每日爬樓梯、疾病易感性與動脈粥樣硬化心血管疾病風險：一項前瞻性隊列研究 Daily stair climbing, disease susceptibility, and risk of atherosclerotic cardiovascular disease: A prospective cohort study

https://www.atherosclerosis-journal.com/article/S0021-9150(23)05221-8/abstract 

Daily stair climbing, disease susceptibility, and risk of atherosclerotic cardiovascular disease: A prospective cohort study

每日爬樓梯、疾病易感性與動脈粥樣硬化心血管疾病風險：一項前瞻性隊列研究

Highlights  重點摘要

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This large cohort of UK adults demonstrated that climbing more than five flights of stairs daily was associated with over a 20% lower risk of ASCVD.

這項針對英國成年人的大型隊列研究顯示，每日爬超過五層樓梯與動脈粥樣硬化心血管疾病風險降低超過20%相關。

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The associations were broadly concordant in populations with varying susceptibilities to ASCVD.

此關聯性在對動脈粥樣硬化心血管疾病具有不同易感性的群體中大致一致。

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Participants who discontinued stair climbing between the baseline and resurvey exhibited a higher risk of ASCVD in comparison to those who never engaged in stair climbing.

與從未進行爬樓梯活動的參與者相比，在基線調查與後續追蹤調查期間停止爬樓梯的參與者表現出更高的動脈粥樣硬化心血管疾病風險。

Abstract  摘要

Background and aims  背景與目的

The associations between intensity of stair climbing and atherosclerotic cardiovascular disease (ASCVD) and how these vary by underlying disease susceptibility are not fully understood. We aim to evaluate the intensity of stair climbing and risk of ASCVD types and whether these vary with the presence of ASCVD risk factors.

爬樓梯強度與動脈粥狀硬化心血管疾病（ASCVD）之間的關聯，以及這些關聯如何因潛在疾病易感性而變化，目前尚未完全明瞭。本研究旨在評估爬樓梯強度與各類 ASCVD 風險的關係，並探討此關係是否因 ASCVD 風險因子的存在而有所不同。

Methods  方法

This prospective study used data of 458,860 adult participants from the UK Biobank. Information about stair climbing, sociodemographic, and lifestyle factors was collected at baseline and a resurvey 5 years after baseline. ASCVD was defined as coronary artery disease (CAD), ischemic stroke (IS), or acute complications. Associations between flights of stair climbing and ASCVD were examined as hazard ratios (HRs) from Cox proportional hazards models. The modification role of disease susceptibility on such associations was assessed by analyses stratified by levels of genetic risk score (GRS), 10-year risks of ASCVD, and self-reported family history of ASCVD.

這項前瞻性研究使用了英國生物銀行（UK Biobank）中 458,860 名成年參與者的數據。關於爬樓梯、社會人口統計學和生活方式因子的資訊於基線時及基線後 5 年的再次調查中收集。ASCVD 定義為冠狀動脈疾病（CAD）、缺血性中風（IS）或急性併發症。研究使用 Cox 比例風險模型，以風險比（HRs）檢視爬樓梯樓層數與 ASCVD 之間的關聯。並透過按基因風險評分（GRS）等級、10 年 ASCVD 風險以及自我報告的 ASCVD 家族史進行分層分析，評估疾病易感性對此關聯的修飾作用。

Results  結果

During a median of 12.5 years of follow-up, 39,043 ASCVD, 30,718 CAD, and 10,521 IS cases were recorded. Compared with the reference group (reported climbing stairs 0 times/day at baseline), the multivariable-adjusted HRs for ASCVD were 0.97 (95% CI, 0.93–1.01), 0.84 (0.82–0.87), 0.78 (0.75–0.81), 0.77 (0.73–0.80) and 0.81 (0.77–0.85) for stair climbing of 1–5, 6–10, 11–15, 16–20 and ≥21 times/day, respectively. Comparable results were obtained for CAD and IS. When stratified by different disease susceptibility based on the GRS for CAD/IS, 10-year risk, and family history of ASCVD, the protection association of stair climbing was attenuated by increasing levels of disease susceptibility. Furthermore, compared with people who reported no stair climbing (<5 times/d) at two examinations, those who climbed stairs at baseline and then stopped at resurvey experienced a 32% higher risk of ASCVD (HR 1.32, 95% CI:1.06–1.65).

在為期中位數 12.5 年的追蹤期間，共記錄到 39,043 例動脈粥樣硬化心血管疾病、30,718 例冠狀動脈疾病及 10,521 例缺血性中風病例。與對照組（基準線時每日爬樓梯次數為 0 次）相比，每日爬樓梯 1–5 次、6–10 次、11–15 次、16–20 次及≥21 次者，其經多變量調整後的動脈粥樣硬化心血管疾病風險比分別為 0.97（95%信賴區間 0.93–1.01）、0.84（0.82–0.87）、0.78（0.75–0.81）、0.77（0.73–0.80）及 0.81（0.77–0.85）。冠狀動脈疾病與缺血性中風的分析結果亦呈現相似趨勢。若依據冠狀動脈疾病/缺血性中風的基因風險評分、10 年風險評估及動脈粥樣硬化心血管疾病家族病史進行疾病易感性分層，爬樓梯的保護性關聯會隨著疾病易感性層級升高而減弱。此外，與兩次檢測中均未爬樓梯（每日<5 次）者相比，那些在基準線時有爬樓梯習慣但於後續調查中停止者，其動脈粥樣硬化心血管疾病風險增加了 32%（風險比 1.32，95%信賴區間：1.06–1.65）。

Conclusions  結論

Climbing more than five flights of stairs (approx 50 steps) daily was associated with a lower risk of ASCVD types independent of disease susceptibility. Participants who stopped stair climbing between baseline and resurvey had a higher risk of ASCVD compared with those who never climbed stairs.

每日爬超過五層樓梯（約50階）與降低動脈粥樣硬化心血管疾病風險相關，此關聯性不受疾病易感性影響。與從不爬樓梯者相比，在基線調查與追蹤調查期間停止爬樓梯的參與者，其動脈粥樣硬化心血管疾病風險更高。