1 Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2 Center for Cohort Studies, Total Healthcare Center, Kanbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eur J Prev Cardiol. 2018 Jul;25(10):1065-1073. doi: 10.1177/2047487318774419. Epub 2018 May 3.
Background The association between baseline and temporal changes in physical activity and incident hypertension or diabetes mellitus in initially non-hypertensive or non-diabetic subjects is rarely known. Methods Among individuals who underwent consecutive comprehensive health screenings, their physical activity level was measured using a self-reported international physical activity questionnaire. First, subjects were classified into four categories: no regular physical activity with a sedentary lifestyle; minimal physical activity (<75 min/week); insufficient physical activity (≥75 min but <150 min/week); and sufficient physical activity (≥150 min/week). Second, subjects were sub-grouped, based on temporal changes in physical activity level between baseline and consecutive follow-up: increase, no change, and decrease. Results Finally, among 174,314 subjects (mean age 36.7 ± 6.9 years), 5544 (3.18%) and 21,276 (12.2%) developed incident diabetes mellitus and arterial hypertension, respectively. After a multivariate adjustment, sufficient baseline physical activity was associated with significantly lower risk for incident hypertension (hazard ratio 0.89; 95% confidence interval (CI) 0.81 to 0.97), but the difference was not significant, and showed a lower trend in diabetes mellitus incidence (hazard ratio 0.87; 95% CI 0.69 to 1.04) in reference to no regular physical activity group. Regardless of the baseline physical activity level, subjects with a temporal increase in physical activity showed significantly decreased risk for incident hypertension (hazard ratio 0.93; 95% CI 0.87 to 0.99) and diabetes mellitus (hazard ratio 0.83; 95% CI 0.74 to 0.92) compared with those with a temporal decrease in their physical activity level. Conclusion Both sufficient baseline physical activity level and its temporal increase were associated with a lower risk of incident hypertension and diabetes mellitus in a large, relatively healthy, cohort.
在最初血压正常或无糖尿病的人群中,基线和时间变化的体力活动与高血压或糖尿病发病之间的关系鲜为人知。
在接受连续全面健康筛查的人群中,使用自我报告的国际体力活动问卷来测量其体力活动水平。首先,将受试者分为四类:无规律体力活动且久坐不动的生活方式;体力活动极少(<75 分钟/周);体力活动不足(≥75 分钟但<150 分钟/周);和体力活动充足(≥150 分钟/周)。其次,根据基线和连续随访期间体力活动水平的时间变化,将受试者分为亚组:增加、不变和减少。
最终,在 174314 名受试者(平均年龄 36.7±6.9 岁)中,分别有 5544(3.18%)和 21276(12.2%)发生了糖尿病和动脉高血压。经多变量调整后,基线体力活动充足与高血压发病风险显著降低相关(危险比 0.89;95%置信区间(CI)为 0.81 至 0.97),但差异无统计学意义,且糖尿病发病的下降趋势较低(危险比 0.87;95%CI 为 0.69 至 1.04)与无规律体力活动组相比。无论基线体力活动水平如何,与体力活动水平随时间减少的受试者相比,体力活动随时间增加的受试者发生高血压(危险比 0.93;95%CI 为 0.87 至 0.99)和糖尿病(危险比 0.83;95%CI 为 0.74 至 0.92)的风险显著降低。
在一个较大的、相对健康的队列中,充足的基线体力活动水平及其随时间的增加与较低的高血压和糖尿病发病风险相关。