Williams Paul T
Donner Laboratory, Life Sciences Division, Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA.
Med Sci Sports Exerc. 2014 Feb;46(2):312-7. doi: 10.1249/MSS.0b013e3182a4e89c.
This study aimed to test whether incident kidney cancer risk is associated with exercise energy expenditure (i.e., metabolic equivalents, 1 MET) when calculated from distance walked or run.
Hazard ratios (HR) and 95% confidence intervals (95% CI) from Cox proportional hazard analyses of self-reported physician-diagnosed incident kidney cancer versus MET-hours per week in 91,820 subjects recruited between 1991 and 1993 (7.7 yr follow-up of 42,833 subjects) and between 1998 and 1999 (6.4 yr follow-up of 33,053 subjects) as part of the National Runners' Health Study and between 1998 and 1999 as part of the National Walkers' Health Study (5.7 yr follow-up of 15,934 subjects).
Fifty-two incident cancers were reported. Age- and sex-adjusted risk declined 1.9% per MET-hour per week run or walked (HR = 0.981, 95% CI = 0.964-0.997, P = 0.02). Compared with walking or running below guidelines levels (<7.5 MET·h·wk(-1)), the risk for incident kidney cancer was 61% lower for meeting the guidelines (HR = 0.39, 95% CI = 0.11-1.08, P = 0.07 for 7.5-12.5 MET·h·wk(-1)), 67% lower for exercising one to two times the recommended level (HR = 0.33; 95% CI = 0.15-0.72, P = 0.005 for 12.6-25.1 MET·h·wk(-1)), and 76.3% lower for exercising two times or more the recommended level (HR = 0.24, 95% CI = 0.11-0.52, P = 0.0005 for ≥ 25.2 MET·h·wk(-1)). Incident kidney cancer risk also increased in association with baseline body mass index (P = 0.002), smoking (P = 0.02), and hypertensive (P = 0.007) and diabetes medication use (P = 0.01); however, exercise-associated reductions in kidney cancer risk persisted for 12.6-25.1 MET·h·wk(-1) (HR = 0.35, P = 0.01) and ≥ 25.2 MET·h·wk(-1) (HR = 0.29, P = 0.004) vis-à-vis <7.5 MET·h·wk(-1) when also adjusted for body mass index, hypertension, diabetes, and pack-years smoked.
Running and walking may reduce incident kidney cancer risk independent of its other known risk factors.
本研究旨在检验根据步行或跑步距离计算得出的运动能量消耗（即代谢当量，1 MET）与肾癌发病风险之间是否存在关联。
对1991年至1993年招募的91,820名受试者（42,833名受试者进行了7.7年随访）、1998年至1999年招募的受试者（33,053名受试者进行了6.4年随访）以及1998年至1999年招募的受试者（15,934名受试者进行了5.7年随访）进行Cox比例风险分析，得出自我报告的经医生诊断的肾癌发病情况与每周MET小时数的风险比（HR）和95%置信区间（CI），这些受试者分别作为国家跑步者健康研究的一部分、国家步行者健康研究的一部分。
报告了52例新发癌症病例。经年龄和性别调整后，每周每MET小时的跑步或步行风险降低1.9%（HR = 0.981，95% CI = 0.964 - 0.997，P = 0.02）。与低于指南水平（<7.5 MET·h·wk⁻¹）的步行或跑步相比，达到指南水平（7.5 - 12.5 MET·h·wk⁻¹）时肾癌发病风险降低61%（HR = 0.39，95% CI = 0.11 - 1.08，P = 0.07），运动达到推荐水平的1至2倍时风险降低67%（HR = 0.33；95% CI = 0.15 - 0.72，P = 0.005，12.6 - 25.1 MET·h·wk⁻¹），运动达到推荐水平的2倍或更多时风险降低76.3%（HR = 0.24，95% CI = 0.11 - 0.52，P = 0.0005，≥ ²⁵.² MET·h·wk⁻¹）。肾癌发病风险还与基线体重指数（P = 0.002）、吸烟（P = 0.02）、高血压（P = 0.007）以及糖尿病用药（P = 0.01）相关；然而，在对体重指数、高血压、糖尿病和吸烟包年数进行调整后，与<7.5 MET·h·wk⁻¹相比，运动相关的肾癌风险降低在12.6 - 25.1 MET·h·wk⁻¹（HR = 0.35，P = 0.01）和≥ ²⁵.² MET·h·wk⁻¹（HR = 0.29, P = 0.004）时仍然存在。
跑步和步行可能降低肾癌发病风险，且独立于其他已知风险因素。
