Siscovick D S, Fried L, Mittelmark M, Rutan G, Bild D, O'Leary D H
Department of Medicine, University of Washington, Harborview Medical Center, Seattle, USA.
Am J Epidemiol. 1997 Jun 1;145(11):977-86. doi: 10.1093/oxfordjournals.aje.a009066.
The authors assessed the cross-sectional association between intensity of exercise in later life and coronary heart disease risk factors and subclinical disease among 2,274 men and women, 65 years of age and older, who were participants in the Cardiovascular Health Study (CHS) during 1989-1990. Subjects were free of prior clinical cardiovascular disease or impairment of physical function. Exercise intensity was characterized as low, moderate, or high, based on highest intensity exercise reported over the 2 weeks prior to the CHS baseline examination. After adjustment for age, education, and postmenopausal hormone therapy (among women), there was an inverse dose-response relationship of exercise intensity with selected risk factors. By low, moderate, and high exercise intensity, respectively: fasting insulin-men, 15.6 microU/ml, 14.1 microU/ml, and 12.6 microU/ml, p for trend <0.001; women, 14.8 microU/ml, 13.8 microU/ml, and 12.0 microU/ml, p for trend = 0.01; serum fibrinogen-men, 316.2 mg/dl, 315.4 mg/dl, and 300.0 mg/dl, p for trend = 0.01; women, 327.3 mg/dl, 317.0 mg/dl, and 310.7 mg/dl, p for trend = 0.01; lower extremity arterial disease by percent with ankle-arm index <0.9-men, 18.3, 5.5, and 3.7, p for trend = 0.01; women, 10.0, 5.7, and 2.8, p for trend = 0.02; evidence of myocardial injury by cardiac infarction/injury score (CIIS)-men, 8.0, 6.0, 3.9, p for trend <0.001; women, 4.6, 3.9, and 3.6, p for trend = 0.03. Adjustment for smoking, alcohol consumption, and total kilocalories expended in exercise altered the findings only slightly. The authors conclude that intensity of exercise in later life is associated with favorable coronary disease risk factor levels and a reduced prevalence of several markers of subclinical disease.
作者评估了1989年至1990年期间参与心血管健康研究（CHS）的2274名65岁及以上男性和女性晚年运动强度与冠心病危险因素及亚临床疾病之间的横断面关联。研究对象既往无临床心血管疾病或身体功能损害。根据CHS基线检查前2周报告的最高强度运动，将运动强度分为低、中、高三个等级。在调整年龄、教育程度和绝经后激素治疗（女性）后，运动强度与选定的危险因素之间存在剂量反应负相关关系。分别按低、中、高运动强度来看：空腹胰岛素——男性分别为15.6微单位/毫升、14.1微单位/毫升和12.6微单位/毫升，趋势p<0.001；女性分别为14.8微单位/毫升、13.8微单位/毫升和12.0微单位/毫升，趋势p=0.01；血清纤维蛋白原——男性分别为316.2毫克/分升、315.4毫克/分升和300.0毫克/分升，趋势p=0.01；女性分别为327.3毫克/分升、317.0毫克/分升和310.7毫克/分升，趋势p=0.01；踝臂指数<0.9的下肢动脉疾病患病率（百分比）——男性分别为18.3、5.5和3.7，趋势p=0.01；女性分别为10.0、5.7和2.8，趋势p=0.02；心肌梗死/损伤评分（CIIS）显示的心肌损伤证据——男性分别为8.0、6.0、3.9，趋势p<0.001；女性分别为4.6、3.9和3.6，趋势p=0.03。对吸烟、饮酒和运动消耗的总千卡数进行调整后，研究结果仅略有改变。作者得出结论，晚年运动强度与有利的冠心病危险因素水平以及几种亚临床疾病标志物的患病率降低有关。
