体力活动与成年人缺血性脑卒中发病关联的前瞻性研究

王浩; 谢开婿; 陈玲琍; 曹元; 沈钲杰; 吕筠; 余灿清; 孙点剑一; 裴培; 钟节鸣; 俞敏

Abstract

王浩,谢开婿,陈玲琍,曹元,沈钲杰,吕筠,余灿清,孙点剑一,裴培,钟节鸣,俞敏.体力活动与成年人缺血性脑卒中发病关联的前瞻性研究[J].Chinese journal of Epidemiology,2024,45(3):325-330

体力活动与成年人缺血性脑卒中发病关联的前瞻性研究

A prospective study of association between physical activity and ischemic stroke in adults

Received:September 04, 2023

DOI：10.3760/cma.j.cn112338-20230904-00125

KeyWord: 缺血性脑卒中体力活动前瞻性研究

English Key Word: Ischemic stroke Physical activity Prospective study

FundProject:国家自然科学基金（82192900，82192901，82192904，81390540，91846303）；国家重点研发计划“精准医学研究”重点专项（2016YFC0900500）；中国香港Kadoorie Charitable基金；英国Wellcome Trust（202922/Z/16/Z，088158/Z/09/Z，104085/Z/14/Z）

Author Name	Affiliation	E-mail
Wang Hao	Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Xie Kaixu	Department of Chronic and Non-communicable Disease Control and Prevention, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314599, China
Chen Lingli	Department of Chronic and Non-communicable Disease Control and Prevention, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314599, China
Cao Yuan	Department of Chronic and Non-communicable Disease Control and Prevention, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314599, China
Shen Zhengjie	Department of Chronic and Non-communicable Disease Control and Prevention, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314599, China
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China
Sun Dianjianyi	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China
Pei Pei	Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Zhong Jieming	Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Yu Min	Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China	myu@cdc.zj.cn

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Abstract:

目的探讨体力活动和成年人缺血性脑卒中发病的关联。方法使用中国慢性病前瞻性研究浙江省桐乡市数据，剔除基线时自报患有恶性肿瘤、心脏病、脑卒中和糖尿病患者后，纳入分析30~79岁53 916名研究对象。体力活动分组采用五分位数。采用Cox比例风险回归模型计算缺血性脑卒中发病风险比（HR）值。结果调查对象体力活动水平为（30.63±15.25）代谢当量（MET）-h/d，男性体力活动水平［（31.04±15.48）MET-h/d］高于女性［（30.33±15.07）MET-h/d ］（P<0.001）。调查对象累计随访595 526人年（平均随访11.4年）。随访期间，1 138名男性和1 082名女性被新诊断为缺血性脑卒中。在调整了社会人口学因素、行为生活方式、BMI、腰围和SBP等多种危险因素后，缺血性脑卒中发病风险随体力活动的增加而降低，趋势检验结果均有统计学意义（P<0.001）。与体力活动最低组（<16.17 MET-h/d）人群相比，中低组（16.17~24.94 MET-h/d）、中等组（24.95~35.63 MET-h/d）、中高组（35.64~43.86 MET-h/d）和最高组（≥43.87 MET-h/d）人群缺血性脑卒中发病HR值分别为0.93（95%CI：0.83~1.04）、0.87（95%CI：0.76~0.98）、0.82（95%CI：0.71~0.95）和0.76（95%CI：0.64~0.89）。结论增加体力活动可以降低缺血性脑卒中的发病风险。

English Abstract:

Objective To explore the prospective associations between physical activity and incident ischemic stroke in adults. Methods Data of China Kadoorie Biobank study in Tongxiang of Zhejiang were used. After excluding participants with cancers, strokes, heart diseases and diabetes at baseline study, a total of 53 916 participants aged 30-79 years were included in the final analysis. The participants were divided into 5 groups according to the quintiles of their physical activity level. Cox proportional hazard regression models was used to calculate the hazard ratios (HR) for the analysis on the association between baseline physical activity level and risk for ischemic stroke. Results The total physical activity level in the participants was (30.63±15.25) metabolic equivalent (MET)-h/d, and it was higher in men [(31.04±15.48) MET-h/d] than that in women [(30.33±15.07) MET-h/d] (P<0.001). In 595 526 person-years of the follow-up (average 11.4 years), a total of 1 138 men and 1 082 women were newly diagnosed with ischemic stroke. Compared to participants with the lowest physical activity level (<16.17 MET-h/d), after adjusting for socio-demographic factors, lifestyle, BMI, waist circumference, and SBP, the HRs for the risk for ischemic stroke in those with moderate low physical activity level (16.17-24.94 MET-h/d), moderate physical activity level (24.95-35.63 MET-h/d), moderate high physical activity level (35.64-43.86 MET-h/d) and the highest physical activity level (≥43.87 MET-h/d) were 0.93 (95%CI: 0.83-1.04), 0.87 (95%CI: 0.76-0.98), 0.82 (95%CI: 0.71-0.95) and 0.76 (95%CI: 0.64-0.89), respectively. Conclusion Improving physical activity level has an effect on reducing the risk for ischemic stroke.

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