Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013.
Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013.
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DOI：
10.1136/bmj.i3857
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发表时间：
2016-08-09
期刊：
影响因子：
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通讯作者：
Forouzanfar MH
中科院分区：
文献类型：
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作者：
Kyu HH;Bachman VF;Alexander LT;Mumford JE;Afshin A;Estep K;Veerman JL;Delwiche K;Iannarone ML;Moyer ML;Cercy K;Vos T;Murray CJ;Forouzanfar MH
目的量化总体体力活动与乳腺癌、结肠癌、糖尿病、缺血性心脏病和缺血性中风事件风险之间的剂量反应关系。设计系统评价和贝叶斯剂量反应荟萃分析。数据来源：1980 年至 2016 年 2 月 27 日期间的 PubMed 和 Embase，以及相关系统评价的参考文献。 2007 年至 2010 年在中国、加纳、印度、墨西哥、俄罗斯和南非进行的全球老龄化和成人健康研究以及 1999 年至 2011 年美国国家健康和营养检查调查的数据被用来将特定领域的身体活动（纳入研究中报告的）映射到总活动。选择研究的资格标准前瞻性队列研究检查身体活动（任何领域）与所研究的五种疾病中的至少一种之间的关联。结果 共识别出 174 篇文章：35 篇关于乳腺癌、19 篇关于结肠癌、55 篇关于糖尿病、43 篇关于缺血性心脏病、26 篇关于缺血性中风（一些文章包含多种结果）。尽管较高水平的总体力活动与较低的所有结果风险显着相关，但主要收益发生在较低的活动水平（每周最多 3000-4000 代谢当量 (MET) 分钟）。例如，与那些没有进行体力活动的人相比，每周总活动量为 600 MET 分钟（最低推荐水平）的人患糖尿病的风险要低 2%。每周 MET 分钟从 600 增加到 3600 分钟，风险又降低了 19%。在较高的活动水平下，相同的增加量产生的回报要小得多：将总活动量从 9000 MET 分钟/周增加到 12 000 MET 分钟/周，患糖尿病的风险仅降低了 0.6%。与活动不足的个体（总活动<600 MET 分钟/周）相比，高度活动类别（≥8000 MET 分钟/周）的乳腺癌风险降低了 14%（相对风险 0.863，95% 不确定区间 0.829 至 0.900）；结肠癌为 21%（0.789、0.735 至 0.850）；糖尿病为 28%（0.722、0.678 至 0.768）；缺血性心脏病为 25%（0.754、0.704 至 0.809）；缺血性中风为 26%（0.736、0.659 至 0.811）。结论 总体力活动水平高于当前建议最低水平数倍的人，所研究的五种疾病的风险显着降低。更多对总身体活动进行详细量化的研究将有助于找到不同活动水平的更精确的相对风险估计。
Objective To quantify the dose-response associations between total physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events. Design Systematic review and Bayesian dose-response meta-analysis. Data sources PubMed and Embase from 1980 to 27 February 2016, and references from relevant systematic reviews. Data from the Study on Global AGEing and Adult Health conducted in China, Ghana, India, Mexico, Russia, and South Africa from 2007 to 2010 and the US National Health and Nutrition Examination Surveys from 1999 to 2011 were used to map domain specific physical activity (reported in included studies) to total activity. Eligibility criteria for selecting studies Prospective cohort studies examining the associations between physical activity (any domain) and at least one of the five diseases studied. Results 174 articles were identified: 35 for breast cancer, 19 for colon cancer, 55 for diabetes, 43 for ischemic heart disease, and 26 for ischemic stroke (some articles included multiple outcomes). Although higher levels of total physical activity were significantly associated with lower risk for all outcomes, major gains occurred at lower levels of activity (up to 3000-4000 metabolic equivalent (MET) minutes/week). For example, individuals with a total activity level of 600 MET minutes/week (the minimum recommended level) had a 2% lower risk of diabetes compared with those reporting no physical activity. An increase from 600 to 3600 MET minutes/week reduced the risk by an additional 19%. The same amount of increase yielded much smaller returns at higher levels of activity: an increase of total activity from 9000 to 12 000 MET minutes/week reduced the risk of diabetes by only 0.6%. Compared with insufficiently active individuals (total activity <600 MET minutes/week), the risk reduction for those in the highly active category (≥8000 MET minutes/week) was 14% (relative risk 0.863, 95% uncertainty interval 0.829 to 0.900) for breast cancer; 21% (0.789, 0.735 to 0.850) for colon cancer; 28% (0.722, 0.678 to 0.768) for diabetes; 25% (0.754, 0.704 to 0.809) for ischemic heart disease; and 26% (0.736, 0.659 to 0.811) for ischemic stroke. Conclusions People who achieve total physical activity levels several times higher than the current recommended minimum level have a significant reduction in the risk of the five diseases studied. More studies with detailed quantification of total physical activity will help to find more precise relative risk estimates for different levels of activity.