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论文标题：Time- vs Step-Based Physical Activity Metrics for Health 作者：Rikuta Hamaya, Eric J Shiroma Jr, Christopher C Moore, Julie E Buring, Kelly R Evenson, I-Min Lee 期刊：JAMA Internal Medicine 发表时间：2024/05/20 数字识别码：10.1001/jamainternmed.2024.0892 摘要：Importance Current US physical activity (PA) guidelines prescribe moderate to vigorous PA (MVPA) time of at least 150 minutes per week for health. An analogous step-based recommendation has not been issued due to insufficient evidence.Objective To examine the associations of MVPA time and step counts with all-cause mortality and cardiovascular disease (CVD).Design, Setting, and Participants This cohort study analyzed data from an ongoing follow-up study of surviving participants of the Women’s Health Study, a randomized clinical trial conducted from 1992 to 2004 in the US to evaluate use of low-dose aspirin and vitamin E for preventing cancer and CVD. Participants were 62 years or older who were free from CVD and cancer, completed annual questionnaires, and agreed to measure their PA with an accelerometer as part of a 2011-2015 ancillary study. Participants were followed up through December 31, 2022.Exposures Time spent in MVPA and step counts, measured with an accelerometer for 7 consecutive days.Main Outcomes and Measures The associations of MVPA time and step counts with all-cause mortality and CVD (composite of myocardial infarction, stroke, and CVD mortality) adjusted for confounders. Cox proportional hazards regression models, restricted mean survival time differences, and area under the receiver operating characteristic curve (AUC) were used to evaluate the associations.Results A total of 14 399 women (mean [SD] age, 71.8 [5.6] years) were included. The median (IQR) MVPA time and step counts were 62 (20-149) minutes per week and 5183 (3691-7001) steps per day, respectively. During a median (IQR) follow-up of 9.0 (8.0-9.9) years, the hazard ratios (HR) per SD for all-cause mortality were 0.82 (95% CI, 0.75-0.90) for MVPA time and 0.74 (95% CI, 0.69-0.80) for step counts. Greater MVPA time and step counts (top 3 quartiles vs bottom quartile) were associated with a longer period free from death: 2.22 (95% CI, 1.58-2.85) months and 2.36 (95% CI, 1.73-2.99) months at 9 years follow-up, respectively. The AUCs for all-cause mortality from MVPA time and step counts were similar: 0.55 (95% CI, 0.52-0.57) for both metrics. Similar associations of these 2 metrics with CVD were observed.Conclusion and Relevance Results of this study suggest that among females 62 years or older, MVPA time and step counts were qualitatively similar in their associations with all-cause mortality and CVD. Step count–based goals should be considered for future guidelines along with time-based goals, allowing for the accommodation of personal preferences. 查看更多 摘要翻译（由计算机程序完成，仅供参考，内容以英文原文为准）： 重要性 ；目前的美国体育活动（PA）指南规定，为了健康，每周至少有150分钟的中等至剧烈的体育活动（MVPA）时间。由于证据不足，尚未发布类似的基于步骤的建议。目标 ；研究MVPA时间和步数与全因死亡率和心血管疾病（CVD）的关系。设计、设置和参与者 ；这项队列研究分析了妇女健康研究（1992年至2004年在美国进行的一项随机临床试验）幸存参与者的后续研究数据，该研究旨在评估低剂量阿司匹林和维生素E预防癌症和心血管疾病的使用。参与者年龄在62岁或以上，没有心血管疾病和癌症，完成了年度问卷调查，并同意作为2011-2015年辅助研究的一部分，用加速度计测量他们的PA。参与者被随访至2022年12月31日。风险敞口 ；使用加速度计连续7天测量MVPA和步数所花费的时间。主要结果和措施 ；MVPA时间和步数与全因死亡率和CVD（心肌梗死、中风和CVD死亡率的复合物）的相关性对混杂因素进行了调整。Cox比例风险回归模型、限制性平均生存时间差和受试者工作特征曲线下面积（AUC）用于评估相关性。结果 ；共有14⁄399名女性（平均[SD]年龄71.8[5.6]岁）被纳入研究。中位数（IQR）MVPA时间和步数分别为每周62（20-149）分钟和每天5183（3691-7001）步。在9.0（8.0-9.9）年的中位（IQR）随访期间，MVPA时间的每SD全因死亡率的危险比（HR）为0.82（95%CI，0.75-0.90），步数的危险比为0.74（95%CI，0.69-0.80）。较大的MVPA时间和步数（前三个四分位数与后四分位数）与较长的无死亡期相关：9年随访时分别为2.22个月（95%CI，1.58-2.85）和2.36个月（95%CI，1.73-2.99）。MVPA时间和步数的全因死亡率AUC相似：两个指标均为0.55（95%CI，0.52-0.57）。观察到这两个指标与CVD的相似关联。结论和相关性 ；这项研究的结果表明，在62岁或以上的女性中，MVPA时间和步数与全因死亡率和心血管疾病的相关性在质量上相似。未来的指导方针应考虑基于步数的目标以及基于时间的目标，以适应个人偏好。 查看更多 |
