Laddu Deepika R, Rana Jamal S, Murillo Rosenda, Sorel Michael E, Quesenberry Charles P, Allen Norrina B, Gabriel Kelley P, Carnethon Mercedes R, Liu Kiang, Reis Jared P, Lloyd-Jones Donald, Carr J Jeffrey, Sidney Stephen
Department of Physical Therapy, University of Illinois at Chicago.
Division of Research, Kaiser Permanente Northern California, Oakland; Division of Cardiology, Kaiser Permanente Northern California, Oakland; Department of Medicine, University of California at San Francisco.
Mayo Clin Proc. 2017 Nov;92(11):1660-1670. doi: 10.1016/j.mayocp.2017.07.016. Epub 2017 Oct 16.
To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC).
This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography. Group-based trajectory modeling was used to identify PA trajectories with increasing age.
We identified 3 distinct PA trajectories: trajectory 1, below PA guidelines (n=1813; 57.1%); trajectory 2, meeting PA guidelines (n=1094; 34.5%); and trajectory 3, 3 times PA guidelines (n=268; 8.4%). Trajectory 3 participants had higher adjusted odds of CAC>0 (adjusted odds ratio [OR], 1.27; 95% CI, 0.95-1.70) vs those in trajectory 1. Stratification by race showed that white participants who engaged in PA 3 times the guidelines had higher odds of developing CAC>0 (OR, 1.80; 95% CI, 1.21-2.67). Further stratification by sex showed higher odds for white males (OR, 1.86; 95% CI, 1.16-2.98), and similar but nonsignificant trends were noted for white females (OR, 1.71; 95% CI, 0.79-3.71). However, no such higher odds of CAC>0 for trajectory 3 were observed for black participants.
White individuals who participated in 3 times the recommended PA guidelines over 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, especially by race, into possible biological mechanisms for CAC risk at very high levels of PA.
评估从青年到中年25年的身体活动（PA）轨迹，并评估其与冠状动脉钙化（CAC）患病率的关联。
本研究纳入了3175名参加青年成人冠状动脉风险发展（CARDIA）研究的参与者，他们在25年（从1985年3月 - 1986年6月至2010年6月 - 2011年5月）的8次随访检查中通过问卷自我报告了PA情况。在第25年时使用计算机断层扫描测量CAC（CAC>0）的存在情况。基于组的轨迹模型用于识别随年龄增长的PA轨迹。
我们识别出3种不同的PA轨迹：轨迹1，低于PA指南（n = 1813；57.1%）；轨迹2，符合PA指南（n = 1094；34.5%）；轨迹3，是PA指南的3倍（n = 268；8.4%）。与轨迹1的参与者相比，轨迹3的参与者发生CAC>0的调整后优势比更高（调整优势比[OR]，1.27；95%可信区间[CI]，0.95 - 1.70）。按种族分层显示，进行3倍于指南PA量的白人参与者发生CAC>0的几率更高（OR，1.80；95%CI，1.21 - 2.67）。进一步按性别分层显示，白人男性几率更高（OR，1.86；95%CI，1.16 - 2.98），白人女性有类似但无统计学意义的趋势（OR，1.71；95%CI，0.79 - 3.71）。然而，黑人参与者中未观察到轨迹3发生CAC>0的几率有如此高。
在25年中参加量为推荐PA指南3倍的白人个体在中年时发生冠状动脉亚临床动脉粥样硬化的几率更高。这些发现值得进一步探索，特别是按种族探索PA水平非常高时CAC风险的可能生物学机制。
