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成年癌症幸存者的心血管疾病与身体活动:一项来自大西洋PATH队列的嵌套式回顾性研究。

Cardiovascular disease and physical activity in adult cancer survivors: a nested, retrospective study from the Atlantic PATH cohort.

作者信息

Keats Melanie R, Cui Yunsong, Grandy Scott A, Parker Louise

机构信息

School of Health and Human Performance, Dalhousie University, 6230 South Street, Halifax, NS, B3H 4R2, Canada.

Population Cancer Research Program, Dalhousie University, 1494 Carlton Street, Halifax, NS, B3H 3B7, Canada.

出版信息

J Cancer Surviv. 2017 Apr;11(2):264-273. doi: 10.1007/s11764-016-0584-x. Epub 2016 Nov 16.

DOI:10.1007/s11764-016-0584-x
PMID:27854007
Abstract

PURPOSE

The study aimed to examine the relationship between cardiovascular disease (CVD) and physical activity (PA) levels in cancer survivors (CS).

METHODS

Using a nested, retrospective follow-up design, this study presents the self-reported prevalence of CVD in an Atlantic Canadian population-based cohort of 1526 CS and 6034 age-sex matched, non-cancer controls ranging from 35 to 69 years of age. Univariate and multiple logistic regression models were used to explore the association between CVD and PA.

RESULTS

Overall, CS were 30% more likely to have ever experienced a CVD event than controls (OR = 1.3; 95% CI 1-1.7, p = .07). Survivors were also significantly more likely to report having hypertension (OR = 1.60; 95% CI 1.03-1.3, p = .02) and diabetes (OR = 1.27; 95% CI 1.03-1.16, p = .02). Compared to controls, CS were significantly less likely to engage in high levels of PA. For survivors, compared to those who were least physically active, the odds of having a CVD risk factor was 35% lower for those who were moderately active (OR = 0.65; 95% CI 0.48-0.88) and 45% lower in the most highly active group (OR = 0.55; 95% CI 0.4-0.73). For controls, the odds of having a CVD risk factor was 25% lower for those in the moderately active group (OR = 0.75; 95% CI 0.64-0.88) and 30% lower for those in the high active group (OR = 0.70; 95% CI 0.6-0.81).

CONCLUSION

Low active survivors appear to be at a high risk of CVD-related comorbidity.

IMPLICATIONS FOR CANCER SURVIVORS

PA is associated with lower CVD-related comorbidity in CS, suggesting that interventions directed at increasing PA should be implemented to improve long-term health outcomes.

摘要

目的

本研究旨在探讨癌症幸存者(CS)的心血管疾病(CVD)与身体活动(PA)水平之间的关系。

方法

采用嵌套式回顾性随访设计,本研究呈现了在加拿大东部一个基于人群的队列中,1526名CS和6034名年龄性别匹配的非癌症对照者(年龄在35至69岁之间)自我报告的CVD患病率。单因素和多因素逻辑回归模型用于探讨CVD与PA之间的关联。

结果

总体而言,CS经历过CVD事件的可能性比对照组高30%(比值比[OR]=1.3;95%置信区间[CI]1-1.7,p=0.07)。幸存者报告患有高血压(OR=1.60;95%CI1.03-1.3,p=0.02)和糖尿病(OR=1.27;95%CI1.03-1.16,p=0.02)的可能性也显著更高。与对照组相比,CS进行高强度PA的可能性显著更低。对于幸存者,与身体活动最少的人相比,中度活跃者患CVD危险因素的几率低35%(OR=0.65;95%CI0.48-0.88),最活跃组低45%(OR=0.55;95%CI0.4-0.73)。对于对照组,中度活跃组患CVD危险因素的几率低25%(OR=0.75;95%CI0.64-0.88),高度活跃组低30%(OR=0.70;95%CI0.6-0.81)。

结论

活动水平低的幸存者似乎患CVD相关合并症的风险很高。

对癌症幸存者的启示

PA与CS中较低的CVD相关合并症有关,这表明应实施旨在增加PA的干预措施以改善长期健康结果。

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