Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
Respiration. 2018;95(1):27-34. doi: 10.1159/000481202. Epub 2017 Oct 19.
Lifestyle behaviors are not well-characterized in idiopathic pulmonary fibrosis (IPF).
To assess the association between lifestyle behaviors and clinical outcomes in patients with IPF.
A total of 34 IPF patients (median age 68 years) were assessed for daily sitting and weekly walking times using the International Physical Activity Questionnaire by in-person interview at baseline, and they were followed up for up to 40 months. Cox proportional hazard analysis was conducted for cardiorespiratory-related hospitalizations and mortality as outcomes.
Fifty percent of all patients were hospitalized, and 32% died during the follow-up period. Sitting and walking times were associated with hospitalizations and mortality in IPF. Compared to patients who reported a sitting time of <5 h/day, patients who sat 5 to <10 and ≥10 h/day experienced an increased risk of 2.4 and 5.8 (p trend = 0.036) for hospitalization and of 4.6 and 21.2 (p trend = 0.018) for mortality, respectively. Compared to patients walking <100 min/week, patients with a walking time of 100 to <150 and ≥150 min/week were associated with a 49 and 74% reduced risk for hospitalizations (p trend = 0.022) and a 62 and 86% reduced risk for mortality (p trend = 0.018), respectively. The risk for mortality was further reduced with a combination of shorter sitting and extended walking times.
Shorter daily sitting and longer weekly walking times were associated with reduced hospitalization and mortality risks in patients with IPF. These findings suggest a clinical importance of assessing lifestyle behaviors in a comprehensive evaluation and prognostication of IPF patients. The results underscore potential clinical benefits of reducing sedentary behaviors among IPF patients; however, this warrants further investigation.
特发性肺纤维化（IPF）患者的生活方式行为尚未得到充分描述。
评估 IPF 患者生活方式行为与临床结局的相关性。
通过面对面访谈，使用国际体力活动问卷（International Physical Activity Questionnaire）评估 34 名 IPF 患者（中位年龄 68 岁）的每日久坐时间和每周步行时间，随访时间最长为 40 个月。采用 Cox 比例风险分析评估与心肺相关的住院和死亡作为结局。
所有患者中有 50%住院，随访期间有 32%死亡。久坐时间和步行时间与 IPF 的住院和死亡相关。与报告每天坐 5 小时以下的患者相比，每天坐 5-<10 小时和≥10 小时的患者住院风险分别增加 2.4 倍和 5.8 倍（趋势检验 p=0.036），死亡风险分别增加 4.6 倍和 21.2 倍（趋势检验 p=0.018）。与每周步行<100 分钟的患者相比，每周步行 100-<150 分钟和≥150 分钟的患者住院风险分别降低 49%和 74%（趋势检验 p=0.022），死亡风险分别降低 62%和 86%（趋势检验 p=0.018）。较短的每日久坐时间和较长的每周步行时间相结合，可进一步降低死亡风险。
较短的每日久坐时间和较长的每周步行时间与 IPF 患者的住院和死亡风险降低相关。这些发现提示在全面评估和预测 IPF 患者时，评估生活方式行为具有重要的临床意义。研究结果突出了减少 IPF 患者久坐行为的潜在临床获益，但这仍需要进一步研究。
