体力活动和久坐时间与功能性上腹痛的相关性：基于NHANES数据库的横断面研究
| 作 者：魏重操, 邢欣, 刘娜, 王进海 |
| 单 位：西安交通大学第二附属医院 |
| 基金项目： |
| 摘 要： |
| 背景：功能性上腹痛（FUAP）是一种常见的功能性胃肠病，其发病机制尚未完全阐明。目前，体力活动和久坐行为与FUAP的相关性尚未在人群层面得到系统评估。目的：基于美国国家健康与营养检查调查（NHANES）数据库，探讨不同强度体力活动和久坐时间与FUAP的相关性，为FUAP的预防和管理提供流行病学依据。方法：本研究采用横断面研究设计，纳入2017年1月—2020年3月NHANES数据库中年龄≥20岁且具有完整人口统计学、体力活动和上腹痛数据的参与者。采用较为宽泛的标准诊断FUAP。以全球体力活动问卷（GPAQ）评估体力活动情况，包括工作、娱乐活动及其强度和久坐时间。采用单因素分析和多因素Logistic回归分析评估FUAP的影响因素。利用平滑曲线拟合探索久坐时间与FUAP间的非线性关系。结果：共纳入6 285名参与者，FUAP患病率为18.6%。单因素分析显示，FUAP组与对照组的性别、体质指数、种族、出生国家、教育水平、婚姻状况、饮酒情况、目前吸烟情况、高强度工作、中等强度工作、高强度娱乐活动和中等强度娱乐活动差异有统计学意义（P均<0.05）。进一步的多因素Logistic回归分析显示，在校正所有人口统计学变量后，高强度工作（OR=1.302，95% CI：1.125~1.507，P=0.000 4）和中等强度工作（OR=1.365，95% CI：1.194~1.560，P<0.000 1）为FUAP的危险因素，高强度娱乐活动为保护因素（OR=0.772，95% CI：0.654~0.912，P=0.002 3）。平滑曲线拟合显示久坐时间与FUAP间呈U型关系。久坐时间>420 min/d时，FUAP发生率随久坐时间的增加而升高（OR=1.000 84，95% CI：1.000 04~1.001 65，P=0.039 9）。结论：中高强度工作可能增加FUAP风险，而高强度娱乐活动具有保护作用。久坐行为与FUAP的关系存在阈值效应，每日久坐时间超过7 h会显著增加FUAP风险。职业人群需优化工作强度管理，并将减少久坐时间纳入FUAP的预防策略。 |
| 关键词：功能性上腹痛；体力活动；久坐生活方式；横断面研究 |
Association Between Physical Activity, Sedentary Time and Functional Upper Abdominal Pain: A Cross-sectional Study Based on NHANES Database
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| Abstract: |
| Background: Functional upper abdominal pain (FUAP) is a common functional gastrointestinal disorder whose pathogenesis remains incompletely understood. Currently, the association between physical activity, sedentary behavior, and FUAP has not been systematically evaluated at the population level. Aims: To investigate the associations of different physical activity intensities and sedentary time with FUAP using the National Health and Nutrition Examination Survey (NHANES) database, providing epidemiological evidence for the prevention and management of FUAP. Methods: This cross-sectional study included participants aged ≥20 years from the NHANES database (from January 2017 to March 2020) with complete data on demography, physical activity, and upper abdominal pain. Relatively broad diagnostic criteria were applied for FUAP. The global physical activity questionnaire (GPAQ) was used to assess physical activity, including work-related and recreational activities (with their respective intensities) as well as sedentary time. Univariate analysis and multivariate Logistic regression analysis were employed to assess the influencing factors of FUAP, and smooth curve fitting was used to explore nonlinear relationship between sedentary time and FUAP. Results: A total of 6 285 participants were included, with a FUAP prevalence of 18.6%. Univariate analysis showed that there were statistically significant differences in gender, body mass index, race, country of birth, educational level, marital status, alcohol use, current smoking status, high-intensity work, moderate-intensity work, high-intensity recreational activity, and moderate-intensity recreational activity between FUAP group and control group (all P<0.05). After adjusting for all demographic variables, multivariate Logistic regression analysis further confirmed that high-intensity work (OR=1.302, 95% CI: 1.125-1.507, P=0.000 4) and moderate-intensity work (OR=1.365, 95% CI: 1.194-1.560, P<0.000 1) were risk factors for FUAP, while high-intensity recreational activity was a protective factor (OR=0.772, 95% CI: 0.654-0.912, P=0.002 3). Smooth curve fitting indicated a U-shaped relationship between sedentary time and FUAP. When sedentary time exceeded 420 min/d, the incidence of FUAP increased with the prolonged sedentary time (OR=1.000 84, 95% CI: 1.000 04-1.001 65, P=0.039 9). Conclusions: Moderate-to-high-intensity work may increase the risk of FUAP, while high-intensity recreational activity exerts a protective effect. Sedentary behavior exhibits a threshold effect on FUAP, with daily sedentary time exceeding 7 hours significantly increasing the risk of FUAP. For occupational populations, it is necessary to optimize work intensity management and incorporate reducing sedentary time into FUAP prevention strategies. |
| Keywords: Functional Upper Abdominal Pain; Physical Activity; Sedentary Lifestyle; Cross-Sectional Studies |
| 投稿时间：2025-04-27 |
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