多巴胺相关基因型与干预期间体力活动变化：生活方式干预和老年人独立研究。
Dopamine-Related Genotypes and Physical Activity Change During an Intervention: The Lifestyle Interventions and Independence for Elders Study.
机构信息
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina.
出版信息
J Am Geriatr Soc. 2018 Jul;66(6):1172-1179. doi: 10.1111/jgs.15369. Epub 2018 Apr 10.
OBJECTIVES
To determine whether intervention-induced physical activity (PA) changes in sedentary older adults differed according to dopamine-related genotype.
DESIGN
Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial (2010-13)).
SETTING
Multicenter study, 8 U.S.
PARTICIPANTS
Volunteer sample of sedentary adults aged 70 to 89 at risk of disability (N=1635).
INTERVENTIONS
Structured PA versus health education (HE) for an average of 2.6 years.
MEASUREMENTS
Single-nucleotide polymorphisms of dopamine-related genes (dopamine receptor (DR) D1, DRD2, DRD3, and catechol-O-methyltransferase (COMT)) were assessed. Average moderate to vigorous PA (MVPA) was calculated using accelerometry (min/d) at baseline and 6, 12, and 24 months. Between-arm MVPA differences according to genotype and genotype with square root-transformed MVPA separately according to arm were tested, stratified according to race, and adjusted for multiple comparisons.
RESULTS
White participants in the PA arm (n=513) had higher average square root transformed MVPA (4.91±1.91)than those in the HE arm (n=538) (4.51±1.82) (p=.001). Between-arm differences were greater for DRD2 Met/Met (high dopamine; HE: 4.76±1.80, PA: 5.53±1.60, p=.03) than Val/Val (low dopamine; HE: 4.58±1.92, PA: 4.81±1.83, p=.16); results were similar for COMT. In the PA arm, DRD2 Met/Met was associated with higher average MVPA (5.39±2.00) than Met/Val (4.46±2.51) (p=.01) and Val/Val (4.65±2.71) (p=.01). There were no associations for other genes. Associations were not significant in blacks but followed similar trends.
CONCLUSION
Higher dopamine signaling may support changes in PA during an intervention. The role of dopamine-related pathways in promoting PA participation and enhancing response to interventions in sedentary older adults should be studied.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT01072500.
目的
确定干预引起的久坐老年人的体力活动（PA）变化是否因多巴胺相关基因型而异。
设计
随机临床试验（生活方式干预和老年人独立试验（2010-13 年））。
地点
美国 8 个中心的多中心研究。
参与者
有残疾风险的 70 至 89 岁久坐成年人志愿者样本（n=1635）。
干预措施
有组织的 PA 与健康教育（HE），平均时间为 2.6 年。
测量
评估多巴胺相关基因（多巴胺受体（DR）D1、DRD2、DRD3 和儿茶酚-O-甲基转移酶（COMT））的单核苷酸多态性。使用加速度计（min/d）在基线和 6、12 和 24 个月时计算平均中度至剧烈 PA（MVPA）。根据基因型和根据手臂分别对平方根转换的 MVPA 进行臂间差异测试，根据种族分层，并进行多次比较调整。
结果
PA 组（n=513）的白人参与者的平均平方根转换 MVPA（4.91±1.91）高于 HE 组（n=538）（4.51±1.82）（p=.001）。DRD2 Met/Met（高多巴胺；HE：4.76±1.80，PA：5.53±1.60，p=.03）的臂间差异大于 Val/Val（低多巴胺；HE：4.58±1.92，PA：4.81±1.83，p=.16）；COMT 的结果类似。在 PA 组中，DRD2 Met/Met 与较高的平均 MVPA（5.39±2.00）相关，而 Met/Val（4.46±2.51）（p=.01）和 Val/Val（4.65±2.71）（p=.01）。其他基因没有关联。在黑人中，这些关联并不显著，但遵循相似的趋势。
结论
较高的多巴胺信号可能支持干预期间 PA 的变化。多巴胺相关途径在促进久坐老年人的 PA 参与和增强对干预的反应中的作用应加以研究。
试验注册
clinicaltrials.gov 标识符：NCT01072500。
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