活动、久坐行为和睡眠行为与中老年人群中普遍存在的脂肪性肝病的关联：巴西ELSA研究
Associations of activity, sedentary and sleep behaviors with prevalent steatotic liver disease in middle-aged and older adults: the ELSA-Brasil study.
作者信息
de Paula Danilo, Feter Natan, Dos Reis Rodrigo Citton Padilha, Griep Rosane Harter, Duncan Bruce Bartholow, Schmidt Maria Inês
机构信息
Department of Epidemiology, Universidade Federal do Rio Grande do Sul, 2400 Ramiro Barcelos St.-2nd floor, Porto Alegre, Rio Grande Do Sul, 90035-003, Brazil.
Center for Clinical Research, Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos St.-Building 21, 4 Floor, Porto Alegre, Rio Grande do sul, 90035-003, Brazil.
出版信息
J Act Sedentary Sleep Behav. 2024 Jul 3;3(1):16. doi: 10.1186/s44167-024-00055-7.
BACKGROUND
Steatotic liver disease (SLD) is a prevalent metabolic disease. While single component movement behaviors have been related to its development, comprehensive assessments of their joint associations are scarce.
OBJECTIVE
To investigate the single-component and multi-component associations of moderate and vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep with prevalent SLD in Brazilian adults.
METHODS
A cross-sectional analysis using data from the third wave of the ELSA-Brasil cohort (2017-2019). Participants wore an ActiGraph wGT3X-BT in the waist for seven days and completed a sleep diary. SLD was defined by a Fatty Liver Index ≥ 60. To investigate single-component and multi-component associations, we used three exposure modeling approaches based on Poisson models: multivariable-adjusted regression, restricted cubic splines, and compositional data analysis.
RESULTS
Among 8569 participants (55.7% women, mean age 59.2 ± 8.60), 43.9% had SLD. Total activity volume adjusted for covariates was inversely associated with prevalent SLD. Every 1 mg/day increase in total activity volume was associated with a PR of 0.95 in individuals sleeping < 7 h/day (95% CI 0.94-0.97) and 0.95 (95% CI 0.93-0.96) in those sleeping ≥ 7 h/day. Increasing 30 min/day of MVPA was associated with decreasing prevalence of SLD (sleep ≥ 7 h/day [PR 0.83; 95% CI 0.77-0.89]; sleep ≥ 7 h/day [PR 0.78; 95% CI 0.74-0.83]). Sleep, SB, and LPA were not associated with SLD. Associations of total activity volume and MVPA were more pronounced among females. Adjustment with adiposity markers attenuated the associations.
CONCLUSIONS
In adults, total activity volume and MVPA were inversely associated with SLD in a dose-response fashion. Substituting lower-intensity behaviors with MVPA was associated with a lower prevalence of SLD independent of sleep duration, sex, and age.
背景
脂肪性肝病（SLD）是一种常见的代谢性疾病。虽然单一成分的运动行为与其发展有关，但其联合关联的综合评估却很少见。
目的
研究巴西成年人中，中度和剧烈身体活动（MVPA）、轻度身体活动（LPA）、久坐行为（SB）以及睡眠与普遍存在的SLD之间的单一成分和多成分关联。
方法
采用ELSA-Brasil队列第三波（2017-2019年）的数据进行横断面分析。参与者在腰部佩戴ActiGraph wGT3X-BT七天，并完成一份睡眠日记。SLD由脂肪肝指数≥60定义。为了研究单一成分和多成分关联，我们使用了基于泊松模型的三种暴露建模方法：多变量调整回归、受限立方样条和成分数据分析。
结果
在8569名参与者（55.7%为女性，平均年龄59.2±8.60岁）中，43.9%患有SLD。经协变量调整后的总活动量与普遍存在的SLD呈负相关。在每天睡眠<7小时的个体中，总活动量每增加1毫克/天，患病率比值（PR）为0.95（95%置信区间0.94-0.97）；在每天睡眠≥7小时的个体中，PR为0.95（95%置信区间0.93-0.96）。每天增加30分钟的MVPA与SLD患病率降低相关（睡眠≥7小时/天[PR 0.83；95%置信区间0.77-0.89]；睡眠≥7小时/天[PR 0.78；95%置信区间0.74-0.83]）。睡眠、SB和LPA与SLD无关。总活动量和MVPA的关联在女性中更为明显。用肥胖标志物进行调整减弱了这种关联。
结论
在成年人中，总活动量和MVPA与SLD呈剂量反应关系。用MVPA替代低强度行为与较低的SLD患病率相关，且不受睡眠时间、性别和年龄的影响。
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