背景:证据表明,身体活动通过抗炎机制减轻压力并促进无数的健康增强作用。然而,目前尚不清楚这些机制是否会干扰心理社会工作压力和头痛障碍之间的关联。
目的:测试体力活动及其与全身性炎症生物标志物高敏C反应蛋白(hs-CRP)和急性期糖蛋白(GlycA)的相互作用是否会介导工作压力和头痛之间的关联。
方法:我们对巴西成人健康纵向研究(ELSA-Brasil)关于工作压力(较高的需求和较低的控制和支持分量表)的基线数据进行了横断面评估,偏头痛和紧张型头痛(ICHD-2标准),自我报告的休闲时间体力活动,血浆hs-CRP和GlycA水平。采用顺序调解方法的条件过程分析用于计算路径系数和95%置信区间(CI),以围绕身体活动和生物标志物对工作压力-头痛关系的间接影响。单独的模型根据性别进行了调整,年龄,抑郁和焦虑.进一步调整增加了BMI吸烟状况,和社会经济因素。
结果:总计,该研究包括7,644人。偏头痛和紧张型头痛的1年患病率分别为13.1%和49.4%,分别。在根据性别调整的模型中,年龄,焦虑,和抑郁症,工作压力(较低的工作控制)与偏头痛之间的关联是由体力活动[效应=-0.039(95CI:-0.074,-0.010)]介导的,而不是由hs-CRP或GlycA介导的.TTH与较高的工作控制和较低的工作需求有关,这是由身体活动和GlycA之间的负相关[作业控制:效果=0.0005(95CI:0.0001,0.0010);工作需求:效果=0.0003(95CI:0.0001,0.0007]。在包括社会经济因素在内的进一步调整后,只有体力活动在工作压力-偏头痛联系中的中介作用仍然存在。BMI,吸烟,并排除主要慢性疾病。
结论:在ELSA-Brasil研究中,体力活动逆转了工作压力和偏头痛之间的联系,独立于全身性炎症,而LTPA介导的GlycA下调与较低的工作压力相关的TTH相关。
Evidence indicates that physical activity reduces stress and promote a myriad of health-enhancing effects through anti-inflammatory mechanisms. However, it is unknown whether these mechanisms interfere in the association between psychosocial job stress and headache disorders.
To test whether physical activity and its interplay with the systemic inflammation biomarkers high-sensitivity C-reactive protein (hs-CRP) and acute phase glycoproteins (GlycA) would mediate the associations between job stress and headache disorders.
We cross-sectionally evaluated the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) regarding job stress (higher demand and lower control and support subscales), migraine and tension-type headache (ICHD-2 criteria), self-reported leisure-time physical activity, and plasma hs-CRP and GlycA levels. Conditional process analyses with a sequential mediation approach were employed to compute path coefficients and 95 % confidence intervals (CI) around the indirect effects of physical activity and biomarkers on the job stress-headache relationship. Separate models were adjusted for sex, age, and depression and anxiety. Further adjustments added BMI smoking status, and socioeconomic factors.
In total, 7,644 people were included in the study. The 1-year prevalence of migraine and tension-type headache were 13.1 % and 49.4 %, respectively. In models adjusted for sex, age, anxiety, and depression, the association between job stress (lower job control) and migraine was mediated by physical activity [effect = -0.039 (95 %CI: -0.074, -0.010)] but not hs-CRP or GlycA. TTH was associated with higher job control and lower job demand, which was mediated by the inverse associations between physical activity and GlycA [Job Control: effect = 0.0005 (95 %CI: 0.0001, 0.0010); Job Demand: effect = 0.0003 (95 %CI: 0.0001, 0.0007]. Only the mediating effect of physical activity in the job stress-migraine link remained after further adjustments including socioeconomic factors, BMI, smoking, and the exclusion of major chronic diseases.
In the ELSA-Brasil study, physical activity reversed the link between job stress and migraine independently of systemic inflammation, while the LTPA-mediated downregulation of GlycA was associated with lower job stress-related TTH.