心肺适能与年龄相关疾病之间的观察性及遗传关联：英国生物银行研究中的纵向分析
Observational and genetic associations between cardiorespiratory fitness and age-related diseases: longitudinal analyses in the UK Biobank study.
作者信息
Lu Huimin, Wang Haotian, Li Cancan, Meng Xiaoni, Zheng Deqiang, Wu Lijuan, Wang Youxin
机构信息
Department of Epidemiology and Health StatisticsSchool of Public HealthFengtai District, Capital Medical University, 10 Youanmen, Beijing, 100069 China.
School of Public Health, North China University of Science and Technology, 21 Bohaidadao, Tangshan, 063210 Caofeidian China.
出版信息
EPMA J. 2024 Nov 6;15(4):629-641. doi: 10.1007/s13167-024-00382-4. eCollection 2024 Dec.
BACKGROUND
Observational studies have indicated that increased cardiorespiratory fitness is associated with a decreased risk of cardiovascular disease (CVD), Alzheimer's disease (AD), and Parkinson's disease (PD). However, the causal mechanisms remain unclear. The objective of this study was to assess the role of fitness in the early detection and reduction of disease risk within the framework of predictive, preventive, and personalized medicine (PPPM/3PM).
METHODS
The associations of fitness with CVD, AD, and PD were explored in a large cohort of up to 502,486 individuals between the ages of 40 and 69 years from the UK Biobank. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of CVD, AD, and PD among participants who completed a submaximal fitness test. Causality relationships were assessed via two-sample Mendelian randomization (MR).
RESULTS
After a median of 11 years of follow-up, each 3.5 ml of O⋅min⋅kg increase in total body mass (equivalent to 1 metabolic equivalent of task (MET), approximately 0.5 standard deviations (SDs)) was associated with decreased risks of CVD (20.0%, 95% CI 17.6-22.3%), AD (31.9%, 95% CI 26.7-33.6%), and PD (21.2%, 95% CI 11.2-31.8%). After adjusting for obesity, the observational associations were attenuated. According to the MR analyses, fitness was associated with PD (OR 0.937, 95% CI 0.897-0.978) and small vessel stroke (OR 0.964, 95% CI 0.933-0.995).
CONCLUSION
Our results indicate that fitness has an effect on age-related diseases. Protective associations of higher fitness levels with the risk of CVD, AD, and PD were validated in this cohort study. These findings might be valuable for predicting, preventing, and reducing disease morbidity and mortality through primary prevention and healthcare in the context of PPPM.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s13167-024-00382-4.
背景
观察性研究表明，心肺适能的提高与心血管疾病（CVD）、阿尔茨海默病（AD）和帕金森病（PD）风险的降低有关。然而，其因果机制仍不清楚。本研究的目的是在预测、预防和个性化医学（PPPM/3PM）框架内评估适能在疾病早期检测和降低疾病风险中的作用。
方法
在英国生物银行中，对年龄在40至69岁之间的多达502,486人的大型队列进行了适能与CVD、AD和PD之间关联的探索。采用Cox比例风险模型估计完成次极量适能测试的参与者中CVD、AD和PD风险的风险比（HRs）及95%置信区间（CIs）。通过两样本孟德尔随机化（MR）评估因果关系。
结果
经过中位数为11年的随访，每增加3.5毫升氧·分钟·千克的总体重（相当于1代谢当量任务（MET），约0.5标准差（SDs））与CVD风险降低（20.0%，95%CI 17.6 - 22.3%）、AD风险降低（31.9%，95%CI 26.7 - 33.6%）和PD风险降低（21.2%，95%CI 11.2 - 31.8%）相关。在调整肥胖因素后，观察到的关联减弱。根据MR分析，适能与PD（比值比[OR] 0.937，95%CI 0.897 - 0.978）和小血管性卒中（OR 0.964，95%CI 0.933 - 0.995）相关。
结论
我们的结果表明适能对与年龄相关的疾病有影响。在这项队列研究中验证了较高适能水平与CVD、AD和PD风险之间的保护关联。这些发现对于在PPPM背景下通过一级预防和医疗保健预测、预防和降低疾病发病率及死亡率可能具有重要价值。
补充信息
在线版本包含可在10.1007/s13167 - 024 - 00382 - 4获取的补充材料。
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