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光强体力活动如何与成人心脏代谢健康和死亡率相关?实验和观察研究的系统评价和荟萃分析。

How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies.

机构信息

School of Health and Life Science, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.

Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.

出版信息

Br J Sports Med. 2019 Mar;53(6):370-376. doi: 10.1136/bjsports-2017-097563. Epub 2018 Apr 25.

Abstract

AIM

To assess the relationship between time spent in light physical activity and cardiometabolic health and mortality in adults.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Searches in Medline, Embase, PsycInfo, CINAHL and three rounds of hand searches.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Experimental (including acute mechanistic studies and physical activity intervention programme) and observational studies (excluding case and case-control studies) conducted in adults (aged ≥18 years) published in English before February 2018 and reporting on the relationship between light physical activity (<3 metabolic equivalents) and cardiometabolic health outcomes or all-cause mortality.

STUDY APPRAISAL AND SYNTHESIS

Study quality appraisal with QUALSYST tool and random effects inverse variance meta-analysis.

RESULTS

Seventy-two studies were eligible including 27 experimental studies (and 45 observational studies). Mechanistic experimental studies showed that short but frequent bouts of light-intensity activity throughout the day reduced postprandial glucose (-17.5%; 95% CI -26.2 to -8.7) and insulin (-25.1%; 95% CI -31.8 to -18.3) levels compared with continuous sitting, but there was very limited evidence for it affecting other cardiometabolic markers. Three light physical activity programme intervention studies (n ranging from 12 to 58) reduced adiposity, improved blood pressure and lipidaemia; the programmes consisted of activity of >150 min/week for at least 12 weeks. Six out of eight prospective observational studies that were entered in the meta-analysis reported that more time spent in daily light activity reduced risk of all-cause mortality (pooled HR 0.71; 95% CI 0.62 to 0.83).

CONCLUSIONS

Light-intensity physical activity could play a role in improving adult cardiometabolic health and reducing mortality risk. Frequent short bouts of light activity improve glycaemic control. Nevertheless, the modest volume of the prospective epidemiological evidence base and the moderate consistency between observational and laboratory evidence inhibits definitive conclusions.

摘要

目的

评估轻体力活动时间与成年人心脏代谢健康和死亡率之间的关系。

设计

系统评价和荟萃分析。

数据来源

在 Medline、Embase、PsycInfo、CINAHL 中进行检索,并进行了三轮手工检索。

纳入研究的选择标准

在 2018 年 2 月之前以英文发表的、在成年人(年龄≥18 岁)中进行的实验(包括急性机制研究和体育活动干预计划)和观察性研究(不包括病例和病例对照研究),并报告轻体力活动(<3 代谢当量)与心脏代谢健康结果或全因死亡率之间的关系。

研究评估和综合

使用 QUALSYST 工具进行研究质量评估,并进行随机效应逆方差荟萃分析。

结果

有 72 项研究符合纳入标准,包括 27 项实验研究(和 45 项观察性研究)。机制性实验研究表明,与连续久坐相比,全天短时间但频繁的轻强度活动可降低餐后血糖(-17.5%;95%CI-26.2 至-8.7)和胰岛素(-25.1%;95%CI-31.8 至-18.3)水平,但对其他心脏代谢标志物的影响证据非常有限。三项轻体力活动计划干预研究(n 从 12 到 58 不等)降低了肥胖,改善了血压和血脂;这些计划包括每周至少进行 150 分钟以上的活动,持续至少 12 周。纳入荟萃分析的 8 项前瞻性观察性研究中有 6 项报告称,每天进行更多的轻度活动可降低全因死亡率的风险(汇总 HR 0.71;95%CI 0.62 至 0.83)。

结论

低强度体力活动可能在改善成年人心脏代谢健康和降低死亡率风险方面发挥作用。频繁的短时间轻活动可改善血糖控制。然而,前瞻性流行病学证据基础的数量适中,观察性和实验室证据之间的一致性中等,这限制了明确的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e958/6579499/37fd4da69d81/bjsports-2017-097563f01.jpg

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