National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK.
Eur J Epidemiol. 2021 Mar;36(3):259-274. doi: 10.1007/s10654-020-00714-4. Epub 2021 Jan 25.
Regular physical activity is well established to be associated with reduced risk of cardiovascular disease outcomes. Whether physical activity is associated with the future risk of atrial fibrillation (AF) remains a controversy. Using a systematic review and meta-analysis of published observational cohort studies in general populations with at least one-year of follow-up, we aimed to evaluate the association between regular physical activity and the risk of AF. Relevant studies were sought from inception until October 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Extracted relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus the minimal amount of physical activity groups were pooled using random-effects meta-analysis. Quality of the evidence was assessed by GRADE. A total of 23 unique observational cohort studies comprising of 1,930,725 participants and 45,839 AF cases were eligible. The pooled multivariable-adjusted RR (95% CI) for AF comparing the most physically active versus the least physically active groups was 0.99 (0.93-1.05). This association was modified by sex: an increased risk was observed in men: 1.20 (1.02-1.42), with a decreased risk in women: 0.91 (0.84-0.99). The quality of the evidence ranged from low to moderate. Pooled observational cohort studies suggest that the absence of associations reported between regular physical activity and AF risk in previous general population studies and their aggregate analyses could be driven by a sex-specific difference in the associations - an increased risk in men and a decreased risk in women.Systematic review registration: PROSPERO 2020: CRD42020172814.
定期进行身体活动已被充分证实可降低心血管疾病结局的风险。身体活动是否与未来发生心房颤动（AF）的风险相关仍存在争议。本研究采用系统评价和荟萃分析，纳入至少随访 1 年的普通人群中发表的观察性队列研究，旨在评估规律身体活动与 AF 风险之间的关系。从研究开始到 2020 年 10 月，我们在 MEDLINE、Embase、Web of Science 以及相关文章的手动检索中检索相关研究。使用随机效应荟萃分析汇总最大与最小身体活动组之间的相对风险（RR）及其 95%置信区间（CI）。使用 GRADE 评估证据质量。共有 23 项独立的观察性队列研究纳入了 1930725 名参与者和 45839 例 AF 病例。多变量调整后 RR（95%CI）比较最活跃与最不活跃组的 AF 为 0.99（0.93-1.05）。这种关联受到性别影响：男性观察到风险增加（1.20[1.02-1.42]），而女性风险降低（0.91[0.84-0.99]）。证据质量从低到中。汇总的观察性队列研究表明，以前的普通人群研究及其综合分析报告的规律身体活动与 AF 风险之间无关联，可能是由于关联存在性别特异性差异——男性风险增加，女性风险降低。系统评价注册：PROSPERO 2020：CRD42020172814。
