Bai Pufei, Zhou Saijun, Shao Xian, Lin Yao, Liu Hongyan, Yu Pei
NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300134, China; Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin 300134, China.
NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300134, China; Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin 300134, China.
Int J Cardiol. 2024 Mar 15;399:131770. doi: 10.1016/j.ijcard.2024.131770. Epub 2024 Jan 9.
Physical activity (PA) is associated with mortality and cardiovascular disease (CVD). However, the effect of circadian PA trajectories remains ambiguous. This study aimed to explore ideal circadian PA patterns to reduce mortality and CVD, and potential mediators.
502,400 participants from UK Biobank were recruited between 2006 and 2010. Among them, 102,323 participants got valid continuously capturing acceleration data over 7 days by wrist-worn accelerometer. K-means cluster analysis was used to identify PA trajectories. The associations of PA with all-cause, cause-specific mortality and CVD were assessed by cox regression. A sensitivity test was also conducted, starting from the time of acceleration collection and excluding participants with corresponding disease prior to it. Furthermore, the mediation of aging and inflammation were explored.
During a median follow-up of 12.9 years, 3482 deaths were recorded (704 were due to CVD). Five distinct PA trajectories were identified: Persistently Low, Moderate and Stable, Single Increase, Double Increase, and Vigorous patterns. Ideal PA trajectory patterns offered progressively protective benefits against all-cause, CVD caused mortality and CVD, especially in Double Increase and Vigorous patterns. Other cause-specific mortality and renal failure incidence showed similar trend. The sensitivity result was consistent. The mediating effects of phenotypic age and inflammation markers were statistically significant.
Ideal PA trajectories offered protective benefits against all-cause, cause-specific mortality and CVD. The protection was associated with both intensity and circadian distribution. Double Increase and Vigorous activity patterns decreased these risks more significantly. Crucially, this protection was mediated by aging deceleration and inflammation regulation.
身体活动（PA）与死亡率和心血管疾病（CVD）相关。然而，昼夜节律性PA轨迹的影响仍不明确。本研究旨在探索理想的昼夜节律性PA模式以降低死亡率和CVD，并探究潜在的中介因素。
2006年至2010年期间招募了来自英国生物银行的502,400名参与者。其中，102,323名参与者通过佩戴在手腕上的加速度计获得了连续7天有效的加速度数据。采用K均值聚类分析来识别PA轨迹。通过Cox回归评估PA与全因、特定病因死亡率及CVD之间的关联。还进行了一项敏感性测试，从加速度数据收集时间开始，并排除在此之前患有相应疾病的参与者。此外，还探究了衰老和炎症的中介作用。
在中位随访12.9年期间，记录了3482例死亡（704例死于CVD）。识别出五种不同的PA轨迹：持续低水平、中等且稳定、单次增加、两次增加和剧烈模式。理想的PA轨迹模式对全因、CVD导致的死亡率和CVD具有逐步的保护作用，尤其是在两次增加和剧烈模式中。其他特定病因死亡率和肾衰竭发病率也呈现类似趋势。敏感性结果一致。表型年龄和炎症标志物的中介作用具有统计学意义。
理想的PA轨迹对全因、特定病因死亡率和CVD具有保护作用。这种保护作用与强度和昼夜分布均有关。两次增加和剧烈活动模式更显著地降低了这些风险。关键的是，这种保护作用是通过减缓衰老和调节炎症来介导的。
