等时替代模型在流行病学研究中的应用

等时替代模型（ISM）是探索身体行为与健康结局之间真实关联的有力工具，在大型自然人群队列研究中具有突出的应用潜力。本文系统介绍ISM的原理和具体分析中的实现方法，以期为国内身体行为相关的流行病学研究提供分析思路。通过西北区域自然人群队列研究陕西省人群基线调查数据，分别采用单一活动模型、分割模型以及ISM分析身体活动与心血管疾病的关联，比较不同模型优缺点，展示ISM在量化身体活动健康风险研究中的优势。ISM可以较好量化身体活动与健康结局的真实关联，在流行病学研究中具有广泛的应用价值。

Application of isotemporal substitution model in epidemiological research

Isotemporal substitution model is a powerful tool to explore the real association between physical behavior and health outcomes, which has the potential of the application in large-scale cohort study. This paper systematically introduces the principle of isotemporal substitution model and its implementation method in specific analysis to provide analytical ideas for the epidemiological research related to physical behavior in China. The baseline data of Regional Ethic Cohort Study in Northwest China conducted in Shaanxi province were used to analyze the relationship between physical behavior and cardiovascular disease with single-factor model, partition model and isotemporal substitution model. The advantages and disadvantages of different models were compared, and the advantages of isotemporal substitution model in quantifying physical activity health risk were introduced. Isotemporal substitution model could qualify physical behavior and health outcomes, which has wide application value in epidemiological research.