K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.
Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
Semin Thromb Hemost. 2018 Nov;44(8):765-779. doi: 10.1055/s-0038-1673636. Epub 2018 Oct 4.
Venous thromboembolism (VTE) is a complex multifactorial disease that represents a growing public health concern. Identification of modifiable risk factors at the population level may provide a measure to reduce the burden of VTE. In this review, we summarize current knowledge of the role of physical activity on the risk of VTE and VTE-related complications. We also discuss methodological challenges related to research on physical activity, and put forward plausible mechanisms for an association between physical activity and VTE. Up to now, published studies have reported diverging results on the relationship between physical activity and VTE, and a complex picture has emerged. However, the available evidence appears to be balanced toward a small beneficial effect of physical activity on the risk of incident VTE, but not in a dose-dependent manner. Still, the lack of an operational definition and standardized assessment method for physical activity, as well as several sources of bias, impairs the interpretation of the available literature. Additional work is necessary to understand the role and how to apply physical activity in the VTE setting. Future research should utilize objective assessment strategies of physical activity and physical fitness, account for the fluctuating nature in habitual activity levels, and explore the role of physical activity in the areas of secondary prevention and VTE-related complications.
静脉血栓栓塞症（VTE）是一种复杂的多因素疾病，是日益受到关注的公共卫生问题。在人群水平上确定可改变的风险因素可能是降低 VTE 负担的一种措施。在这篇综述中，我们总结了目前关于体力活动对 VTE 风险和 VTE 相关并发症的作用的知识。我们还讨论了与体力活动研究相关的方法学挑战，并提出了体力活动与 VTE 之间关联的可能机制。到目前为止，已发表的研究报告了体力活动与 VTE 之间关系的不一致结果，出现了复杂的情况。然而，现有证据似乎倾向于体力活动对首发 VTE 风险有较小的有益影响，但不是剂量依赖性的。尽管如此，由于缺乏体力活动的操作性定义和标准化评估方法，以及存在多种偏倚来源，这损害了对现有文献的解释。需要进一步的工作来了解体力活动的作用以及如何将其应用于 VTE 环境。未来的研究应利用体力活动和身体适应性的客观评估策略，考虑习惯性活动水平的波动性质，并探索体力活动在二级预防和 VTE 相关并发症领域的作用。
