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肥胖青少年的身体活动与心血管代谢风险因素聚类。

Physical Activity and Cardiometabolic Risk Factor Clustering in Young Adults with Obesity.

机构信息

Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC.

Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC.

出版信息

Med Sci Sports Exerc. 2020 May;52(5):1050-1056. doi: 10.1249/MSS.0000000000002214.

Abstract

INTRODUCTION

There is a paucity of information on the clustering of cardiometabolic risk factors in young adults and how this clustering may vary based on whether or not they perform sufficient levels of physical activity.

METHODS

We analyzed baseline data from 346 young adults (23.3 ± 4.4 yr) participating in the Healthy Body Healthy U clinical trial from 2015 to 2018. Cardiometabolic risk factors were measured according to standard procedures and moderate- to vigorous-intensity physical activity (MVPA) was determined by accelerometry. A cardiometabolic clustering score (ranging from 0 to 5) was created from five biomarkers according to whether or not a standard clinical risk cut point was exceeded (0, no; 1, yes): abdominal circumference (>102 cm (men) or >88 cm (women)), hemoglobin A1c (≥5.7%), HDL cholesterol (<40 mg·dL (men) or <50 mg·dL (women)), systolic blood pressure (≥130 mm Hg), and diastolic blood pressure (≥85 mm Hg). Cardiometabolic dysregulation (CD) was defined as a cardiometabolic clustering score ≥3. Multiple logistic regression determined the independent association between level of MVPA and CD, while adjusting for sex, race/ethnicity, sedentary time, and smoking.

RESULTS

The prevalence of CD was 18% (22% in men, 17% in women). We observed a nonlinear graded association between MVPA and CD. Participants performing 150-300 min·wk of MVPA significantly lowered their odds of CD by 66% (odds ratio, 0.34; 95% confidence interval, 0.16-0.75), whereas those exceeding 300 min·wk lowered their odds by 61% (odds ratio, 0.39; 95% confidence interval, 0.18-0.86) compared with those performing <150 min·wk, independent of obesity and the other covariables.

CONCLUSION

Recommended levels of moderate-intensity physical activity is significantly associated with lower odds of CD and thus may prevent or diminish the need for expensive pharmaceutical treatment over the remainder of the life-span.

摘要

简介

年轻人中心血管代谢危险因素的聚类情况以及这种聚类情况是否因他们是否进行足够水平的体育活动而有所不同,相关信息十分匮乏。

方法

我们分析了 2015 年至 2018 年参加“健康身体,健康 U”临床研究的 346 名年轻成年人(23.3±4.4 岁)的基线数据。根据标准程序测量心血管代谢危险因素,通过加速度计确定中等到剧烈强度的身体活动(MVPA)。根据是否超过标准临床风险切点(0,否;1,是),从五个生物标志物创建心血管代谢聚类评分(范围为 0 至 5):腰围(男性>102cm 或女性>88cm)、糖化血红蛋白(≥5.7%)、高密度脂蛋白胆固醇(男性<40mg·dL 或女性<50mg·dL)、收缩压(≥130mmHg)和舒张压(≥85mmHg)。心血管代谢失调(CD)定义为心血管代谢聚类评分≥3。多因素逻辑回归确定了 MVPA 水平与 CD 之间的独立关联,同时调整了性别、种族/民族、久坐时间和吸烟状况。

结果

CD 的患病率为 18%(男性为 22%,女性为 17%)。我们观察到 MVPA 与 CD 之间存在非线性分级关联。进行 150-300min·wk MVPA 的参与者显著降低了 CD 的患病风险 66%(比值比,0.34;95%置信区间,0.16-0.75),而超过 300min·wk MVPA 的参与者降低了 CD 的患病风险 61%(比值比,0.39;95%置信区间,0.18-0.86),与进行<150min·wk MVPA 的参与者相比,独立于肥胖和其他协变量。

结论

推荐的中等强度体力活动水平与 CD 发病风险降低显著相关,因此可能预防或减少在剩余的生命期限内对昂贵的药物治疗的需求。

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