Liu Qiong, Liu Fangchao, Li Jianxin, Huang Keyong, Yang Xueli, Chen Jichun, Liu Xiaoqing, Cao Jie, Shen Chong, Yu Ling, Zhao Yingxin, Wu Xianping, Zhao Liancheng, Li Ying, Hu Dongsheng, Lu Xiangfeng, Huang Jianfeng, Gu Dongfeng
Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China.
Sci Bull (Beijing). 2020 Oct 30;65(20):1760-1766. doi: 10.1016/j.scib.2020.05.029. Epub 2020 May 30.
Although emerging studies from high-income countries investigated the relationship between sedentary behavior (SB) and cardiovascular risk, little evidence came from developing countries. Moreover, the benefits of reallocating time from SB to physical activity (PA) on incident cardiovascular disease (CVD) are unknown. Using three cohorts from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project, we included 93 110 adults who were free from CVD at baseline. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD, including stroke, coronary heart disease, and CVD death. Isotemporal substitution models were applied to estimate the per-hour effects of replacing SB with PA. After 5.8 years follow-up, 3799 CVD cases were identified. A gradient positive association between sedentary time and incident CVD was observed. Relative to those with < 5 h/d sedentary time, the multivariable-adjusted HRs (95% CIs) of CVD incidence were 1.07(0.96-1.20), 1.27(1.13-1.43) and 1.51(1.34-1.70) for those having 5-<8, 8-<10, and ≥ 10 h/d sedentary time, respectively. When participants were cross-classified by SB and moderate to vigorous physical activity (MVPA) level, the CVD risk was highest in those with ≥ 10 h/d SB and < 150 min/week MVPA. Among those who reported ≥ 5 h/d sedentary time, per-hour substitution of SB with light, moderate, and vigorous PA reduced incident CVD risk by 5%, 6%, and 8%, respectively. The study first found that sedentary time was associated with increased incident CVD risk among Chinese adults and that substitution of SB with PA of any intensity could convey cardiovascular benefits among those with ≥ 5 h/d SB.
尽管来自高收入国家的新兴研究调查了久坐行为（SB）与心血管风险之间的关系，但来自发展中国家的证据很少。此外，将用于SB的时间重新分配为体育活动（PA）对心血管疾病（CVD）发病的益处尚不清楚。利用中国动脉粥样硬化性心血管疾病风险预测项目的三个队列，我们纳入了93110名基线时无CVD的成年人。使用Cox比例风险模型计算CVD（包括中风、冠心病和CVD死亡）的风险比（HR）和95%置信区间（CI）。应用等时替代模型来估计用PA替代SB的每小时效应。经过5.8年的随访，共识别出3799例CVD病例。观察到久坐时间与CVD发病之间呈梯度正相关。相对于每天久坐时间<5小时的人，每天久坐时间为5-<8小时、8-<10小时和≥10小时的人，CVD发病率的多变量调整HR（95%CI）分别为1.07（0.96-1.20）、1.27（1.13-1.43）和1.51（1.34-1.70）。当参与者按SB和中度至剧烈体育活动（MVPA）水平进行交叉分类时，每天久坐时间≥10小时且每周MVPA<150分钟的人CVD风险最高。在报告每天久坐时间≥5小时的人中，用轻度、中度和剧烈PA每小时替代SB分别可使CVD发病风险降低5%、6%和8%。该研究首次发现，久坐时间与中国成年人CVD发病风险增加有关，并且用任何强度的PA替代SB都可以使每天久坐时间≥5小时的人获得心血管益处。
