Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Children's Health and Exercise Research Centre, Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
J Hum Hypertens. 2024 May;38(5):393-403. doi: 10.1038/s41371-024-00905-6. Epub 2024 Feb 26.
This study examined the mediating effect of total body fat mass, lean mass, blood pressure (BP) and insulin resistance on the associations of sedentary time (ST), light physical activity (LPA) and moderate-to-vigorous PA (MVPA) with carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT) and carotid elasticity in 1574 adolescents from the Avon Longitudinal Study of Parents and Children birth cohort, UK. ST, LPA and MVPA were assessed with ActiGraph accelerometer. ST and LPA were sex-categorised in tertiles as low (reference), moderate and high, while MVPA was categorised as <40 min/day (reference), 40-<60 min/day and ≥60 min/day. cfPWV, cIMT and carotid elasticity were measured with Vicorder and ultrasound. Fat mass and lean mass were assessed with dual-energy X-ray absorptiometry and homeostatic model assessment of insulin resistance (HOMA-IR) was computed. Mediation analyses structural equation models and linear mixed-effect models adjusted for cardiometabolic and lifestyle factors were conducted. Among 1574 adolescents [56.2% female; mean (SD) age 15.4 (0.24) years], 41% males and 17% females accumulated ≥60 min/day of MVPA. Higher ST was associated with lower cIMT partly mediated by lean mass. Higher LPA (standardized β = -0.057; [95% CI -0.101 to -0.013; p = 0.014]) and the highest LPA tertile were associated with lower cfPWV. BP had no significant mediating effect movement behaviour relations with vascular indices. Lean mass partially mediated associations of higher MVPA with higher cIMT (0.012; [0.007-0.002; p = 0.001], 25.5% mediation) and higher carotid elasticity (0.025; [0.014-0.039; p = 0.001], 28.1% mediation). HOMA-IR mediated the associations of higher MVPA with higher carotid elasticity (7.7% mediation). Engaging in ≥60 min/day of MVPA was associated with higher carotid elasticity. In conclusion, higher LPA was associated with lower arterial stiffness, but higher MVPA was associated with thicker carotid wall explained by higher lean mass.
这项研究考察了总体脂肪量、瘦体重、血压（BP）和胰岛素抵抗在久坐时间（ST）、低强度体力活动（LPA）和中高强度体力活动（MVPA）与颈动脉-股动脉脉搏波速度（cfPWV）、颈动脉内膜中层厚度（cIMT）和颈动脉弹性之间的关联中的中介作用，1574 名青少年来自英国阿冯纵向研究父母和孩子出生队列。ST、LPA 和 MVPA 使用 ActiGraph 加速度计进行评估。ST 和 LPA 按三分位法分为低（参考）、中、高，而 MVPA 则分为<40min/天（参考）、40-<60min/天和≥60min/天。cfPWV、cIMT 和颈动脉弹性使用 Vicorder 和超声进行测量。脂肪量和瘦体重使用双能 X 射线吸收法进行评估，稳态模型评估的胰岛素抵抗（HOMA-IR）计算得出。进行中介分析结构方程模型和调整心血管代谢和生活方式因素的线性混合效应模型。在 1574 名青少年中[56.2%女性；平均（SD）年龄 15.4（0.24）岁]，41%的男性和 17%的女性积累了≥60min/天的 MVPA。较高的 ST 与较低的 cIMT 相关，这部分是由瘦体重介导的。较高的 LPA（标准化β=-0.057；[95%CI-0.101 至-0.013；p=0.014]）和最高的 LPA 三分位数与较低的 cfPWV 相关。血压（BP）对运动行为与血管指数的关系没有显著的中介作用。瘦体重部分介导了较高的 MVPA 与较高的 cIMT（0.012；[0.007-0.002；p=0.001]，25.5%的中介作用）和较高的颈动脉弹性（0.025；[0.014-0.039；p=0.001]，28.1%的中介作用）的关联。HOMA-IR 介导了较高的 MVPA 与较高的颈动脉弹性之间的关联（7.7%的中介作用）。进行≥60min/天的 MVPA 与较高的颈动脉弹性相关。总之，较高的 LPA 与较低的动脉僵硬度相关，而较高的 MVPA 与较高的瘦体重相关，导致颈动脉壁较厚。
