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持续体力活动和缺乏运动对儿童及青年成人冠心病危险因素的影响。芬兰青年人心血管风险研究。

Effects of persistent physical activity and inactivity on coronary risk factors in children and young adults. The Cardiovascular Risk in Young Finns Study.

作者信息

Raitakari O T, Porkka K V, Taimela S, Telama R, Räsänen L, Viikari J S

机构信息

Cardiorespiratory Research Unit, University of Turku, Finland.

出版信息

Am J Epidemiol. 1994 Aug 1;140(3):195-205. doi: 10.1093/oxfordjournals.aje.a117239.

Abstract

The tracking of physical activity and its influence on selected coronary heart disease risk factors were studied in a 6-year (original survey in 1980, with follow-ups in 1983 and 1986) study of Finnish adolescents and young adults as part of the Cardiovascular Risk in Young Finns Study. The subjects in this analysis were aged 12, 15, and 18 years at baseline. Physical activity was assessed with a standardized questionnaire, and a sum index was derived from the product of intensity, frequency, and duration of leisure time physical activity. Complete data on physical activity index from each study year were available on 961 participants. Significant tracking of physical activity was observed with 3-year correlations of the index ranging from 0.35 to 0.54 in boys and from 0.33 to 0.39 in girls. Tracking was better in older age groups. Two groups of adolescents (active and sedentary groups) were formed at baseline according to high and low values of the index, respectively. Approximately 57% of those classified as inactive remained inactive after a 6-year follow-up. The corresponding value for active subjects was 44% (p < 0.01, active vs. inactive). The long-term effects of physically active and sedentary life-styles were studied by comparing groups of young adults who had remained active or inactive in every three examinations. Serum insulin and serum triglyceride concentrations were significantly lower in active young men. They had a more beneficial high density lipoprotein to total cholesterol ratio and thinner subscapular skinfolds. Among young women, significant differences were seen in adiposity (subscapular skinfold) and in serum triglyceride concentration. Physical activity was also related to less smoking in both sexes and, among young men, to lower consumption of saturated fatty acids and to higher polyunsaturated to saturated fatty acids ratio of the diet. In regression analyses adjusted for the 6-year change in obesity, smoking status, and diet, the change in physical activity was inversely associated with changes in serum insulin and triglycerides in boys. Independent association with triglycerides disappeared when insulin change was added to the model, suggesting that the effect may partly be mediated through insulin metabolism. The authors conclude that the level of physical activity tracks significantly from adolescence to young adulthood. Physical inactivity shows better tracking than does physical activity, and subjects who are constantly inactive express a less beneficial coronary risk profile compared with those who are constantly active.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

作为芬兰年轻人心血管风险研究的一部分,在一项为期6年(1980年进行初始调查,1983年和1986年进行随访)的针对芬兰青少年和年轻人的研究中,对身体活动的追踪及其对选定的冠心病危险因素的影响进行了研究。本分析中的受试者在基线时年龄分别为12岁、15岁和18岁。通过标准化问卷评估身体活动情况,并根据休闲时间身体活动的强度、频率和持续时间的乘积得出一个综合指数。961名参与者提供了各研究年份完整的身体活动指数数据。观察到身体活动有显著的追踪现象,该指数在男孩中的3年相关性为0.35至0.54,在女孩中为0.33至0.39。年龄较大的组追踪情况更好。根据指数的高值和低值在基线时分别形成两组青少年(活跃组和久坐组)。在6年随访后,约57%被归类为不活跃的人仍保持不活跃状态。活跃受试者的相应比例为44%(p<0.01,活跃组与不活跃组相比)。通过比较在每三次检查中都保持活跃或不活跃的年轻成人组,研究了积极和久坐生活方式的长期影响。活跃的年轻男性血清胰岛素和血清甘油三酯浓度显著较低。他们的高密度脂蛋白与总胆固醇比值更有利,肩胛下皮肤褶厚度更薄。在年轻女性中,在肥胖程度(肩胛下皮肤褶)和血清甘油三酯浓度方面存在显著差异。身体活动在两性中也与较少吸烟有关,在年轻男性中,与较低的饱和脂肪酸摄入量以及饮食中较高的多不饱和脂肪酸与饱和脂肪酸比值有关。在针对肥胖、吸烟状况和饮食的6年变化进行调整的回归分析中,身体活动的变化与男孩血清胰岛素和甘油三酯的变化呈负相关。当将胰岛素变化添加到模型中时,与甘油三酯的独立关联消失,这表明该效应可能部分通过胰岛素代谢介导。作者得出结论,身体活动水平从青春期到年轻成年期有显著的追踪现象。身体不活动的追踪情况比身体活动更好,与持续活跃的受试者相比,持续不活动的受试者表现出更不利的冠心病风险特征。(摘要截选至400字)

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