Department of Big Data in Health Science, Zhejiang University School of Public Health and Sir Run Run Shaw Hospital (H.W., J.W., S.W., X.T.), Zhejiang University School of Medicine, Hangzhou, China.
Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, China (H.W., J.W., S.W., X.T.).
Arterioscler Thromb Vasc Biol. 2024 Sep;44(9):e227-e237. doi: 10.1161/ATVBAHA.124.321214. Epub 2024 Aug 1.
Metabolic dysfunction-associated fatty liver disease is a significant risk factor for cardiovascular disease (CVD). This study assesses the association between leisure-time physical activity, sedentary behavior, and CVD risk among patients with metabolic dysfunction-associated fatty liver disease, considering genetic predisposition to CVD.
This cohort study included 157 794 participants with metabolic dysfunction-associated fatty liver disease from the UK Biobank who were free of CVD at baseline. The study measured leisure-time sedentary behaviors (watching TV, using a computer, and driving) and physical activities (walking for pleasure, light and heavy do-it-yourself activities, strenuous sports, and other exercises) in terms of frequency and duration over the 4 weeks before assessment. Both a Cox proportional hazard model and an isotemporal substitution model were utilized in the study to assess the association between leisure sedentary behavior, physical activities, and CVD risk.
During a median 12.5 years of follow-up, 26 355 CVD cases were reported, including 19 746 coronary heart disease, 4836 stroke, and 7398 heart failure cases. High physical activity levels were linked to a significantly lower risk of CVD (21%), coronary heart disease (20%), stroke (15%), and heart failure (31%). In contrast, individuals with >6.5 h/d of sedentary behavior faced a 16% to 21% higher risk of these conditions compared with those with ≤3.5 h/d. Notably, replacing 30 minutes of inactivity with physical activity reduced CVD risks by 3% to 16%, particularly with strenuous sports. A significant interaction was observed between physical activity, sedentary behavior, and genetic predisposition in relation to stroke risk.
Among patients with metabolic dysfunction-associated fatty liver disease, higher leisure-time physical activity levels correlate with reduced CVD risks, while increased sedentary behavior is linked to higher CVD risks. Replacing sedentary time with physical activity consistently shows benefits in reducing CVD outcomes, irrespective of genetic predisposition.
代谢功能障碍相关脂肪性肝病是心血管疾病（CVD）的重要危险因素。本研究评估了考虑 CVD 遗传易感性的情况下，代谢功能障碍相关脂肪性肝病患者的休闲时间体力活动、久坐行为与 CVD 风险之间的关系。
本队列研究纳入了来自英国生物库的 157794 名代谢功能障碍相关脂肪性肝病患者，这些患者在基线时无 CVD。研究通过在评估前的 4 周内测量休闲时间久坐行为（看电视、使用电脑和开车）和体力活动（散步娱乐、轻体力和重体力 DIY 活动、剧烈运动和其他运动）的频率和持续时间来评估其与 CVD 风险的关系。研究采用 Cox 比例风险模型和等时替代模型来评估休闲久坐行为、体力活动与 CVD 风险之间的关系。
在中位 12.5 年的随访期间，共报告了 26355 例 CVD 病例，包括 19746 例冠心病、4836 例卒中和 7398 例心力衰竭。高水平的体力活动与 CVD（20%）、冠心病（20%）、卒中和心力衰竭（31%）风险显著降低相关。相比之下，与每天久坐时间≤3.5 小时的人相比，每天久坐时间＞6.5 小时的人患这些疾病的风险增加了 16%到 21%。值得注意的是，用体力活动替代 30 分钟的不活动时间可使 CVD 风险降低 3%至 16%，尤其是剧烈运动。在体力活动、久坐行为和遗传易感性与卒中风险之间观察到显著的交互作用。
在代谢功能障碍相关脂肪性肝病患者中，较高的休闲时间体力活动水平与降低 CVD 风险相关，而增加的久坐行为与较高的 CVD 风险相关。用体力活动替代久坐时间始终显示出降低 CVD 结局的益处，而与遗传易感性无关。
