文章摘要
周婷钰,苏健,周金意,陶然,陆艳,华钰洁,金建荣,郭彧,吕筠,陈铮鸣,李立明,武鸣.高血压人群体力活动在休闲静坐行为与肥胖指标间的中介效应[J].中华流行病学杂志,2021,42(12):2125-2130
高血压人群体力活动在休闲静坐行为与肥胖指标间的中介效应
Mediating effect of physical activity on association between sedentary leisure-time and obesity indexes among hypertensive individuals
收稿日期:2021-01-12  出版日期:2021-12-16
DOI:10.3760/cma.j.cn112338-20210112-00031
中文关键词: 高血压;体力活动;休闲静坐行为;肥胖;中介效应
英文关键词: Hypertension;Physical activity;Sedentary leisure-time;Obesity;Mediating effect
基金项目:国家重点研发计划精准医学研究重点专项(2016YFC0900500,2016YFC0900501);中国香港Kadoorie Charitable基金;英国Wellcome Trust(202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z)
作者单位E-mail
周婷钰 常州市疾病预防控制中心 213000
南京医科大学公共卫生学院流行病与卫生统计学系 211166 
 
苏健 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009  
周金意 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009  
陶然 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009  
陆艳 苏州市疾病预防控制中心慢性非传染病防制科 215004  
华钰洁 苏州市疾病预防控制中心慢性非传染病防制科 215004  
金建荣 苏州市吴中区疾病预防控制中心 215100  
郭彧 中国医学科学院中国慢性病前瞻性研究办公室, 北京 102308  
吕筠 北京大学公共卫生学院 100191  
陈铮鸣 英国牛津大学临床与流行病学研究中心, 牛津OX3 7LF  
李立明 北京大学公共卫生学院 100191 lmlee@pumc.edu.cn 
武鸣 南京医科大学公共卫生学院流行病与卫生统计学系 211166
江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 
jswuming@vip.sina.com 
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中文摘要:
      目的 探索高血压人群体力活动在休闲静坐行为与肥胖指标关联的中介效应。方法 基于中国慢性病前瞻性研究项目(CKB)苏州市吴中区基线数据,选择高血压人群并剔除自报患冠心病、脑卒中和肿瘤等慢性疾病的个体,最终纳入分析20 178人。采用中介效应模型分析静坐行为与肥胖指标关联中体力活动的中介效应。结果 调整年龄、性别、吸烟、饮酒、文化程度、肉类摄入、新鲜水果摄入等因素后,休闲静坐行为与体力活动呈负相关(β=-0.246,P<0.001);与肥胖指标如体脂比(β=0.061,P<0.001)、腰围(β=0.087,P<0.001)和BMI(β=0.071,P<0.001)呈正相关。纳入中介变量体力活动后,休闲静坐行为对肥胖指标的直接作用仍有统计学意义;控制休闲静坐行为后,体力活动与体脂比、腰围和BMI呈负相关(β值分别为-0.052,-0.083和-0.028,均P<0.001)。中介效应分析显示,体力活动在休闲静坐行为对体脂比、腰围和BMI的影响中均存在部分中介效应,中介效应占其总效应的比例分别为20.820%,23.421%和9.915%。对性别分层分析后,体力活动的中介效应在男女性中不相同,女性体力活动在休闲静坐行为与各肥胖指标间存在中介效应,而男性体力活动在休闲静坐行为与体脂比和腰围的关联中存在中介效应。结论 体力活动在休闲静坐行为对肥胖指标的影响中均具有部分中介效应,高血压人群应增加体力活动水平,减少长时间休闲静坐以获得较好的健康效果。
英文摘要:
      Objective To explore the mediating effect of physical activity on association between sedentary leisure-time and obesity indexes among hypertensive individuals. Methods After excluding of those with a prior history of heart disease, stroke and cancer, a total of 20 178 hypertensive participants in the China Kadooire Biobank (CKB) study from Wuzhong district of Suzhou city were included. Mediating effect analysis was used to analyze the mediating effect of physical activity (PA) on correlation between sedentary leisure-time and body fat percentage (BFP), waist circumference (WC) and body mass index (BMI). Results After adjusted for age, gender, smoking status, alcohol consumption, education levels, intake frequencies of meat and intake frequencies of fresh fruit, sedentary leisure-time (SLT) was negatively correlated with PA (β=-0.246, P<0.001), but positively associated with BFP (β=0.061, P<0.001), WC (β=0.087, P<0.001) and BMI (β=0.071, P<0.001). After including the mediator variable PA, the direct effect of SLT on obesity index was still significant. PA was negatively correlated with BFP, WC and BMI (β=-0.052, -0.083 and -0.028, respectively, P<0.001). Analysis of mediating effect indicated that the association of SLT with BFP, WC and BMI were partly mediated by PA, the proportion of mediating effect was 20.820%, 23.421% and 9.915%. Stratified by gender, PA had mediating effect on SLT and all obesity indexes in women, while only on SLT and BFP and WC in men.Conclusions There is a significant mediating effect of PA on correlation between SLT and obesity indexes among hypertensive individuals. Hypertensive patients should increase the level of physical activity and reduce sedentary behavior to achieve a profounder healthy effect.
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