Physical activity reduces the risk of symptomatic gallstones: a prospective cohort study
Physical activity reduces the risk of symptomatic gallstones: a prospective cohort study
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DOI：
10.1097/meg.0b013e32833732c3
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发表时间：
2010-08-01
影响因子：
2.1
通讯作者：
Hart, Andrew R.
中科院分区：
文献类型：
--
作者：
Banim, Paul J. R.;Luben, Robert N.;Hart, Andrew R.
研究背景和目的：体力活动可以通过减少胆汁淤积、降低血浆甘油三酯和升高高密度脂蛋白胆固醇水平来预防胆结石的形成。这项前瞻性研究调查的关系，体力活动和有症状的胆结石在两种性别，使用问卷验证对生理measurement.Methods，共25 639名志愿者，年龄在40-74岁，被招募到欧洲癌症前瞻性调查，诺福克，并完成了一份问卷，记录职业和娱乐的体力活动。这份问卷在早些时候针对能量消耗和心肺健康的措施进行了验证。参与者被分为四组身体活动。对该队列进行了14年的症状性胆结石监测。主要结局是使用考克斯回归模型计算的5年时发生胆结石的风险比（HR）。HR根据体重指数、酒精、激素替代治疗和产次进行调整。一个二元变量的进一步分析比较了最低的三个levels.Results的组合的最高水平的体力活动后，5年的随访，135名参与者（69.6%的妇女）发展有症状的胆结石。将最高体力活动水平与最低三个水平进行比较，5年时的多变量分析为HR=0.30（95%置信区间=0.14-0.64，P=0.002）。14年后，发现的结果减弱（HR=0.70，95%可信区间=0.49-1.01，P=0.055）。结论5年后，最高水平的体力活动与70%的症状性胆结石风险降低相关。这种关联可能是因果关系，因为有一致的实验和流行病学数据表明具有保护作用。在胆结石病因学研究中，应准确测量体力活动。Eur J Gastroenterol Hepatol 22：983-988（C）2010 Wolters Kluwer Health|利平科特威廉姆斯&威尔金斯。
Background and aims Physical activity may prevent gallstones formation by reducing bile stasis and plasma triglycerides and elevating high-density lipoprotein cholesterol levels. This prospective study investigated the relationship of physical activity and symptomatic gallstones in both sexes, using a questionnaire validated against physiological measurements.Methods A total of 25 639 volunteers, aged 40-74 years, were recruited into the European Prospective Investigation of Cancer, Norfolk and completed a questionnaire recording occupational and recreational physical activity. This questionnaire was validated earlier against measures of energy expenditure and cardio-respiratory fitness. Participants were ranked into four groups of physical activity. The cohort was monitored over 14 years for symptomatic gallstones. The primary outcome was hazard ratios (HR) of developing gallstones at 5 years, calculated using Cox regression modelling. HRs were adjusted for body mass index, alcohol, hormone replacement therapy and parity. Further analysis of a binary variable compared the highest level of physical activity against a combination of the lowest three levels.Results After 5 years of follow-up, 135 participants (69.6% women) developed symptomatic gallstones. Comparing the highest level of physical activity against the lowest three levels, the multivariable analysis at 5 years was HR=0.30 (95% confidence interval=0.14-0.64, P=0.002). After 14 years the findings were attenuated (HR=0.70, 95% confidence interval=0.49-1.01, P=0.055).Conclusion The highest level of physical activity was associated with a 70% decreased risk of symptomatic gallstones after 5 years. This association may be causal as there are consistent experimental and epidemiological data for a protective effect. Physical activity should be accurately measured in studies investigating gallstones aetiology. Eur J Gastroenterol Hepatol 22: 983-988 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.