中国人群中久坐时间与全因死亡及心血管疾病的关联

doi:10.16352/j.issn.1001-6325.2025.11.1438

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (11): 1438-1443.doi: 10.16352/j.issn.1001-6325.2025.11.1438

中国人群中久坐时间与全因死亡及心血管疾病的关联

兰磊¹, 郎欣月¹, 陈飞龙², 王慧³, 何国敏⁴, 李卫², 刘之光^1*, 代表前瞻性城乡流行病学研究中国地区协作者

1.首都医科大学附属北京安贞医院药事部临床试验机构,北京 100029;
2.中国医学科学院北京协和医学院国家心血管病中心阜外医院医学统计部,北京 102308;
3.和田区疾病预防控制中心,新疆和田 848099;
4.勐腊县疾病预防控制中心,云南西双版纳 666399

收稿日期:2024-12-26 修回日期:2025-02-26 出版日期:2025-11-05 发布日期:2025-10-24
通讯作者: ^*liuzhiguang@anzhengcp.com
基金资助:
国家心血管疾病临床医学研究中心·深圳自主课题(NCRCSZ-2023-012)

Association of sitting time with all-cause mortality and cardiovascular disease in the Chinese population

LAN Lei¹, LANG Xinyue¹, CHEN Feilong², WANG Hui³, HE Guomin⁴, LI Wei², LIU Zhiguang^1*, on behalf of PURE-China investigators

1. Department of Pharmacy and Clinical Trial Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029;
2. Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, CAMS & PUMC, Beijing 102308;
3. Hetian District Center for Disease Control and Prevention, Hetian 848099;
4. Mengla County Center for Disease Control and Prevention, Xishuangbanna 666399, China

Received:2024-12-26 Revised:2025-02-26 Online:2025-11-05 Published:2025-10-24
Contact: ^*liuzhiguang@anzhengcp.com

摘要/Abstract

摘要： 目的使用前瞻性城乡流行病学(PURE)研究的数据,探索在中国人群中久坐时间与全因死亡和心血管疾病(CVD)的关系。方法依托前瞻性城乡流行病学中国地区(PURE-China)队列研究,自 2005—2009 年通过标准化问卷及体格检查对受试者进行基线调查,并随访至2022年8月31日,主要研究终点为全因死亡和CVD(非致死性心肌梗死、卒中或心力衰竭)。通过多因素Cox共享脆弱模型分析中国人群中久坐时间与全因死亡及CVD风险的关联,并比较在不同性别、年龄和城乡中的关联差异。结果本研究共招募 47 931名参与者,最终43 367名纳入分析。平均随访(11.9±3.0)年,共2 277例参与者发生全因死亡事件,3 551例参与者发生CVD。多因素Cox共享脆弱模型表明,相较于久坐小于4 h的人群,久坐时间6~8 h全因死亡风险增加23%(HR=1.23,95% CI:1.06~1.44),CVD风险增加18%(HR=1.18,95% CI:1.04~1.33);久坐时间8 h以上全因死亡风险增加50%(HR=1.50,95% CI:1.16~1.94),CVD风险增加44%(HR=1.44,95% CI:1.16~1.79)。在男性和年龄50岁以上人群中这种关联更加明显。结论中国人群中久坐与全因死亡及心血管疾病的风险增加有关,尤其是久坐6 h及以上。减少久坐时间和增加体力活动可能是减轻心血管疾病负担和过早死亡的重要策略。

关键词: 久坐, 心血管疾病, 队列研究, 全因死亡, 风险比

Abstract: Objective To explore potential association between sedentary time and the risk of all-cause mortality and cardiovascular disease (CVD) in Chinese population using data from the Prospective Urban Rural Epidemiology (PURE-China) cohort study. Methods Baseline data were collected, from 2022 standardized questionnaires and physical examinations, with follow-up until August 31, 2022. The primary endpoints were all-cause mortality and cardiovascular events (non-fatal myocardial infarction, stroke or heart failure). Multivariable Cox shared frailty model was used to analyze the association between sedentary time and the risks of all-cause mortality and CVD in the target population, and to compare differences across subgroups based on gender, age and geographic location. Results A total of 47 931 participants were recruited, and 43 367 were included in the final analysis. Over a median follow-up of 11.9±3.0 years, 2 277 participants experienced all-cause mortality, 3 551 experienced cardiovascular events. The Cox model indicated that, compared to individuals with less than 4 h of sedentary time per day, those with 6-8 h had a 23% increased in risk of all-cause mortality (HR=1.23, 95% CI: 1.06-1.44) and an 18% increased risk of CVD (HR=1.18, 95% CI: 1.04-1.33). For individuals with more than 8 h of sedentary time, the risk increased by 50% for all-cause mortality (HR=1.50, 95% CI: 1.16-1.94) and 44% for CVD(HR=1.44, 95% CI: 1.16-1.79). These associations were more pronounced in men and individuals aged 50 years and older. Conclusions Sedentary behavior is associated with an increased risk of all-cause mortality and cardiovascular disease in Chinese population, especially in the population with sedentary time of 6 hrs or more per day. Reducing sedentary time and increasing physical activity is an important strategy to mitigate the disease burden of cardiovascular disease and premature death.

Key words: sedentary behavior, cardiovascular disease, cohort study, all-cause mortality, hazard ratio

中图分类号:

R181

兰磊, 郎欣月, 陈飞龙, 王慧, 何国敏, 李卫, 刘之光, 代表前瞻性城乡流行病学研究中国地区协作者. 中国人群中久坐时间与全因死亡及心血管疾病的关联[J]. 基础医学与临床, 2025, 45(11): 1438-1443.

LAN Lei, LANG Xinyue, CHEN Feilong, WANG Hui, HE Guomin, LI Wei, LIU Zhiguang, on behalf of PURE-China investigators. Association of sitting time with all-cause mortality and cardiovascular disease in the Chinese population[J]. Basic & Clinical Medicine, 2025, 45(11): 1438-1443.

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中国人群中久坐时间与全因死亡及心血管疾病的关联

Association of sitting time with all-cause mortality and cardiovascular disease in the Chinese population

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