美国成年人载脂蛋白指数与体力活动和饮食的关系：中心性肥胖的中介作用考虑
Physical activity and diet on atherogenic index of plasma among adults in the United States: mediation considerations by central adiposity.
机构信息
Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, 38677, USA.
Jackson Heart Study Vanguard Center of Oxford, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, 38677, USA.
出版信息
Eur J Clin Nutr. 2018 Jun;72(6):826-831. doi: 10.1038/s41430-017-0066-x. Epub 2018 Jan 10.
BACKGROUND/OBJECTIVES: The potential interactive or combined association of moderate-to-vigorous physical activity (MVPA) and dietary behavior with atherogenic index of plasma (AIP) has yet to be explored in a representative sample of US adults. Thus, the study aim was to examine the association of MVPA and dietary behavior on AIP, with potential mediation considerations by central adiposity.
SUBJECTS/METHODS: Data from the National Health and Nutrition Examination Survey were used (N = 2701 adults aged 20-85 years). AIP was evaluated via blood sample, MVPA was assessed via accelerometry, and two 24-h recalls were utilized to calculate Healthy Eating Index (HEI), a metric of dietary quality. Android-specific dual energy X-ray absorptiometry (DXA) was used to measure central adiposity.
RESULTS
Meeting MVPA guidelines (OR = 0.58; 95% CI: 0.41-0.82; P = 0.004), but not meeting dietary guidelines (OR = 0.89; 95% CI: 0.69-1.15; P = 0.37), was associated with reduced odds of having an elevated (>0.24 mmol/L) AIP. Having one (OR = 0.68; 95% CI: 0.52-0.89; P = 0.007) or both (OR = 0.55; 95 CI: 0.37-0.82; P = 0.005) health-enhancing behaviors (adequate physical activity and/or healthy diet), when compared to having neither, was associated with reduced odds (32 and 45%) for having an elevated AIP. The relative excess risk due to interaction (RERI) was 0.06 (95% CI: -0.06 to 0.18; P = 0.31), suggesting there is no additive interaction between MVPA and dietary behavior on AIP. All associations were attenuated when including central adiposity as a covariate, suggesting a mediation effect of central adiposity.
CONCLUSIONS
MVPA is independently associated with reduced odds of having an elevated AIP, having both adequate levels of MVPA and a healthy diet does not substantively reduce the odds of AIP, and there is no additive interaction effect between MVPA and diet on AIP. Central adiposity mediated the relationship between MVPA and AIP.
背景/目的：中高强度体力活动（MVPA）和饮食行为与血浆致动脉粥样硬化指数（AIP）的潜在交互或联合关联，尚未在具有代表性的美国成年人样本中得到探索。因此，本研究旨在通过中心性肥胖的潜在中介作用，研究 MVPA 和饮食行为与 AIP 的相关性。
受试者/方法：使用来自全国健康和营养检查调查的数据（N=2701 名 20-85 岁成年人）。通过血液样本评估 AIP，通过加速度计评估 MVPA，利用两次 24 小时回忆计算健康饮食指数（HEI），作为饮食质量的衡量标准。使用特定于安卓的双能 X 射线吸收法（DXA）测量中心性肥胖。
结果
符合 MVPA 指南（OR=0.58；95%CI：0.41-0.82；P=0.004），但不符合饮食指南（OR=0.89；95%CI：0.69-1.15；P=0.37），与降低 AIP 升高（>0.24mmol/L）的几率相关。与既不进行体力活动也不进行健康饮食（OR=0.55；95%CI：0.37-0.82；P=0.005）相比，只有一种（OR=0.68；95%CI：0.52-0.89；P=0.007）或两种健康增强行为（适当的体力活动和/或健康饮食）与降低 AIP 升高的几率相关（分别降低 32%和 45%）。交互的相对超额风险（RERI）为 0.06（95%CI：-0.06 至 0.18；P=0.31），表明 MVPA 和饮食行为对 AIP 无附加交互作用。当将中心性肥胖作为协变量包含在内时，所有关联均减弱，表明中心性肥胖对 MVPA 和 AIP 之间的关系具有中介作用。
结论
MVPA 与降低 AIP 升高的几率独立相关，同时达到足够的 MVPA 和健康饮食水平并不能实质性降低 AIP 的几率，MVPA 和饮食之间对 AIP 没有附加的交互作用。中心性肥胖介导了 MVPA 和 AIP 之间的关系。
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