Fabre-Estremera Blanca, Buño-Soto Antonio, García-Esquinas Esther, Cabanas-Sánchez Verónica, Martínez-Gómez David, Rodríguez-Artalejo Fernando, Ortolá Rosario
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.
Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Paseo de la Castellana 261, 28046, Madrid, Spain.
Eur Rev Aging Phys Act. 2023 Mar 9;20(1):5. doi: 10.1186/s11556-023-00313-8.
High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are biomarkers of myocardial infarction and heart failure, respectively, and indicate cardiovascular risk. Since low physical activity (PA) and sedentary behavior (SB) are also associated with higher cardiovascular risk, and this association could be a consequence of higher levels of cardiac biomarkers, we examined the association of device-measured movement behaviors with hs-cTnT and NT-proBNP in older men and women without major cardiovascular disease (CVD).
We used data from 1939 older adults from the Seniors-ENRICA-2 study. Accelerometers were used to assess time spent in sleep, SB, light PA (LPA), and moderate-to-vigorous PA (MVPA). Linear regression models were fitted separately in eight strata defined by sex, by median total PA time, and by the presence of subclinical cardiac damage according to cardiac biomarkers levels.
In the less active men with subclinical cardiac damage, spending 30 min/day more of MVPA was associated with a mean percentage difference (MPD) (95% confidence interval) in hs-cTnT of - 13.1 (- 18.3, - 7.5); MPDs in NT-proBNP per 30 min/day increment were 5.8 (2.7, 8.9) for SB, - 19.3 (- 25.4, - 12.7) for LPA and - 23.1 (- 30.7, - 14.6) for MVPA. In women with subclinical cardiac damage who were less physically active, 30 min/day more of SB, LPA and MVPA were associated with MPDs in hs-cTnT of 2.1 (0.7, 3.6), - 5.1 (- 8.3, - 1.7) and - 17.5 (- 22.9, - 11.7), respectively, whereas in those more active, LPA and MVPA were associated with MPDs of 4.1 (1.2, 7.2) and - 5.4 (- 8.7, - 2.0), respectively. No associations were found with NT-proBNP in women.
The relationship between movement behaviors and cardiac biomarkers in older adults without major CVD depends on sex, subclinical cardiac damage and PA level. More PA and less SB were generally related to lower cardiac biomarkers levels among less active individuals with subclinical cardiac damage, with greater benefits for hs-cTnT in women than men and no benefits for NT-proBNP in women.
高敏心肌肌钙蛋白T（hs-cTnT）和N末端脑钠肽前体（NT-proBNP）分别是心肌梗死和心力衰竭的生物标志物，提示心血管风险。由于低体力活动（PA）和久坐行为（SB）也与较高的心血管风险相关，且这种关联可能是心脏生物标志物水平升高的结果，我们研究了在无重大心血管疾病（CVD）的老年男性和女性中，通过设备测量的运动行为与hs-cTnT和NT-proBNP之间的关联。
我们使用了来自老年人-ENRICA-2研究的1939名老年人的数据。使用加速度计评估睡眠、SB、轻度PA（LPA）和中度至剧烈PA（MVPA）所花费的时间。根据性别、PA总时间中位数以及根据心脏生物标志物水平是否存在亚临床心脏损伤，在八个分层中分别拟合线性回归模型。
在亚临床心脏损伤且体力活动较少的男性中，每天多进行30分钟的MVPA与hs-cTnT的平均百分比差异（MPD）（95%置信区间）为-13.1（-18.3，-7.5）；SB每增加30分钟/天，NT-proBNP的MPD为5.8（2.7，8.9），LPA为-19.3（-25.4，-12.7），MVPA为-23.1（-30.7，-14.6）。在亚临床心脏损伤且体力活动较少的女性中，每天多进行30分钟的SB、LPA和MVPA与hs-cTnT的MPD分别为2.1（0.7，3.6）、-5.1（-8.3，-1.7）和-17.5（-22.9，-11.7），而在体力活动较多的女性中，LPA和MVPA的MPD分别为4.1（1.2，7.2）和-5.4（-8.7，-2.0）。在女性中未发现与NT-proBNP有关联。
在无重大CVD的老年人中，运动行为与心脏生物标志物之间的关系取决于性别、亚临床心脏损伤和PA水平。在亚临床心脏损伤且体力活动较少的个体中，更多的PA和更少的SB通常与较低的心脏生物标志物水平相关，对女性hs-cTnT的益处大于男性，对女性NT-proBNP则无益处。
