【作者】
武亚飞；
秦贵军；
王桂侠；
刘礼斌；
陈兵；
管庆波；
袁中尚；
侯旭；
高聆；
徐潮；
张海清；
张栩；
李秋；
宋勇峰；
景斐；
马世瞻；
邵珊珊；
赵萌；
郭庆玲；
童南伟；
赵红燕；
谢晓敏；
刘超；
单忠艳；
成志锋；
余学峰；
陈述林；
杨涛；
王颜刚；
李冬梅；
闫朝丽；
郭立新；
姬秋和；
王文绢；
赵家军；
【Author】
Yafei Wu;Guijun Qin;Guixia Wang;Libin Liu;Bing Chen;Qingbo Guan;Zhongshang Yuan;Xu Hou;Ling Gao;Chao Xu;Haiqing Zhang;Xu Zhang;Qiu Li;Yongfeng Song;Fei Jing;Shizhan Ma;Shanshan Shao;Meng Zhao;Qingling Guo;Nanwei Tong;Hongyan Zhao;Xiaomin Xie;Chao Liu;Zhongyan Shan;Zhifeng Cheng;Xuefeng Yu;Shulin Chen;Tao Yang;Yangang Wang;Dongmei Li;Zhaoli Yan;Lixin Guo;Qiuhe Ji;Wenjuan Wang;Jiajun Zhao;Department of Endocrinology & Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital Affiliated to Shandong First Medical University;Shandong Key Laboratory of Endocrinology and Lipid Metabolism & Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong First Medical University;Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Zhengzhou University;Department of Endocrinology and Metabolism, First Hospital of Jilin University;Department of Endocrinology and Metabolism, Fujian Medical University Union Hospital;Endocrinology Department, The Southwest Hospital of AMU;Department of Biostatistics, School of Public Health, Shandong University;Department of Endocrinology and Metabolism, West China Hospital of Sichuan University;Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine;Department of Endocrinology, The First People’s Hospital of Yinchuan;Department of Endocrinology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital (the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine);Department of Endocrinology and Metabolism & Institute of Endocrinology, the First Hospital of China Medical University;Department of Endocrinology, the Fourth Affiliated Hospital of Harbin Medical University;Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology;Department of Endocrinology, Yantai Yuhuangding Hospital Affiliated to Qingdao University Medical College;Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University;Department of Endocrinology and Metabolic Diseases, the Affiliated Hospital of Qingdao University;Division of Endocrinology, Department of Internal Medicine, Inner Mongolia Autonomous Region People’s Hospital;Department of Endocrinology, the Affiliated Hospital of Inner Mongolia Medical University;Department of Endocrinology & Beijing Institute of Geriatrics, National Health Commission, Beijing Hospital;Division of Endocrinology, Department of Internal Medicine, Xijing Hospital of Air Force Military Medical University;National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention;Department of Endocrinology, Shandong Provincial Hospital, Shandong University;
【通讯作者】
郭立新;姬秋和;王文绢;赵家军;
【机构】
Department of Endocrinology & Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Shandong Provincial Hospital Affiliated to Shandong First Medical University；
Shandong Key Laboratory of Endocrinology and Lipid Metabolism & Shandong Prevention and Control Engineering Laboratory of Endocrine and Metabolic Diseases, Shandong First Medical University；
Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Zhengzhou University；
Department of Endocrinology and Metabolism, First Hospital of Jilin University；
Department of Endocrinology and Metabolism, Fujian Medical University Union Hospital；
Endocrinology Department, The Southwest Hospital of AMU；
Department of Biostatistics, School of Public Health, Shandong University；
Department of Endocrinology and Metabolism, West China Hospital of Sichuan University；
Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine；
Department of Endocrinology, The First People’s Hospital of Yinchuan；
Department of Endocrinology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital (the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine)；
Department of Endocrinology and Metabolism & Institute of Endocrinology, the First Hospital of China Medical University；
