Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100000, China.
Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, 100000, China.
Osteoporos Int. 2024 Dec;35(12):2195-2202. doi: 10.1007/s00198-024-07280-5. Epub 2024 Oct 10.
We utilized data from the NHANES to investigate the impact of physical activity on mortality in osteoporotic patients. Our study suggests that osteoporotic patients may require higher volumes of physical activity to reduce mortality risk compared to the general population. In osteoporotic patients, the dose-response relationships between physical activity volumes and both all-cause and cardiovascular mortality were linear. In contrast, these relationships were non-linear in participants without osteoporosis.
To determine the impact of physical activity on mortality in osteoporotic patients.
A total of 5606 participants were included in this study, including 716 osteoporosis patients. Physical activity was assessed using standardized questionnaire. Participants were categorized into four groups: inactive (no physical activity), low active (physical activity volumes < 150 min/week), moderate active (≥ 150 min/week but < 300 min/week), and high active (≥ 300 min/week). Multivariable Cox regression models, using the inactive group as the reference and adjusted for potential confounders, were performed to estimate the hazard ratio (HR) and 95% confidence interval (CI).
Osteoporotic patients demonstrated higher mortality rates attributed to various causes compared to non-osteoporosis participants. Physical activity was associated with lower mortality regardless of osteoporosis status. However, Multivariable Cox regression analysis indicated that among osteoporosis patients, only those engaging in ≥ 300 min/week physical activity experienced a significant decrease in mortality (all-cause mortality, HR (95% CI) 0.453 (0.268, 0.767) and cardiovascular mortality, HR (95% CI) 0.521 (0.259, 1.049)), surpassing the threshold of 150 min observed in non-osteoporosis patients. In sensitivity analysis, or when the proportion of vigorous physical activity was included as a confounder in the multivariate Cox regression analysis, only the high active group still showed a significant reduction in mortality. No significant interactions were observed when the analysis was stratified according to age, sex, and body mass index (P for interaction > 0.05). Restricted cubic spline analysis revealed a linear relationship between physical activity volume and all-cause mortality (P < 0.01 [overall] and P = 0.470 [non-linearity]) and cardiovascular-specific mortality (P = 0.003 [overall] and P = 0.610 [non-linearity]) in patients with osteoporosis. In contrast, these relationships were non-linear in participants without osteoporosis.
Patients with osteoporosis need to engage in ≥ 300 min/week physical activity to significantly reduce their mortality risk. And the higher the volume of physical activity, the lower the risk of death.
确定体力活动对骨质疏松症患者死亡率的影响。
本研究纳入了 5606 名参与者，包括 716 名骨质疏松症患者。使用标准化问卷评估体力活动。参与者分为四组：不活动（无体力活动）、低活动（体力活动量<150 分钟/周）、中活动（≥150 分钟/周但<300 分钟/周）和高活动（≥300 分钟/周）。使用多变量 Cox 回归模型，以不活动组为参照，并调整了潜在的混杂因素，估计了危险比（HR）和 95%置信区间（CI）。
与非骨质疏松症参与者相比，骨质疏松症患者的各种原因导致的死亡率更高。无论骨质疏松症状态如何，体力活动与较低的死亡率相关。然而，多变量 Cox 回归分析表明，在骨质疏松症患者中，只有那些进行≥300 分钟/周体力活动的患者死亡率显著降低（全因死亡率，HR（95%CI）0.453（0.268，0.767）和心血管死亡率，HR（95%CI）0.521（0.259，1.049）），超过了非骨质疏松症患者中观察到的 150 分钟阈值。在敏感性分析中，或当剧烈体力活动的比例被纳入多变量 Cox 回归分析的混杂因素时，只有高活动组仍显示出死亡率的显著降低。当根据年龄、性别和体重指数对分析进行分层时，没有观察到显著的交互作用（P 交互作用>0.05）。受限立方样条分析显示，体力活动量与全因死亡率（P<0.01[总体]和 P=0.470[非线性]）和心血管特异性死亡率（P=0.003[总体]和 P=0.610[非线性]）之间存在线性关系骨质疏松症患者。相比之下，这些关系在非骨质疏松症患者中是非线性的。
骨质疏松症患者需要进行≥300 分钟/周的体力活动，才能显著降低死亡率。而且，体力活动量越高，死亡风险越低。
