year follow-up. In the intervention group, absolute CRF, relative CRF, and poor CRF were 2.7 l/min (95% confidence interval [CI]: 2.6; 2.8), 34.5 ml/kg/min (95% CI: 33.5; 35.4), and 31.0% (95% CI: 26.8; 35.2). In the control group, the corresponding figures were 2.8 l/min (95% CI: 2.7; 2.9), 35.2 ml/kg/min (95% CI: 34.2; 36.1), and 25.9% (95% CI: 21.8; 30.0). Adjusted absolute CRF was lower in the intervention group (-0.1 l/min [95% CI: -0.2; -0.01]). Adjusted relative CRF (-0.7 ml/kg/min [95% CI: -2.0; 0.6]) and poor CRF (5.0% [95% CI: -0.002; 10.1]) did not differ between groups. No differences were found when adjusting for potential confounding factors.

CONCLUSION

Preventive health checks with CRF assessment did not provide higher CRF levels at 1-year follow-up than preventive health checks without CRF assessment.

摘要

背景

心肺适能差(CRF)会增加发病率和死亡率风险。因此,临床实践中提倡常规的 CRF 评估,但对其效果知之甚少。在这项研究中,我们调查了 CRF 评估对预防保健检查计划中 CRF 的影响。

方法

我们采用随机设计,邀请了 4153 名中年成年人,并纳入了 2201 名接受了 CRF 评估的预防保健检查(干预组)或没有 CRF 评估的预防保健检查(对照组)的参与者。一年后,对参与者进行了检查。主要结局是通过 Astrand-Ryhming 测试评估的调整后的绝对(l/min)、相对(ml/kg/min)和较差(%)CRF。我们调整了基线体力活动和一般实践内的组内相关性。

结果

共有 901 人参加了 1 年的随访。在干预组中,绝对 CRF、相对 CRF 和较差 CRF 分别为 2.7 l/min(95%置信区间 [CI]:2.6;2.8)、34.5 ml/kg/min(95% CI:33.5;35.4)和 31.0%(95% CI:26.8;35.2)。在对照组中,相应的数字分别为 2.8 l/min(95% CI:2.7;2.9)、35.2 ml/kg/min(95% CI:34.2;36.1)和 25.9%(95% CI:21.8;30.0)。干预组的调整后绝对 CRF 较低(-0.1 l/min [95% CI:-0.2;-0.01])。调整后的相对 CRF(-0.7 ml/kg/min [95% CI:-2.0;0.6])和较差 CRF(5.0% [95% CI:-0.002;10.1])在两组之间没有差异。在调整潜在混杂因素后,没有发现差异。

结论

与没有 CRF 评估的预防保健检查相比,CRF 评估的预防保健检查在 1 年随访时并未提供更高的 CRF 水平。

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