PDF(Pubmed)
Abstract：
OBJECTIVE: Longitudinal evidence on the relationship of sedentary time (ST), light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) with changes in cardiac structure and function in the paediatric population is scarce. This evidence is clinically important due to the impact ST can have on the long-term prognosis of healthy young population in the lifetime continuum. This prospective observational study examined the relationships of cumulative ST, LPA, and MVPA from childhood with longitudinal changes in cardiac structure and function.
RESULTS: This is a secondary analysis from the Avon Longitudinal Study of Parents and Children, UK birth cohort of 1682 children aged 11 years. Participants who had at least one follow-up timepoints accelerometer-measured ST, LPA, and MVPA over a period of 13 years and repeated echocardiography-measured cardiac structure and function at ages 17- and 24-year clinic visit were included. Left ventricular mass indexed for height2.7 (LVMI2.7) and left ventricular (LV) diastolic function from mitral E/A ratio (LVDF) were computed. Among 1682 children (mean [SD] age, 11.75 [0.24] years; 1054 [62.7%] females), the cumulative one-min/day increase in ST from ages 11 to 24 years was associated with progressively increased LVMI2.7 {effect estimate 0.002 g/m2.7 [confidence interval (CI) 0.001-0.003], P < 0.001}, irrespective of sex, obesity, and hypertensive status. Cumulative one-min/day increase in LPA was associated with a decreased LVMI2.7 (-0.005 g/m2.7 [-0.006 to -0.003], P < 0.0001) but an increased LVDF. Cumulative one-minute/day increase in MVPA was associated with progressively increased LVMI2.7 (0.003 g/m2.7 [0.001-0.006], P = 0.015).
CONCLUSIONS: ST contributed +40% to the 7-year increase in cardiac mass, MVPA increased cardiac mass by +5%, but LPA reduced cardiac mass by -49%. Increased ST may have long-term pathologic effects on cardiac structure and function during growth from childhood through young adulthood; however, engaging in LPA may enhance cardiac health in the young population.
The aim of this longitudinal study including 1682 children and adolescents was to examine the effect of sedentary time (ST), light-intensity physical activity (LPA), moderate-to-vigorous-intensity physical activity (MVPA) on changes in cardiac structural and functional properties during growth until young adulthood.Cumulative ST from childhood contributed a maximum of 40% (+1.29 g/m2.7 out of the total 7-year increase in cardiac mass of 3 g/m2.7) during growth from adolescence to young adulthood. Cumulative LPA from childhood was associated with decreased cardiac mass (−0.005 g/m2.7), amounting to a −49% average reduction (−1.49 g/m2.7 out of 3 g/m2.7) in the increase in cardiac mass across the 7-year observation period. Each minute of cumulative MVPA from childhood was associated with a 5% progressively increased cardiac mass, amounting to +0.15 g/m2.7 out of 3 g/m2.7 increase during growth from adolescence to young adulthood.Participation in LPA of at least 3 h/day and decreasing ST was longitudinally associated with healthier cardiac indices in the young population. The contribution of ST to increased cardiac mass is eight times more than the MVPA-associated physiological increase. Hence, progressively increasing childhood sedentariness may independently and pathologically contribute to worsening cardiac structural and functional alterations in the young population. Childhood sedentariness causes an increased body fat, inflammation, blood pressure, lipid levels, arterial stiffness, and subsequently cardiac enlargement, thereby increasing the risk of adverse cardiovascular health consequences in later life.
RESULTS: This is a secondary analysis from the Avon Longitudinal Study of Parents and Children, UK birth cohort of 1682 children aged 11 years. Participants who had at least one follow-up timepoints accelerometer-measured ST, LPA, and MVPA over a period of 13 years and repeated echocardiography-measured cardiac structure and function at ages 17- and 24-year clinic visit were included. Left ventricular mass indexed for height2.7 (LVMI2.7) and left ventricular (LV) diastolic function from mitral E/A ratio (LVDF) were computed. Among 1682 children (mean [SD] age, 11.75 [0.24] years; 1054 [62.7%] females), the cumulative one-min/day increase in ST from ages 11 to 24 years was associated with progressively increased LVMI2.7 {effect estimate 0.002 g/m2.7 [confidence interval (CI) 0.001-0.003], P < 0.001}, irrespective of sex, obesity, and hypertensive status. Cumulative one-min/day increase in LPA was associated with a decreased LVMI2.7 (-0.005 g/m2.7 [-0.006 to -0.003], P < 0.0001) but an increased LVDF. Cumulative one-minute/day increase in MVPA was associated with progressively increased LVMI2.7 (0.003 g/m2.7 [0.001-0.006], P = 0.015).
