炎症饮食与高强度休闲时间体育锻炼对心血管疾病病死率影响

Effect of inflammatory diet and vigorous-leisure time physical activity on mortality of cardiovascular disease

目的探讨炎症饮食与高强度休闲时间体育锻炼(v-LTPA)对心血管疾病(CVD)病死率的影响。方法选取美国国家健康与营养调查数据库中2007—2014年收集的16068例符合标准的参与者为研究对象。根据饮食的炎症特性与v-LTPA是否充分,将患者分为A组(促炎饮食+v-LTPA不足,n=10411)、B组(抗炎饮食+v-LTPA不足,n=2196)、C组(促炎饮食+v-LTPA充足,n=2456)、D组(抗炎饮食+v-LTPA充足,n=1005)。使用R软件进行数据读取并比较4组患者的基线特征。采用多变量Cox比例风险回归模型评估不同炎症饮食与v-LTPA对CVD病死率的影响。结果4组患者年龄、体质量指数、肾小球滤过率、种族、受教育水平,以及男性、高血压、糖尿病、高血脂症、吸烟、饮酒比例比较,差异均有统计学意义(P<0.05)。与A组生活方式比较,B组、D组生活方式均能降低CVD病死率,多变量校正危险比分别为0.71(95%可信区间0.53~0.92,P=0.020)、0.31(95%可信区间0.12~0.80,P=0.016);而C组生活方式对CVD病死率无显著改善作用,多变量校正危险比为0.60(95%可信区间0.32~1.13,P=0.114)。结论抗炎饮食及充足的v-LTPA有利于降低CVD死亡风险,且抗炎饮食可以部分抵消v-LTPA不足对CVD死亡的危害。

Objective To investigate the effects of inflammatory diet and vigorous-leisure time physical activity(v-LTPA)on the mortality of cardiovascular disease(CVD).Methods A total of 16068 eligible participants were selected from the National Health and Nutrition Examination Survey Database from 2007 to 2014.According to the inflammatory properties of diet and the adequacy of v-LTPA,patients were divided into group A(pro-inflammatory diet+insufficient v-LTPA,n=10411),group B(anti-inflammatory diet+insufficient v-LTPA,n=2196),and group C(pro-inflammatory diet+v-LTPA sufficient,n=2456)and group D(anti-inflammatory diet+v-LTPA adequate,n=1005).Data were read using R software and baseline characteristics of the four groups were compared.Multivariate Cox proportional hazard regression model was used to evaluate the effects of different inflammatory diets and v-LTPA on CVD mortality.Results There were significant differences in age,body mass index,estimated glomerular filtration rat,race,education level,male,hypertension,diabetes,hyperlipidemia,smoking and drinking among 4 groups(P<0.05).Compared with the lifestyle of group A,the lifestyle of group B and group D could reduce the mortality of CVD,and the multivariate adjusted hazard ratios were 0.71(95%confidence interval 0.53 to 0.92,P=0.020)and 0.31(95%confidence interval 0.12 to 0.80,P=0.016),respectively.In group C,lifestyle had no significant effect on CVD mortality,and the multivariable adjusted hazard ratio was 0.60(95%confidence interval 0.32 to 1.13,P=0.114).Conclusion Anti-inflammatory diet and sufficient v-LTPA can reduce the risk of CVD death,and anti-inflammatory diet can partially offset the harm of insufficient v-LTPA on CVD death.