Objectives This study aims to examine the associations of daily step count with all-cause mortality and incident cardiovascular disease (CVD) by sedentary time levels and to determine if the minimal and optimal number of daily steps is modified by high sedentary time. Methods Using data from the UK Biobank, this was a prospective dose–response analysis of total daily steps across low (<10.5 hours/day) and high (≥10.5 hours/day) sedentary time (as defined by the inflection point of the adjusted absolute risk of sedentary time with the two outcomes). Mortality and incident CVD was ascertained through 31 October 2021. Results Among 72 174 participants (age=61.1±7.8 years), 1633 deaths and 6190 CVD events occurred over 6.9 (±0.8) years of follow-up. Compared with the referent 2200 steps/day (5th percentile), the optimal dose (nadir of the curve) for all-cause mortality ranged between 9000 and 10 500 steps/day for high (HR (95% CI)=0.61 (0.51 to 0.73)) and low (0.69 (0.52 to 0.92)) sedentary time. For incident CVD, there was a subtle gradient of association by sedentary time level with the lowest risk observed at approximately 9700 steps/day for high (0.79 (0.72 to 0.86)) and low (0.71 (0.61 to 0.83)) sedentary time. The minimal dose (steps/day associated with 50% of the optimal dose) of daily steps was between 4000 and 4500 steps/day across sedentary time groups for all-cause mortality and incident CVD. Conclusions Any amount of daily steps above the referent 2200 steps/day was associated with lower mortality and incident CVD risk, for low and high sedentary time. Accruing 9000–10 500 steps/day was associated with the lowest mortality risk independent of sedentary time. For a roughly equivalent number of steps/day, the risk of incident CVD was lower for low sedentary time compared with high sedentary time. Data are available on reasonable request. The UK Biobank data that support the findings of this study can be accessed by researchers on application ().

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每日步数与死亡率和心血管疾病发生率的关联是否因久坐时间水平的不同而不同？基于设备的队列研究

目的 本研究旨在通过久坐时间水平检查每日步数与全因死亡率和心血管疾病 (CVD) 事件的关联，并确定每日最少和最佳步数是否会因久坐时间长而改变。方法 使用英国生物银行的数据，这是对低（<10.5 小时/天）和高（≥10.5 小时/天）久坐时间（由调整后的拐点定义）的每日总步数的前瞻性剂量反应分析。久坐时间与两种结果的绝对风险）。死亡率和 CVD 事件的确定截至 2021 年 10 月 31 日。结果 在 72 174 名参与者（年龄=61.1±7.8 岁）中，6.9 (±0.8) 年的随访期间发生了 1633 例死亡和 6190 例 CVD 事件。与参考的 2200 步/天（第 5 个百分位数）相比，全因死亡率的最佳剂量（曲线最低点）范围为 9000 至 10 500 步/天，高 (HR (95% CI)=0.61（0.51 至0.73)) 和低 (0.69 (0.52 至 0.92)) 久坐时间。对于CVD事件，久坐时间水平存在微妙的关联梯度，在每天大约9700步时观察到的最低风险为高久坐时间（0.79（0.72至0.86））和低久坐时间（0.71（0.61至0.83））。对于全因死亡率和心血管疾病事件，久坐时间组的每日步数最小剂量（与最佳剂量的 50% 相关的步数/天）为 4000 至 4500 步/天。结论 无论久坐时间长短，每日步数超过 2200 步/天都与较低的死亡率和 CVD 风险相关。每天行走 9000-10500 步与最低的死亡风险相关，与久坐时间无关。在每天步数大致相同的情况下，与久坐时间长的人相比，久坐时间少的人发生 CVD 的风险较低。可根据合理要求提供数据。研究人员可以通过应用程序访问支持本研究结果的英国生物银行数据（）。