CONCLUSIONS: ST contributed +40% to the 7-year increase in cardiac mass, MVPA increased cardiac mass by +5%, but LPA reduced cardiac mass by -49%. Increased ST may have long-term pathologic effects on cardiac structure and function during growth from childhood through young adulthood; however, engaging in LPA may enhance cardiac health in the young population.
The aim of this longitudinal study including 1682 children and adolescents was to examine the effect of sedentary time (ST), light-intensity physical activity (LPA), moderate-to-vigorous-intensity physical activity (MVPA) on changes in cardiac structural and functional properties during growth until young adulthood.Cumulative ST from childhood contributed a maximum of 40% (+1.29 g/m2.7 out of the total 7-year increase in cardiac mass of 3 g/m2.7) during growth from adolescence to young adulthood. Cumulative LPA from childhood was associated with decreased cardiac mass (−0.005 g/m2.7), amounting to a −49% average reduction (−1.49 g/m2.7 out of 3 g/m2.7) in the increase in cardiac mass across the 7-year observation period. Each minute of cumulative MVPA from childhood was associated with a 5% progressively increased cardiac mass, amounting to +0.15 g/m2.7 out of 3 g/m2.7 increase during growth from adolescence to young adulthood.Participation in LPA of at least 3 h/day and decreasing ST was longitudinally associated with healthier cardiac indices in the young population. The contribution of ST to increased cardiac mass is eight times more than the MVPA-associated physiological increase. Hence, progressively increasing childhood sedentariness may independently and pathologically contribute to worsening cardiac structural and functional alterations in the young population. Childhood sedentariness causes an increased body fat, inflammation, blood pressure, lipid levels, arterial stiffness, and subsequently cardiac enlargement, thereby increasing the risk of adverse cardiovascular health consequences in later life.
摘要：
目的：久坐时间（ST）关系的纵向证据，光强度体力活动（LPA），在儿科人群中，伴有心脏结构和功能变化的中度至剧烈强度体力活动（MVPA）很少。由于ST可能对一生中健康年轻人群的长期预后产生影响，因此该证据在临床上很重要。这项前瞻性观察性研究检查了累积ST，LPA,和MVPA从儿童心脏结构和功能的纵向变化。
