Preventive Medicine and Public Health, Universidad Autonoma de Madrid, Madrid, Spain
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Br J Sports Med. 2022 Aug;56(16):919-926. doi: 10.1136/bjsports-2021-104961. Epub 2022 Apr 6.
We aimed to investigate the dose-response associations of long-term leisure-time physical activity (LTPA) obtained from repeated measures with all-cause and cardiovascular disease (CVD) mortality outcomes in Taiwanese adults.
We included 210 327 participants with self-reported LTPA at least in two medical examinations (867 968 data points) for up to 20 years (median, IQR: 4.8 years, 2.3-9.0). Dose-response relationships were modelled with restricted cubic spline functions and Cox regressions HRs (95% CIs) adjusted for main covariates.
During up to 23 years of follow-up (3 655 734 person-years), 10 539 participants died, of which 1919 of CVD. We observed an inverse, non-linear dose-response association between long-term LTPA and all-cause and CVD mortality. Compared with the referent (0 metabolic equivalent of task (MET) hours/week), insufficient (0.01-7.49 MET hours/week), recommended (7.50-15.00 MET hours/week) and additional (>15 MET hours/week) amounts of LTPA had a lower mortality risk of 0.74 (0.69-0.80), 0.64 (0.60-0.70) and 0.59 (0.54-0.64) for all-cause mortality and 0.68 (0.60-0.84), 0.56 (0.47-0.67) and 0.56 (0.47-0.68) for CVD mortality. When using only baseline measures of LTPA, the corresponding mortality risk was 0.88 (0.84-0.93), 0.83 (0.78-0.88) and 0.78 (0.73-0.83) for all-cause and 0.91 (0.81-1.02), 0.78 (0.68-0.89) and 0.80 (0.70-0.92) for CVD mortality.
Long-term LTPA was associated with lower risks of all-cause and CVD mortality. The magnitude of risk reductions was larger when modelling repeated measures of LTPA compared with one measure of LTPA at baseline.
我们旨在探讨来自重复测量的长期休闲时间体力活动（LTPA）与全因和心血管疾病（CVD）死亡率结局之间的剂量-反应关系，在台湾成年人中进行研究。
我们纳入了 210327 名至少在两次体检中报告过 LTPA（867968 个数据点）的参与者，随访时间长达 20 年（中位数，IQR：4.8 年，2.3-9.0）。使用限制立方样条函数和 Cox 回归模型调整主要协变量后的 HR（95%CI）来建立剂量-反应关系。
在长达 23 年的随访期间（3655734人年），有 10539 名参与者死亡，其中 1919 人死于 CVD。我们观察到长期 LTPA 与全因和 CVD 死亡率之间呈负相关的非线性剂量-反应关系。与参照（每周 0 代谢当量任务（MET）小时）相比，不充足（每周 0.01-7.49 MET 小时）、推荐（每周 7.50-15.00 MET 小时）和额外（每周>15 MET 小时）量的 LTPA 具有更低的全因死亡率风险（0.74（0.69-0.80）、0.64（0.60-0.70）和 0.59（0.54-0.64））和 CVD 死亡率风险（0.68（0.60-0.84）、0.56（0.47-0.67）和 0.56（0.47-0.68））。当仅使用 LTPA 的基线测量值时，全因死亡率的相应风险为 0.88（0.84-0.93）、0.83（0.78-0.88）和 0.78（0.73-0.83），CVD 死亡率的相应风险为 0.91（0.81-1.02）、0.78（0.68-0.89）和 0.80（0.70-0.92）。
长期 LTPA 与全因和 CVD 死亡率风险降低相关。与仅在基线测量一次 LTPA 相比，重复测量 LTPA 建模的风险降低幅度更大。
