Cardiorespiratory fitness and death from cancer: a 42-year follow-up from the Copenhagen Male Study
Cardiorespiratory fitness and death from cancer: a 42-year follow-up from the Copenhagen Male Study
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DOI：
10.1136/bjsports-2016-096860
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发表时间：
2017-09-01
影响因子：
18.4
通讯作者：
Gyntelberg, Finn
中科院分区：
文献类型：
--
作者：
Jensen, Magnus Thorsten;Holtermann, Andreas;Gyntelberg, Finn
目的心肺适能（CRF）差与癌症死亡有关。如果随访时间较短，这种关联可能会受到CRF评估时已存在的亚临床疾病的混淆。本研究调查CRF与癌症死亡和任何原因之间的关联，随访时间分别为42年和44年，研究对象为1970-1971年参加哥本哈根男性前瞻性研究的中年、就业和无癌症的丹麦男性。CRF（最大耗氧量（VO（2）max））使用自行车测力计测试进行估计，并在多变量考克斯模型中进行分析，包括传统的风险因素，社会阶层和自我报告的体力活动。使用丹麦国家登记册评估癌症死亡和全因死亡率。结果共纳入5131名男性，平均（SD）年龄48.8（5.4）岁。在44年的随访中，4486例受试者死亡（87.4%），1527例（29.8%）死于癌症。在多变量模型中，CRF与癌症死亡率和全因死亡率呈高度显著负相关（VO（2）max估计值每增加10 mL/kg/min，HR（95% CI）分别为0.83（0.77 - 0.90）和0.89（0.85 - 0.93））。除前列腺癌死亡（1.00（0.82 - 1.2）; p=0.97; n=231）外，在特定癌症组中观察到类似的相关性。CRF和结果之间的关联基本上保持不变后，排除受试者死亡10年（n=377）和20年（n=1276）including.Conclusions CRF是非常显着负相关的癌症死亡率和全因死亡率。排除研究纳入后20年内死亡的受试者，相关性是稳健的，从而表明反向因果关系的影响最小。
Objectives Poor cardiorespiratory fitness (CRF) is associated with death from cancer. If follow-up time is short, this association may be confounded by subclinical disease already present at the time of CRF assessment. This study investigates the association between CRF and death from cancer and any cause with 42 years and 44 years of follow-up, respectively.Setting, participants and main outcome measures Middle-aged, employed and cancer-free Danish men from the prospective Copenhagen Male Study, enrolled in 1970-1971, were included. CRF (maximal oxygen consumption (VO(2)max)) was estimated using a bicycle ergometer test and analysed in multivariable Cox models including conventional risk factors, social class and self-reported physical activity. Death from cancer and all-cause mortality was assessed using Danish national registers. Follow-up was 100% complete.Results In total, 5131 men were included, mean (SD) age 48.8 (5.4) years. During 44 years of follow-up, 4486 subjects died (87.4%), 1527 (29.8%) from cancer. In multivariable models, CRF was highly significantly inversely associated with death from cancer and allcause mortality ((HR (95% CI)) 0.83 (0.77 to 0.90) and 0.89 (0.85 to 0.93) per 10 mL/kg/min increase in estimated VO(2)max, respectively). A similar association was seen across specific cancer groups, except death from prostate cancer (1.00 (0.82 to 1.2); p=0.97; n=231). The associations between CRF and outcomes remained essentially unchanged after excluding subjects dying within 10 years (n=377) and 20 years (n=1276) of inclusion.Conclusions CRF is highly significantly inversely associated with death from cancer and all-cause mortality. The associations are robust for exclusion of subjects dying within 20 years of study inclusion, thereby suggesting a minimal influence of reverse causation.