Strate Lisa L, Liu Yan L, Aldoori Walid H, Giovannucci Edward L
Division of Gastroenterology, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington 98104, USA.
Am J Gastroenterol. 2009 May;104(5):1221-30. doi: 10.1038/ajg.2009.121. Epub 2009 Apr 14.
Little is known about the effect of physical activity on diverticular complications. This study prospectively examined the associations between physical activity and diverticular bleeding and diverticulitis.
We studied 47,228 US males in the Health Professionals Follow-up Study cohort who were aged 40-75 years and free of diverticular disease, gastrointestinal cancer, and inflammatory bowel disease at baseline in 1986. Men reporting newly diagnosed diverticular disease on biennial follow-up questionnaires were sent supplemental questionnaires outlining details of diagnosis and treatment. Physical activity was assessed every 2 years. Men recorded the average time per week spent in eight recreational activities, and flights of stairs climbed per day. Cox proportional hazards regression was used to calculate relative risks (RRs).
During 18 years of follow-up, 800 cases of diverticulitis and 383 cases of diverticular bleeding were identified. Total cumulative physical activity was associated with a decreased risk of diverticulitis and diverticular bleeding. After adjustment for potential confounders, the RR for men in the highest quintile of total activity (> or = 57.4 metabolic equivalent hours per week (MET-h/week) was 0.75 (95% confidence interval, CI, 0.58-0.95) for diverticulitis and 0.54 (95% CI, 0.38-0.77) for bleeding, as compared with men in the lowest quintile (< or = 8.2 MET-h/week). Vigorous activity was inversely related to diverticulitis in a high vs. low comparison (multivariable RR, 0.66; 95% CI, 0.51-0.86) and bleeding (multivariable RR, 0.61; 95% CI, 0.41-0.90), whereas nonvigorous activity was not. These results were similar for recent (simple updated) and baseline activity.
Data from this large prospective cohort suggest that physical activity lowers the risk of diverticulitis and diverticular bleeding. Vigorous activity appears to account for this association.
关于体力活动对憩室并发症的影响，人们了解甚少。本研究前瞻性地考察了体力活动与憩室出血及憩室炎之间的关联。
我们在健康专业人员随访研究队列中对47228名美国男性进行了研究，这些男性年龄在40至75岁之间，在1986年基线时无憩室病、胃肠道癌和炎症性肠病。在每两年一次的随访问卷中报告新诊断出憩室病的男性会收到补充问卷，其中概述了诊断和治疗的详细情况。每两年评估一次体力活动。男性记录每周花在八项休闲活动上的平均时间以及每天爬的楼梯层数。采用Cox比例风险回归来计算相对风险（RRs）。
在18年的随访期间，共确诊800例憩室炎和383例憩室出血。总的累积体力活动与憩室炎和憩室出血风险降低相关。在对潜在混杂因素进行调整后，与总活动量处于最低五分位数（每周小于或等于8.2代谢当量小时（MET-h/周））的男性相比，总活动量处于最高五分位数（每周大于或等于57.4代谢当量小时（MET-h/周））的男性患憩室炎的RR为0.75（95%置信区间，CI，0.58 - 0.95），患出血的RR为0.54（95%CI，0.38 - 0.77）。高强度活动与憩室炎（多变量RR，0.66；95%CI，0.51 - 0.86）和出血（多变量RR，0.61；95%CI，0.41 - 0.90）呈负相关，而低强度活动则不然。近期（简单更新后）活动和基线活动的结果相似。
来自这个大型前瞻性队列的数据表明，体力活动可降低憩室炎和憩室出血的风险。高强度活动似乎是造成这种关联的原因。
