RESULTS: Participants included 4521 adults from the 2013 to 2014 National Health and Nutrition Examination Survey physical activity monitoring examination. Wrist-worn ActiGraph GT3X+ data were used to estimate RARs. Multivariable logistic models evaluated associations of RARs with prevalent CVD, hypertension, obesity, and central adiposity. Participants (mean age, 49 years) in the highest versus lowest tertile of relative amplitude (greater circadian rhythmicity) had 39% to 62% lower odds of prevalent CVD, hypertension, obesity, and central adiposity. A more active wake period was associated with 19% to 72% lower CVD, hypertension, obesity, and central adiposity odds. Higher interdaily stability (regular sleep-wake and rest-activity patterns) was related to 52% and 23% lower CVD and obesity odds, respectively. In contrast, participants in the highest versus lowest tertile of intradaily variability (fragmented RAR and inefficient sleep) had >3-fold and 24% higher CVD and obesity odds, respectively. A later and less restful sleep period was associated with 36% to 2-fold higher CVD, hypertension, obesity, and central adiposity odds. A statistically significant linear trend was observed for all associations (P-trend<0.05).
CONCLUSIONS: A robust, stable, and less fragmented RAR, an active wake period, and an earlier and more restful sleep period are associated with lower prevalent CVD, hypertension, obesity, and central adiposity, with evidence of a dose-response relationship. The magnitude, timing, and regularity of sleep-wake and rest-activity patterns may be important targets for reducing cardiovascular risk.
结果:参与者包括2013年至2014年国家健康与营养检查调查的4521名成年人身体活动监测检查。手腕佩戴的ActiGraphGT3X数据用于估计RAR。多变量逻辑模型评估了RAR与流行CVD的关联,高血压,肥胖,和中央肥胖。参与者(平均年龄,49年)在相对振幅的最高和最低三位数(昼夜节律更大)中,CVD流行的几率降低了39%至62%,高血压,肥胖,和中央肥胖。更活跃的觉醒期与19%至72%的CVD降低相关,高血压,肥胖,和中心肥胖几率。更高的每日稳定性(有规律的睡眠-觉醒和休息-活动模式)与降低52%和23%的心血管疾病和肥胖几率相关。分别。相比之下,每日内变异性最高和最低的参与者(零散的RAR和低效的睡眠)的心血管疾病和肥胖几率>3倍,高24%,分别。睡眠期越晚越少,CVD就会升高36%到2倍,高血压,肥胖,和中心肥胖几率。所有关联均观察到统计学上显著的线性趋势(P-趋势<0.05)。
结论:稳健,稳定,更少的支离破碎的RAR,活跃的觉醒期,更早和更平静的睡眠期与较低流行的CVD相关,高血压,肥胖,中央肥胖,有剂量反应关系的证据。幅度,定时,睡眠-觉醒和休息-活动模式的规律性可能是降低心血管风险的重要目标。