摘要
目的:以身体活动能量消耗(physical activity energy expenditure,PAEE)作为剂量单位,分析身体活动(physical activity,PA)与代谢综合征(metabolic syndrome,MS)及其相关因素发病风险的剂量-效应关系,构建二者之间量效曲线模型特征,并探讨最佳推荐量。方法:选取450名18~64岁健康成年人(男性216名,女性234名)作为研究对象,采用四分位法将PAEE水平进行分组(Q1~Q4),Q1代表最低PAEE水平组,Q4代表最高PAEE水平组。采用趋势方差分析PAEE水平与MS及其相关因素发病风险的关系,并通过logistic回归分析PAEE水平与MS及其相关因素发病风险的比值比(odds ratio,OR),最后通过限制性立方样条构建剂量-效应关系曲线模型。结果:(1)不同PAEE水平与MS(组合F=7.930,P<0.01)、高血糖(组合F=4.575,P<0.01)以及低高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)(组合F=7.104,P<0.01)发病率在组间趋势差异上都存在统计学意义。MS发病率既存在线性趋势,也存在多次项式;高血糖发病率仅存在多次项式趋势;而低HDL-C发病率仅仅存在线性趋势。(2)相对于总人群来讲,随着PAEE水平的提升,MS、高血糖和低HDL-C的发病风险OR值出现不同程度的降低,在模型2中,MS和低HDL-C的发病风险在Q4组OR值最低,分别为基线组(Q1)的0.21(95%CI:0.10-0.44,P<0.01)和0.29(95%CI:0.16-0.54),高血糖发病风险在Q2组OR值最低,仅为Q1的0.34(95%CI:0.17-0.65),不同性别组最低OR值有所差异。(3)总人群组PAEE水平与MS、高血糖和低HDL-C发病风险均呈非线性剂量-效应关系,MS、高血糖和低HDL-C发病风险最低时(OR=1),阈剂量分别为19.9 kJ/kg/d、18.7 kJ/kg/d和19.9 kJ/kg/d;不同性别之间存在一定差异,MS发病风险最低时,男性和女性阈剂量分别为20.1 kJ/kg/d、15.9 kJ/kg/d。结论:(1)PAEE水平与MS发病风险关系呈“L”形剂量-效应曲线模型特征,MS最佳PA推荐量在不同性别中有所不同,男性和女性PA最佳推荐量分别为最低推荐量(5 kJ/kg/d)的4倍和3倍;(2)PAEE水平与高血糖发病风险关系呈扁平状“U”形剂量-效应曲线模型特征,与低HDL-C发病风险关系呈“L”形剂量-效应曲线模型特征;不同性别之间曲线模型特征有所差异,二者PA最佳推荐量也是最低推荐量的4倍。
Objective To explore the dose-response relationships of physical activity(PA),quantified by physical activity energy expenditure(PAEE),with the prevalence of metabolic syndrome(MS)and its risk factors.Their association curves were constructed using restricted cubic splines(RCS)to determine the optimal PAEE level for risk reduction.Methods A cross-sectional analysis was conducted among 450 healthy adults(male:246,female:234)aged 18~64 years.Participants were classified into quartiles(Q1~Q4)based on their PAEE levels,with Q1 as the lowest-level group,and Q4 as the highest-level group.Trends in the prevalence of MS and its factors across PAEE quartiles were assessed using ANOVA.Moreover,multivariable logistic regression was employed to estimate odds ratios(ORs)and 95%confidence intervals(CIs)for the associations between PAEE quartiles and risk factors,while dose-response relationships were modeled with restricted cubic splines.Results(1)Statistically significant differences in trends across PAEE levels were observed for the prevalence of MS(overall F=7.930,P<0.01),hyperglycemia(overall F=4.575,P<0.01),and low high-density lipoprotein cholesterol(HDL-C;overall F=7.104,P<0.01).Moreover,prevalence of MS exhibited both linear and polynomial trends,while hyperglycemia incidence rate shows only polynomial trends,and low HDL-C incidence rate demonstrates purely linear trends.(2)Increasing PAEE levels were associated with progressively lower ORs for all three conditions in the overall population.In model 2,compared with the Q1 group,the lowest risks for MS and low HDL-C were observed in Q4,with ORs of 0.21(95%CI:0.10-0.44,P<0.01)and 0.29(95%CI:0.16-0.54),respectively.In contrast,the risk for hyperglycemia was the lowest in Q2(OR=0.34,95%CI:0.17-0.65).Moreover,the lowest OR values differed by sex.(3)Restricted cubic spline analyses revealed nonlinear dose-response relationships between PAEE and the risks of MS,hyperglycemia,and low HDL-C in the overall population.The thresholds of the PAEE(OR=1)were 19.9 kJ/kg/d,18.7 kJ/kg/d and 19.9 kJ/kg/d respectively.Significant differences were observed in the risk of MS,with the threshold of PAEE being 20.1 kJ/kg/d for males and 15.9 kJ/kg/d for females,respectively.Conclusion The relationship between PAEE levels and the risk of MS was characterized by an L-shaped dose-response curve,with the optimal PA recommendation for men and women approximately four times and three times the minimum recommended PA level(5 kJ/kg/d),while that between PAEE and the risk of hyperglycemia was a flattened Ushape.However,the relationship between PAEE levels and the low HDL-C exhibited an L-shape curve feature,with significant differences by sex,and the optimal PA for maximizing benefit was approximately four times the minimum recommended level.
作者
林家仕
黄琪棋
李显悦
郑夏夏
曹岩鹏
朱厚远
严翊
Lin Jiashi;Huang Qiqi;Li Xianyue;Zhen Xiaxia;Cao Yanpeng;Zhu Houyuan;Yan Yi(College of Physical Education,Jimei University,Xiamen 361021,China;School of Kinesiology,Beijing Sport University,Beijing 100084,China)
出处
《中国运动医学杂志》
北大核心
2025年第11期859-871,共13页
Chinese Journal of Sports Medicine
基金
教育部人文社科研究项目(20YJA890014)。
关键词
身体活动能量消耗
代谢综合征
剂量-效应
最佳推荐量
physical activity energy expenditure
metabolic syndrome
dose-response relationship
optimal recommendation