Department of Endocrinology, the Fourth Affiliated Hospital of Harbin Medical University；
Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology；
Department of Endocrinology, Yantai Yuhuangding Hospital Affiliated to Qingdao University Medical College；
Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University；
Department of Endocrinology and Metabolic Diseases, the Affiliated Hospital of Qingdao University；
Division of Endocrinology, Department of Internal Medicine, Inner Mongolia Autonomous Region People’s Hospital；
Department of Endocrinology, the Affiliated Hospital of Inner Mongolia Medical University；
Department of Endocrinology & Beijing Institute of Geriatrics, National Health Commission, Beijing Hospital；
Division of Endocrinology, Department of Internal Medicine, Xijing Hospital of Air Force Military Medical University；
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention；
Department of Endocrinology, Shandong Provincial Hospital, Shandong University；
【摘要】 本文的研究目的是探讨中国2型糖尿病（type 2 diabetes mellitus, T2DM）患者的中等至剧烈强度身体活动（Moderate-to-vigorous-intensity physical activity, MVPA）时间和久坐（sedentary,SED）时间与心血管疾病（cardiovascular disease, CVD）风险及多种因素[即血压（blood pressure, BP）、体重指数（body mass index, BMI）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol, LDL-C）和糖化血红蛋白A1（glycated hemoglobin A1c, HbA1c）]控制状况的关系。本研究为一项基于9152名T2DM人群的横断面研究，数据来自于“Multifactorial Intervention on Type 2 Diabetes Study”，简称MIDiab研究。根据患者自我报告的MVPA时间和SED时间，将身体活动水平分为：低(<150 min·week–1)、中(150～450 min·week–1)、高(≥450min·week–1)三组；久坐行为水平也分为：低(<4 h·d–1)、中(4～8 h·d–1)、高(≥8 h·d–1)三组。本研究的主要结局指标是CVD，将有自我报告CVD疾病史的患者定义为有CVD风险。采用混合效应逻辑回归模型估计与MVPA时间和SED时间相关的CVD风险和多因素控制状态的优势比（odds ratio, OR）及95%置信区间（confidence interval, CI），对中国地理区域特征进行调整。本研究人群年龄的平均±标准差为（60.87±8.44）岁，其中44.5%为女性，25.1%的患者自我报告有CVD疾病史。校正潜在的混杂因素后，发现高水平的MVPA时间与CVD风险之间存在负相关关系，且独立于SED时间，然而在中等水平MVPA时间组没有观察到这种关联。与低水平身体活动组的参与者相比，高水平身体活动组的人更容易达到BMI的目标水平。进一步评估二者对CVD风险的联合作用，与参照组(即SED时间<4 h·d–1和MVPA时间≥450 min·week–1)相比，低水平身体活动组(MVPA时间<150 min·week–1)的CVD患病风险显著升高。其中，与SED时间<4 h·d–1相关的OR值为1.270（95%CI为1.040～1.553），与SED时间≥8 h·d–1相关的OR值为1.499（95%CI为1.149～1.955）。在T2DM患者中，长时间的久坐行为(即≥8 h·d–1的SED时间)与CVD风险增加有关；高水平的身体活动(即MVPA时间≥450 min·week–1)与CVD患病风险降低有关，且独立于SED时间。更多还原
【Abstract】 The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity（MVPA） time and sedentary（SED） time with a history of cardiovascular disease（CVD） and multi factorial（i.e.,blood pressure（BP）,body mass index（BMI）,low-density lipoprotein cholesterol（LDL-C）,and glycated hemoglobin A1c（HbAlc）） control status among type 2 diabetes mellitus（T2DM） patients in China,A cross-sectional analysis of 9152 people with type 2 diabetes from the Multi factorial Intervention on Type 2 Diabetes（MIDiab） study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min-week-1;moderate,150 to <450 min·week-1;high,≥ 450 min-week-1) and SED time(low,<4 h-d-1;moderate,4 to <8 h-d-1;high,> 8 h-d-1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios（ORs）and 95% confidence intervals（CIs） of CVD risk and multi factorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation（SD） age of（60.87±8.44） years,44.5% were women,and 25.1% had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥ 450 min·week-1 and SED time <4 h·d-1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time <4 h-d-1 was 1.270（95% CI,1.040-1.553） and that associated with an SED time≥ 8 h-d-1 was 1.499（95% CI,1.149-1.955）.We found that a high MVPA time(i.e.,≥ 450 min·week-1) was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.更多还原
【基金】 supported by the National Key Research and Development Program of China (2017YFC1309800);the “Outstanding University Driven by Talents” Program and Academic Promotion Program of Shandong First Medical University (2019LJ007);the Key Research and Development Program of Shandong Province (2017CXGC1214)
