健身、体育活动、力量与心血管疾病遗传风险的关联：英国生物库研究中的纵向分析。
Associations of Fitness, Physical Activity, Strength, and Genetic Risk With Cardiovascular Disease: Longitudinal Analyses in the UK Biobank Study.
机构信息
Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I., E.T.).
Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (S.G.).
出版信息
Circulation. 2018 Jun 12;137(24):2583-2591. doi: 10.1161/CIRCULATIONAHA.117.032432. Epub 2018 Apr 9.
BACKGROUND
Observational studies have shown inverse associations among fitness, physical activity, and cardiovascular disease. However, little is known about these associations in individuals with elevated genetic susceptibility for these diseases.
METHODS
We estimated associations of grip strength, objective and subjective physical activity, and cardiorespiratory fitness with cardiovascular events and all-cause death in a large cohort of 502 635 individuals from the UK Biobank (median follow-up, 6.1 years; interquartile range, 5.4-6.8 years). Then we further examined these associations in individuals with different genetic burden by stratifying individuals based on their genetic risk scores for coronary heart disease and atrial fibrillation. We compared disease risk among individuals in different tertiles of fitness, physical activity, and genetic risk using lowest tertiles as reference.
RESULTS
Grip strength, physical activity, and cardiorespiratory fitness showed inverse associations with incident cardiovascular events (coronary heart disease: hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.77-0.81; HR, 0.95; 95% CI, 0.93-0.97; and HR, 0.68; 95% CI, 0.63-0.74, per SD change, respectively; atrial fibrillation: HR, 0.75; 95% CI, 0.73-0.76; HR, 0.93; 95% CI, 0.91-0.95; and HR, 0.60; 95% CI, 0.56-0.65, per SD change, respectively). Higher grip strength and cardiorespiratory fitness were associated with lower risk of incident coronary heart disease and atrial fibrillation in each genetic risk score group ( <0.001 in each genetic risk category). In particular, high levels of cardiorespiratory fitness were associated with 49% lower risk for coronary heart disease (HR, 0.51; 95% CI, 0.38-0.69) and 60% lower risk for atrial fibrillation (HR, 0.40; 95%, CI 0.30-0.55) among individuals at high genetic risk for these diseases.
CONCLUSIONS
Fitness and physical activity demonstrated inverse associations with incident cardiovascular disease in the general population, as well as in individuals with elevated genetic risk for these diseases.
背景
观察性研究表明，健康水平、身体活动与心血管疾病之间呈负相关。然而，对于这些疾病遗传易感性较高的个体，人们对这些关联知之甚少。
方法
我们在英国生物库的一个大型队列中（中位随访时间为 6.1 年；四分位间距为 5.4-6.8 年），估计了握力、客观和主观身体活动以及心肺功能与心血管事件和全因死亡之间的关联。然后，我们根据个体的冠心病和心房颤动遗传风险评分对这些关联进行了进一步研究。我们通过基于个体的健康、身体活动和遗传风险的不同三分位数来比较不同三分位数的个体的疾病风险，以最低三分位数作为参考。
结果
握力、身体活动和心肺功能与心血管事件的发生呈负相关（冠心病：风险比[HR]，0.79；95%置信区间[CI]，0.77-0.81；HR，0.95；95%CI，0.93-0.97；HR，0.68；95%CI，0.63-0.74，每标准差变化）；心房颤动：HR，0.75；95%CI，0.73-0.76；HR，0.93；95%CI，0.91-0.95；HR，0.60；95%CI，0.56-0.65，每标准差变化）。在每个遗传风险评分组中，较高的握力和心肺功能与较低的新发冠心病和心房颤动风险相关（在每个遗传风险类别中均<0.001）。特别是，在患有这些疾病遗传风险较高的个体中，较高水平的心肺功能与冠心病风险降低 49%相关（HR，0.51；95%CI，0.38-0.69）和心房颤动风险降低 60%相关（HR，0.40；95%CI，0.30-0.55）。
结论
健康水平和身体活动与普通人群中的心血管疾病发生呈负相关，与这些疾病遗传易感性较高的个体也呈负相关。
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