Abstract：
While physical activity (PA) is understood to promote vascular health, little is known about whether the daily and weekly patterns of PA accumulation associate with vascular health. Accelerometer-derived (activPAL3) 6- or 7-day stepping was analyzed for 6430 participants in The Maastricht Study (50.4% women; 22.4% Type 2 diabetes mellitus (T2DM)). Multivariable regression models examined associations between stepping metrics (average step count, and time spent slower and faster paced stepping) with arterial stiffness (measured as carotid-femoral pulse wave velocity (cfPWV)), and several indices of microvascular health (heat-induced skin hyperemia, retinal vessel reactivity and diameter), adjusting for confounders and moderators. PA pattern metrics were added to the regression models to identify associations with vascular health beyond that of stepping metrics. Analyses were stratified by T2DM status if an interaction effect was present. Average step count and time spent faster paced stepping was associated with better vascular health, and the association was stronger in those with compared to those without T2DM. In fully adjusted models a higher step count inter-daily stability was associated with a higher (worse) cfPWV in those without T2DM (std β = 0.04, p = 0.007) and retinal venular diameter in the whole cohort (std β = 0.07, p = 0.002). A higher within-day variability in faster paced stepping was associated with a lower (worse) heat-induced skin hyperemia in those with T2DM (std β = -0.31, p = 0.008). Above and beyond PA volume, the daily and weekly patterns in which PA was accumulated were additionally associated with improved macro- and microvascular health, which may have implications for the prevention of vascular disease.
摘要：
虽然身体活动（PA）被认为可以促进血管健康，对于PA的每日和每周积累模式是否与血管健康相关，知之甚少。在马斯特里赫特研究中，对6430名参与者（50.4％的女性；22.4％的2型糖尿病（T2DM））分析了加速度计衍生的（activPAL3）6天或7天步进。多变量回归模型检查了步进指标(平均步数，与动脉僵硬度（测量为颈动脉-股动脉脉搏波速度（cfPWV））相比，和几个微血管健康指标(热诱发的皮肤充血，视网膜血管反应性和直径)，调整混杂因素和主持人。将PA模式度量添加到回归模型中，以识别与血管健康的关联，而不是步进度量。如果存在交互作用，则按T2DM状态对分析进行分层。平均步数和较快的步速与更好的血管健康相关，与没有T2DM的患者相比，这种关联更强。在完全调整的模型中，在没有T2DM的患者中，较高的步数每日稳定性与较高（较差）的cfPWV（stdβ=0.04，p=0.007）和整个队列中的视网膜静脉直径（stdβ=0.07，p=0.002）相关。在T2DM患者中，步速较快的一天内变异性较高与较低（较差）的热诱发皮肤充血相关（stdβ=-0.31，p=0.008）。高于和超过PA音量，PA积累的每日和每周模式还与改善的大血管和微血管健康相关，这可能对预防血管疾病有影响。
