24 h活动行为对青少年代谢综合征的成分等时替代效益研究
Study on the Isochronous Substitution Effect of 24-hour Activity Behaviors on Metabolic Syndrome in Adolescents
背景 代谢综合征（MS）的发生逐渐年轻化，青少年MS的发病率逐年增加。24 h活动行为由身体活动（PA）、久坐行为（SB）、睡眠（SLP）构成，活动行为之间相互替代产生的替代效益对于预防与控制青少年MS有重要意义。目的 基于成分等时替代模型探讨SB、低强度身体活动（LPA）、中高强度身体活动（MVPA）、SLP之间重新分配对青少年MS危险因素的替代效益。方法 2022年9月—2023年6月在天津市随机招募12~15岁受试者181名（包括男85名、女96名）。使用三维加速度计采集受试者的SB、LPA、MVPA、SLP；测量受试者的身高、体质量和腰围（WC），安静15 min后测量受试者的血压；使用全自动生化分析仪及试剂盒测量三酰甘油（TG）、高密度脂蛋白（HDL）、血糖（GLU）；建立成分等时替代模型，分别进行15 min的替代效益与以5分钟为间隔的连续替代。结果 受试者SLP时间为（586.5±66.2）min、SB为（571.2±90.8）min、LPA为（233.8±67.2）min、MVPA为（49.5±17.8）min；增加15 min的MVPA活动时间时，标准化腰围将减少0.16~0.20个单位、标准化收缩压将下降0.12~0.24个单位、标准化舒张压将下降0.18~0.29个单位、标准化血糖将下降0.03~0.10个单位、标准化三酰甘油将下降0.02~0.09个单位、标准化高密度脂蛋白将升高0.05~0.07个单位。MVPA替代SB产生的效用>MVPA替代SLP产生的效用>MVPA替代LPA产生的效用；当MVPA时间增加60 min时，标准化腰围降低0.02~0.62个单位、标准化收缩压下降0.06~0.49个单位、标准化舒张压下降0.08~0.64个单位、标准化三酰甘油下降0.01~0.14个单位、标准化高密度脂蛋白升高0.03~0.23个单位、标准化血糖降低0.01~0.12个单位。结论 24 h活动行为的改变对青少年的腰围、收缩压、舒张压、血糖、三酰甘油、高密度脂蛋白均产生明显作用，其中MVPA替代SB能够产生最大的替代效益。MVPA具有不可替代性，其他活动行为替代MVPA产生的负效益远大于MVPA替代其他行为产生的正效益。
预防医学医学研究方法
代谢综合征青少年身体活动久坐生活方式腰围等时替代
冯展鹏,谭思洁,郭振,曹立全.24 h活动行为对青少年代谢综合征的成分等时替代效益研究[EB/OL].(2025-09-29)[2025-10-03].https://chinaxiv.org/abs/202509.00254.点此复制
BackgroundThe onset of metabolic syndromeMSis becoming youngerand the incidence of MS in adolescents is annually increasing. The 24-hour activity behaviors consist of physical activityPAsedentary behaviorSB and sleepSLP. The substitution benefits generated by the mutual substitution of activity behaviors are of great significance to the prevention and control of adolescent MS. ObjectiveTo explore the substitution benefits of redistributing between SBthe Low Intensity Physical ActivityLPAModerate-to-High Intensity Physical ActivityMVPAand SLP on the risk factors of adolescent MS based on the component isochronous substitution model. MethodsFrom September 2022 to June 2023181 subjects aged 12-15 years old from TianjinChina were randomly recruitedincluding 85 males and 96 females. SBLPAMVPASLP of subjects were collected using a 3D accelerometer. The heightbody massand waist circumferenceWCas well as blood pressure after 15 minutes of rest were recorded. TriglyceridesTGhigh-density lipoproteinHDLand blood glucoseGLUwere examined using a fully automated biochemical analyzer and reagent kits. A component equal time substitution model was performedand 15-minute substitution benefits and continuous substitution at 5-minute intervals were conducted. ResultsThe time of SLPSBLPAand MVPA of subjects were586.566.2min571.290.8min233.867.2minand49.517.8minrespectively. With the increased MVPA activity time by 15 minutesthe standardized waist circumference decreased by 0.16-0.20 unitsthe standardized systolic blood pressureSBPdecreased by 0.12-0.24 unitsthe standardized diastolic blood pressureDBPdecreased by 0.18-0.29 unitsthe standardized blood glucose decreased by 0.03-0.10 unitsthe standardized TG decreased by 0.02-0.09 unitsand the standardized HDL increased by 0.05-0.07 units. The utility generated by MVPA replacing SB was superior to the utility generated by MVPA replacing SLPfollowed by the utility generated by MVPA replacing LPA. When the MVPA activity time increased by 60 minutesthe standardized waist circumference decreased by 0.02-0.62 unitsstandardized SBP decreased by 0.06-0.49 unitsstandardized DBP decreased by 0.08-0.64 unitsstandardized TG decreased by 0.01-0.14 unitsstandardized HDL increased by 0.03-0.23 unitsand standardized blood glucose decreased by 0.01-0.12 units. ConclusionChanges in 24-hour activity behaviors have significant effects on waist circumferenceSBPDBPblood glucoseTGand HDL in adolescentswith MVPA replacing SB producing the greatest substitution benefit. MVPA is irreplaceableand the negative benefits generated by other activities replacing MVPA far outweigh the positive benefits generated by MVPA replacing other activities.
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