Wan Qin, Zhou Yue, Zhu Wengen, Liu Xiao
Department of Geriatrics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Front Cardiovasc Med. 2021 Sep 22;8:710071. doi: 10.3389/fcvm.2021.710071. eCollection 2021.
Since evidence regarding the relationship between physical activity (PA) and atrial fibrillation (AF) incidence is inconsistent among studies, we performed a dose-response meta-analysis to comprehensively evaluate the exposure-effect association between PA and incident AF and the potential sex difference in the general population. The PubMed and Embase databases were searched for eligible studies published up to July 2020 (PROSPERO: CRD42018091692). The non-linear or linear exposure-effect relationship between PA and AF was examined using the robust error meta-regression method. A total of 16 prospective studies involving 1,449,017 individuals and 39,884 AF cases were included. We observed an inverse non-linear association between PA level and incident AF ( = 0%, < 0.001). In the linear model, a 5 metabolic equivalent of task (MET)-h/week increase in PA was associated with a decreased risk of AF [risk ratio (RR) = 0.992, 95% confidence interval (CI): 0.988-0.996, = 0%]. In the sex-stratified analysis, we observed an inverse non-linear relationship between PA level and AF risk in females ( = 90%, < 0.0001) but not in males ( = 0%, = 0.40). In the linear model, a 5 MET-h/week increase in PA was associated with a reduced risk of AF in females (RR = 0.982, 95% CI: 0.975-0.989, = 71%) but not in males (RR = 0.998, 95% CI: 0.994-1.002, = 0%), with a significant interaction observed between the two groups ( < 0.0001). There was an inverse non-linear relationship between PA level and incident AF in the general population. The beneficial effect of PA in reducing AF risk might be predominantly observed in females.
由于关于体力活动（PA）与心房颤动（AF）发病率之间关系的证据在各项研究中并不一致，我们进行了一项剂量反应荟萃分析，以全面评估PA与新发AF之间的暴露-效应关联以及普通人群中潜在的性别差异。在PubMed和Embase数据库中检索截至2020年7月发表的符合条件的研究（PROSPERO：CRD42018091692）。使用稳健误差元回归方法检验PA与AF之间的非线性或线性暴露-效应关系。共纳入16项前瞻性研究，涉及1,449,017人及39,884例AF病例。我们观察到PA水平与新发AF之间存在非线性负相关（P = 0%，P < 0.001）。在线性模型中，PA每周增加5代谢当量任务（MET）-小时与AF风险降低相关[风险比（RR）= 0.992，95%置信区间（CI）：0.988 - 0.996，P = 0%]。在按性别分层分析中，我们观察到女性中PA水平与AF风险之间存在非线性负相关（P = 90%，P < 0.0001），而男性中则不存在（P = 0%，P = 0.40）。在线性模型中，PA每周增加5 MET-小时与女性AF风险降低相关（RR = 0.982，95% CI：0.975 - 0.989，P = 71%），而男性中则不然（RR = 0.998，95% CI：0.994 - 1.002，P = 0%），两组之间观察到显著的交互作用（P < 0.0001）。普通人群中PA水平与新发AF之间存在非线性负相关。PA降低AF风险的有益作用可能主要在女性中观察到。
