剧烈的间歇性生活方式体育锻炼与非锻炼成年人的癌症发病率

SCI

8 August 2023

Vigorous Intermittent Lifestyle Physical Activity and Cancer Incidence Among Nonexercising Adults

 (JAMA Oncol IF: 31.78)

Stamatakis E, Ahmadi MN, Friedenreich CM, et al. Vigorous Intermittent Lifestyle Physical Activity and Cancer Incidence Among Nonexercising Adults: The UK Biobank Accelerometry Study [published online ahead of print, 2023 Jul 27]. JAMA Oncol. 2023;e231830. doi:10.1001/jamaoncol.2023.1830

IMPORTANCE 重要意义

Vigorous physical activity (VPA) is a time-efficient way to achieve recommended physical activity (PA) for cancer prevention, although structured longer bouts of VPA (via traditional exercise) are unappealing or inaccessible to many individuals.

剧烈体育锻炼（VPA）是实现建议的体育锻炼（PA）以预防癌症的一种省时方法，尽管结构化的较长时间的剧烈体育锻炼（通过传统锻炼）对许多人来说不受欢迎或无法实现。

OBJECTIVES 目的  

To evaluate the dose-response association of device-measured daily vigorous intermittent lifestyle physical activity (VILPA) with incident cancer, and to estimate the minimal dose required for a risk reduction of 50% of the maximum reduction.

评估设备测量的每日间歇性剧烈体育锻炼（VILPA）与癌症发病率之间的剂量-反应关系，并估算将风险降低到最大降低量的 50%所需的最小剂量。

DESIGN, SETTING, AND PARTICIPANTS 设计、环境和参与者  

This was a prospective cohort analysis of 22 398 self-reported nonexercising adults from the UK Biobank accelerometry subsample. Participants were followed up through October 30, 2021 (mortality and hospitalizations), or June 30, 2021 (cancer registrations).

这是一项前瞻性队列分析，研究对象是英国生物库加速度子样本中的 22 398 名自我报告不锻炼的成年人。参与者的随访时间为 2021 年 10 月 30 日（死亡和住院）或 2021 年 6 月 30 日（癌症登记）。

EXPOSURES 暴露  

Daily VILPA of up to 1 and up to 2 minutes, assessed by accelerometers worn on participants’ dominant wrist.

每天最多 1 分钟和最多 2 分钟的 VILPA，由佩戴在参与者主导手腕上的加速度计进行评估。

MAIN OUTCOMES AND MEASURES 主要结果和测量  

Incidence of total cancer and PA-related cancer (a composite outcome of 13 cancer sites associated with low PA levels). Hazard ratios and 95% CIs were estimated using cubic splines adjusted for age, sex, education level, smoking status, alcohol consumption, sleep duration, fruit and vegetable consumption, parental cancer history, light- and moderate-intensity PA, and VPA from bouts of more than 1 or 2 minute(s), as appropriate.

癌症总发病率和 PA 相关癌症发病率（与低 PA 水平相关的 13 种癌症部位的综合结果）。根据年龄、性别、教育程度、吸烟状况、饮酒量、睡眠时间、水果和蔬菜摄入量、父母癌症史、轻度和中度强度 PA 以及超过 1 或 2 分钟的 VPA（视情况而定），采用三次样条法估计危险比和 95% CI。

RESULTS 研究结果  

The study sample comprised 22 398 participants (mean [SD] age, 62.0 [7.6] years; 10 122 [45.2%] men and 12 276 [54.8%] women; 21 509 [96.0%] White individuals). During a mean (SD) follow-up of 6.7 (1.2) years (149 650 person-years), 2356 total incident cancer events occurred, 1084 owing to PA-related cancer. Almost all (92.3%) of VILPA was accrued in bouts of up to 1 minute. Daily VILPA duration was associated with outcomes in a near-linear manner, with steeper dose-response curves for PA-related cancer than total cancer incidence. Compared with no VILPA, the median daily VILPA duration of bouts up to 1 minute (4.5 minutes per day) was associated with an HR of 0.80 (95% CI, 0.69-0.92) for total cancer and 0.69 (95% CI, 0.55-0.86) for PA-related cancer. The minimal dose was 3.4 minutes per day for total (HR, 0.83; 95% CI, 0.73-0.93) and 3.7 minutes for PA-related (HR, 0.72; 95% CI, 0.59-0.88) cancer incidence. Findings were similar for VILPA bout of up to 2 minutes.

研究样本包括22 398 名参与者（平均 [SD] 年龄 62.0 [7.6] 岁；10 122 [45.2%] 名男性和 12 276 [54.8%] 名女性；21 509 [96.0%] 名白人）。在平均（标度）6.7（1.2）年（149 650 人-年）的随访期间，共发生了 2356 例癌症事件，其中 1084 例为 PA 相关癌症。几乎所有（92.3%）的 VILPA 都是在不超过 1 分钟的间歇中累积的。每天的 VILPA 持续时间与结果呈近似线性相关，与 PA 相关的癌症的剂量-反应曲线比癌症总发病率更陡峭。与不进行VILPA相比，每日VILPA持续时间中位数为1分钟（每天4.5分钟）与癌症总发病率的相关HR为0.80（95% CI，0.69-0.92），与PA相关癌症的相关HR为0.69（95% CI，0.55-0.86）。最低剂量为每天 3.4 分钟（HR，0.83；95% CI，0.73-0.93）和 3.7 分钟（HR，0.72；95% CI，0.59-0.88）。对于不超过 2 分钟的 VILPA 活动，研究结果与此类似。

CONCLUSIONS AND RELEVANCE 结论和相关性  

The findings of this prospective cohort study indicate that small amounts of VILPA were associated with lower incident cancer risk. Daily VILPA may be a promising intervention for cancer prevention in populations not able or motivated to exercise in leisure time. 

这项前瞻性队列研究的结果表明，少量的 VILPA 与较低的癌症发病风险有关。对于没有能力或没有动力在闲暇时间锻炼的人群来说，每天进行 VILPA 可能是一种很有前景的癌症预防干预措施。

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