每日步数与成人哮喘发病率的关系
2025/04/06
摘要
背景：较高的每日步数与降低许多慢性疾病的风险相关。增加体力活动可改善哮喘的预后。没有已知的预防成人偶发哮喘的策略。
目的：探讨客观体育活动对成人哮喘发病率的影响。
方法：纳入年龄≥18岁、具有个人活动追踪器和电子健康记录数据的All of Us研究项目回顾性队列参与者。哮喘定义为两个ICD-9/10代码和≥1种药物。在活动监测开始前/ 6个月内诊断为哮喘的参与者被分配为普遍哮喘；在六个月的活动监测后被诊断为哮喘的参与者被分配为偶发哮喘。
结果：8,360名参与者符合纳入标准。无哮喘参与者[7,795 (5,879-9,921,95% CI), n = 7,700]的平均步数高于普遍哮喘参与者[6,968 (5,036-9,014,95% CI), n = 450]或偶发哮喘参与者[6,953 (5,215-8,261),n = 210] （p < 0.0001）。“在偶发哮喘队列中，随着时间的推移，每天的步数下降幅度更大（p = 0.018），观察到显著的时间与新发哮喘的交互作用。”对年龄、性别、种族、体重指数、重性抑郁障碍、睡眠呼吸暂停和慢性阻塞性肺疾病进行校正后，我们观察到每日平均步数与哮喘发病率呈负相关[每日平均步数每增加1,000步，校正的风险比为0.93 (0.88 ~ 0.98,95% CI)]。
结论：在新发哮喘的成人中，客观测量的每日步数较低，这可能是降低哮喘发病率的一个可改变的危险因素。未来的研究应客观监测有哮喘风险和哮喘患者的身体活动。
Association of Daily Steps Over Time with Adult Asthma Incidence
Joshua C Halevi, Jeffrey Annis, Hiral Master, Basil M Kahwash, Evan L Brittain, Katherine N Cahill
Abstract
Background: Higher daily step counts is associated with reduced risk of many chronic diseases. Increased physical activity improves asthma outcomes. There are no known prevention strategies for adult incident asthma.
Objective: To determine whether objective physical activity impacts adult asthma incidence.
Methods: Participants in the All of Us Research Program retrospective cohort aged ≥ 18 years with linked personal activity tracker and electronic health record data met inclusion. Asthma was defined as two ICD-9/10 codes and ≥ 1 medication. Participants with an asthma diagnosis date before/within six months of activity monitor initiation were assigned prevalent asthma; participants diagnosed after six months of activity monitoring were assigned incident asthma.
Results: 8,360 participants met inclusion. Median average steps/day were higher among asthma-free participants [7,795 (5,879-9,921, 95% CI), n = 7,700] than participants with prevalent [6,968 (5,036-9,014, 95% CI), n = 450] or incident asthma [6,953 (5,215-8,261), n = 210] (p < 0.0001). Significant time by incident asthma interaction was observed with a greater decline in steps/day over time in the incident asthma cohort (p = 0.018). An inverse relationship was observed between average steps/day and asthma incidence after adjusting for age, sex, race, body mass index, major depressive disorder, sleep apnea, and chronic obstructive lung disease [adjusted hazard ratio 0.93 (0.88-0.98, 95% CI) per 1,000 average daily step increase].
Conclusions: Objectively measured daily steps are lower in adults who develop incident asthma and may represent a modifiable risk factor to reduce asthma incidence. Future studies should objectively monitor physical activity among adults at risk for and with asthma.
背景：较高的每日步数与降低许多慢性疾病的风险相关。增加体力活动可改善哮喘的预后。没有已知的预防成人偶发哮喘的策略。
目的：探讨客观体育活动对成人哮喘发病率的影响。
方法：纳入年龄≥18岁、具有个人活动追踪器和电子健康记录数据的All of Us研究项目回顾性队列参与者。哮喘定义为两个ICD-9/10代码和≥1种药物。在活动监测开始前/ 6个月内诊断为哮喘的参与者被分配为普遍哮喘；在六个月的活动监测后被诊断为哮喘的参与者被分配为偶发哮喘。
结果：8,360名参与者符合纳入标准。无哮喘参与者[7,795 (5,879-9,921,95% CI), n = 7,700]的平均步数高于普遍哮喘参与者[6,968 (5,036-9,014,95% CI), n = 450]或偶发哮喘参与者[6,953 (5,215-8,261),n = 210] （p < 0.0001）。“在偶发哮喘队列中，随着时间的推移，每天的步数下降幅度更大（p = 0.018），观察到显著的时间与新发哮喘的交互作用。”对年龄、性别、种族、体重指数、重性抑郁障碍、睡眠呼吸暂停和慢性阻塞性肺疾病进行校正后，我们观察到每日平均步数与哮喘发病率呈负相关[每日平均步数每增加1,000步，校正的风险比为0.93 (0.88 ~ 0.98,95% CI)]。
结论：在新发哮喘的成人中，客观测量的每日步数较低，这可能是降低哮喘发病率的一个可改变的危险因素。未来的研究应客观监测有哮喘风险和哮喘患者的身体活动。
（中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校）
（J Allergy Clin Immunol. 2025 Mar 10:S0091-6749(25)00264-7. doi: 10.1016/j.jaci.2025.02.033.）
Association of Daily Steps Over Time with Adult Asthma Incidence
Joshua C Halevi, Jeffrey Annis, Hiral Master, Basil M Kahwash, Evan L Brittain, Katherine N Cahill
Abstract
Background: Higher daily step counts is associated with reduced risk of many chronic diseases. Increased physical activity improves asthma outcomes. There are no known prevention strategies for adult incident asthma.
Objective: To determine whether objective physical activity impacts adult asthma incidence.
Methods: Participants in the All of Us Research Program retrospective cohort aged ≥ 18 years with linked personal activity tracker and electronic health record data met inclusion. Asthma was defined as two ICD-9/10 codes and ≥ 1 medication. Participants with an asthma diagnosis date before/within six months of activity monitor initiation were assigned prevalent asthma; participants diagnosed after six months of activity monitoring were assigned incident asthma.
Results: 8,360 participants met inclusion. Median average steps/day were higher among asthma-free participants [7,795 (5,879-9,921, 95% CI), n = 7,700] than participants with prevalent [6,968 (5,036-9,014, 95% CI), n = 450] or incident asthma [6,953 (5,215-8,261), n = 210] (p < 0.0001). Significant time by incident asthma interaction was observed with a greater decline in steps/day over time in the incident asthma cohort (p = 0.018). An inverse relationship was observed between average steps/day and asthma incidence after adjusting for age, sex, race, body mass index, major depressive disorder, sleep apnea, and chronic obstructive lung disease [adjusted hazard ratio 0.93 (0.88-0.98, 95% CI) per 1,000 average daily step increase].
Conclusions: Objectively measured daily steps are lower in adults who develop incident asthma and may represent a modifiable risk factor to reduce asthma incidence. Future studies should objectively monitor physical activity among adults at risk for and with asthma.
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1岁前呼吸道与非呼吸道症状对学龄期哮喘的预测价值
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一项系统回顾与荟萃分析：基于机器学习的儿童哮喘和过敏轨迹分析