结果：这是雅芳父母和子女纵向研究的二次分析，英国出生队列1682名11岁儿童。至少有一个随访时间点加速度计测量ST的参与者，LPA,纳入了13年期间的MVPA和17岁和24岁门诊就诊时重复超声心动图测量的心脏结构和功能.计算高度为2.7的左心室质量指数（LVMI2.7）和来自二尖瓣E/A比（LVDF）的左心室（LV）舒张功能。在1682名儿童中(平均[SD]年龄，11.75[0.24]岁；1054[62.7%]名女性)，从11岁到24岁的ST累积1分钟/天增加与LVMI2.7{效应估计0.002g/m2.7[置信区间(CI)0.001-0.003]逐渐增加相关,P<0.001}，不论性别,肥胖，和高血压状态。LPA的累积1分钟/天增加与LVMI2.7降低相关（-0.005g/m2.7[-0.006至-0.003]，P<0.0001），但LVDF增加。MVPA的1分钟/天累积增加与LVMI2.7逐渐增加相关（0.003g/m2.7[0.001-0.006]，P=0.015)。
结论：ST对心脏质量的7年增长贡献了40％，MVPA使心脏质量增加+5%,但是LPA使心脏质量降低了-49%。从儿童到成年，ST段增加可能对心脏结构和功能有长期的病理影响；然而，参与LPA可能会增强年轻人群的心脏健康。
这项包括1682名儿童和青少年的纵向研究的目的是检查久坐时间（ST）的影响。光强度体力活动（LPA），中等至剧烈强度的体力活动（MVPA）对心脏结构和功能特性在生长过程中的变化直到成年。在从青春期到成年的成长过程中，儿童期的累积ST最多贡献了40％（在心脏质量3g/m2.7的7年总增加中，为1.29g/m2.7）。儿童时期的累积LPA与心脏质量下降相关（−0.005g/m2.7），在7年的观察期内，心脏质量的增加平均减少了-49％（3g/m2.7中的-1.49g/m2.7）。从童年开始的每一分钟累积MVPA与5%的逐渐增加的心脏质量相关。从青春期到成年，在3g/m2.7中增加了0.15g/m2.7。在年轻人群中，参与至少3小时/天的LPA和降低的ST与更健康的心脏指数纵向相关。ST对心脏质量增加的贡献是MVPA相关生理增加的八倍。因此，逐渐增加的儿童期静息状态可能独立地和病理性地导致年轻人群心脏结构和功能改变的恶化。童年时期的镇静会导致体内脂肪增加，炎症,血压,脂质水平，动脉僵硬度,随后心脏扩大，从而增加了以后生活中不良心血管健康后果的风险。
结果：这是雅芳父母和子女纵向研究的二次分析，英国出生队列1682名11岁儿童。至少有一个随访时间点加速度计测量ST的参与者，LPA,纳入了13年期间的MVPA和17岁和24岁门诊就诊时重复超声心动图测量的心脏结构和功能.计算高度为2.7的左心室质量指数（LVMI2.7）和来自二尖瓣E/A比（LVDF）的左心室（LV）舒张功能。在1682名儿童中(平均[SD]年龄，11.75[0.24]岁；1054[62.7%]名女性)，从11岁到24岁的ST累积1分钟/天增加与LVMI2.7{效应估计0.002g/m2.7[置信区间(CI)0.001-0.003]逐渐增加相关,P<0.001}，不论性别,肥胖，和高血压状态。LPA的累积1分钟/天增加与LVMI2.7降低相关（-0.005g/m2.7[-0.006至-0.003]，P<0.0001），但LVDF增加。MVPA的1分钟/天累积增加与LVMI2.7逐渐增加相关（0.003g/m2.7[0.001-0.006]，P=0.015)。
结论：ST对心脏质量的7年增长贡献了40％，MVPA使心脏质量增加+5%,但是LPA使心脏质量降低了-49%。从儿童到成年，ST段增加可能对心脏结构和功能有长期的病理影响；然而，参与LPA可能会增强年轻人群的心脏健康。
这项包括1682名儿童和青少年的纵向研究的目的是检查久坐时间（ST）的影响。光强度体力活动（LPA），中等至剧烈强度的体力活动（MVPA）对心脏结构和功能特性在生长过程中的变化直到成年。在从青春期到成年的成长过程中，儿童期的累积ST最多贡献了40％（在心脏质量3g/m2.7的7年总增加中，为1.29g/m2.7）。儿童时期的累积LPA与心脏质量下降相关（−0.005g/m2.7），在7年的观察期内，心脏质量的增加平均减少了-49％（3g/m2.7中的-1.49g/m2.7）。从童年开始的每一分钟累积MVPA与5%的逐渐增加的心脏质量相关。从青春期到成年，在3g/m2.7中增加了0.15g/m2.7。在年轻人群中，参与至少3小时/天的LPA和降低的ST与更健康的心脏指数纵向相关。ST对心脏质量增加的贡献是MVPA相关生理增加的八倍。因此，逐渐增加的儿童期静息状态可能独立地和病理性地导致年轻人群心脏结构和功能改变的恶化。童年时期的镇静会导致体内脂肪增加，炎症,血压,脂质水平，动脉僵硬度,随后心脏扩大，从而增加了以后生活中不良心血管健康后果的风险。
