Mayo Clinic College of Medicine and Science Phoenix AZ.
Mayo Clinic Artificial Intelligence Laboratory Rochester MN.
J Am Heart Assoc. 2024 Jun 4;13(11):e032965. doi: 10.1161/JAHA.123.032965. Epub 2024 May 31.
The goal was to compare patterns of physical activity (PA) behaviors (sedentary behavior [SB], light PA, moderate-to-vigorous PA [MVPA], and sleep) measured via accelerometers for 7 days between patients with incident cerebrovascular disease (CeVD) (n=2141) and controls (n=73 938).
In multivariate models, cases spent 3.7% less time in MVPA (incidence rate ratio [IRR], 0.963 [95% CI, 0.929-0.998]) and 1.0% more time in SB (IRR, 1.010 [95% CI, 1.001-1.018]). Between 12 and 24 months before diagnosis, cases spent more time in SB (IRR, 1.028 [95% CI, 1.001-1.057]). Within the year before diagnosis, cases spent less time in MVPA (IRR, 0.861 [95% CI, 0.771-0.964]). Although SB time was not associated with CeVD risk, MVPA time, both total min/d (hazard ratio [HR], 0.998 [95% CI, 0.997-0.999]) and guideline threshold adherence (≥150 min/wk) (HR, 0.909 [95% CI, 0.827-0.998]), was associated with decreased CeVD risk. Comorbid burden had a significant partial mediation effect on the relationship between MVPA and CeVD. Cases slept more during 12:00 to 17:59 hours (IRR, 1.091 [95% CI, 1.002-1.191]) but less during 0:00 to 5:59 hours (IRR, 0.984 [95% CI, 0.977-0.992]). No between-group differences were significant at subgroup analysis.
Daily behavior patterns were significantly different in patients before CeVD. Although SB was not associated with CeVD risk, the association between MVPA and CeVD risk is partially mediated by comorbid burden. This study has implications for understanding observable behavior patterns in cerebrovascular dysfunction and may help in developing remote monitoring strategies to prevent or reduce cerebrovascular decline.
本研究旨在比较通过加速度计测量的 7 天内，初发脑血管疾病（CeVD）患者（n=2141）与对照组（n=73938）的体力活动（PA）行为（久坐行为[SB]、低强度 PA、中高强度 PA[MVPA]和睡眠）模式。
在多变量模型中，病例组的 MVPA 时间减少了 3.7%（发生率比[IRR]，0.963[95%CI，0.929-0.998]），SB 时间增加了 1.0%（IRR，1.010[95%CI，1.001-1.018]）。在诊断前 12-24 个月，病例组 SB 时间增加（IRR，1.028[95%CI，1.001-1.057]）。在诊断前 1 年内，病例组 MVPA 时间减少（IRR，0.861[95%CI，0.771-0.964]）。虽然 SB 时间与 CeVD 风险无关，但 MVPA 时间（总分钟/天，HR，0.998[95%CI，0.997-0.999]）和指南阈值达标（≥150 分钟/周）（HR，0.909[95%CI，0.827-0.998]）与 CeVD 风险降低相关。合并症负担对 MVPA 与 CeVD 之间的关系具有显著的部分中介作用。病例组在 12:00 至 17:59 小时睡眠时间增加（IRR，1.091[95%CI，1.002-1.191]），而在 0:00 至 5:59 小时睡眠时间减少（IRR，0.984[95%CI，0.977-0.992]）。亚组分析中，两组间无显著差异。
在 CeVD 发生前，患者的日常行为模式存在显著差异。虽然 SB 与 CeVD 风险无关，但 MVPA 与 CeVD 风险之间的关联部分由合并症负担介导。本研究对理解脑血管功能障碍中的可观察行为模式具有重要意义，可能有助于制定远程监测策略以预防或减少脑血管下降。
