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闲暇时间体力活动与高密度脂蛋白胆固醇在“Elsa-Brasil 研究参与者”中的关系:在剂量-反应效应方面是否存在性别差异?

Association between Leisure Time Physical Activity and HDL-C in the Elsa-Brasil Study Participants: Are There Any Gender Differences in the Dose-Response Effect?

机构信息

Programa de Pós-Graduação em Ciências da Reabilitação - Universidade Federal da Bahia, Salvador, BA - Brasil.

Laboratório de Educação em Meio Ambiente e Saúde, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ - Brasil.

出版信息

Arq Bras Cardiol. 2021 Sep;117(3):494-500. doi: 10.36660/abc.20200438.

Abstract

BACKGROUND

High levels of high-density lipoprotein (HDL-C) are known for their protective effect against cardiovascular diseases and the regular practice of leisure time physical activity (LTPA) may be associated with their increase.

OBJECTIVE

To verify the existence of differences between genders in the dose-response effect regarding the association between LTPA and HDL-C in the ELSA-Brasil study cohort.

METHODS

Cross-sectional study with data from wave 2 of 13,931 participants of both genders (7,607 women) from the Longitudinal Study of Adult Health ELSA-Brasil. The LTPA was measured using the International Physical Activity Questionnaire (IPAQ) and classified into four categories: sedentary, low active, active and very active. The discriminatory power of LTPA at different intensities analyzed for high HDL-C was tested using ROC curves. Associations, adjusted for confounders between LTPA and HDL-C were analyzed by logistic regression. A 95% confidence interval was used.

RESULTS

A positive association, with a dose-response effect, was observed between LTPA and HDL-C in both men and women. With regard to intensity, only vigorous physical activity discriminated high HDL-C in men, while both walking and moderate and vigorous physical activity discriminated high HDL-C in women.

CONCLUSIONS

LTPA shows a positive association with gradient dose-response and HDL-C, but in men, the association is not observed for those classified as physically unfit. In women, both walking intensity and moderate or vigorous physical activity can discriminate high HDL-C levels, whereas only vigorous intensity-exercise discriminate elevated HDL-C levels in men, demonstrating that males need to do more physical activity for this benefit to be observed.

摘要

背景

高密度脂蛋白(HDL-C)水平较高与心血管疾病的保护作用有关,而经常进行休闲时间体力活动(LTPA)可能与 HDL-C 水平的升高有关。

目的

验证 ELSA-Brasil 研究队列中,LTPA 与 HDL-C 之间的关联存在性别差异的剂量反应效应。

方法

这是一项横断面研究,数据来自成人健康纵向研究 ELSA-Brasil 第 2 波的 13931 名参与者(7607 名女性)。使用国际体力活动问卷(IPAQ)测量 LTPA,并将其分为四类:久坐、低活跃、活跃和非常活跃。使用 ROC 曲线测试不同强度的 LTPA 对高 HDL-C 的区分能力。使用逻辑回归分析调整混杂因素后,分析 LTPA 与 HDL-C 之间的关联。使用 95%置信区间。

结果

在男性和女性中,LTPA 与 HDL-C 之间均存在正相关,且呈剂量反应效应。就强度而言,只有剧烈体力活动能区分男性的高 HDL-C,而步行以及中等到剧烈体力活动都能区分女性的高 HDL-C。

结论

LTPA 与 HDL-C 呈正相关,且呈梯度剂量反应关系,但在男性中,对于被归类为身体不适合运动的人群,这种关联并不明显。在女性中,步行强度和中等到剧烈体力活动都可以区分高 HDL-C 水平,而只有剧烈强度运动可以区分男性的高 HDL-C 水平,这表明男性需要进行更多的体力活动才能观察到这种益处。

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