Runacres Adam, Mackintosh Kelly A, McNarry Melitta A
Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK.
Sports Med. 2021 Feb;51(2):289-301. doi: 10.1007/s40279-020-01379-5. Epub 2020 Dec 24.
Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be 'J' shaped; with elite athlete's likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes.
38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio's (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis.
Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61-0.78]; female SMR 0.51 [95% CI 0.40-0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91-1.12]). Although male athlete's CVD (SMR 0.73 [95% CI 0.62-0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63-0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86-1.40]) or END athletes cancer mortality (SMR 0.73 [0.50-1.07]). There was insufficient data to calculate female sport-specific SMR's.
Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the 'J' shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).
运动被广泛认为可以改善健康状况，降低过早死亡、心血管疾病（CVD）和癌症的风险。然而，多项流行病学研究表明，运动与寿命之间的关系可能呈“J”形；精英运动员的训练强度和运动量可能超过了这些阈值。因此，本荟萃分析的目的是研究前精英运动员中的这种关系。
从科学网、PubMed和SportDiscus数据库中检索了1970年后发表的38047篇英文文章，其中分别有44篇和24篇被纳入系统评价和荟萃分析。根据主要运动项目，运动员被分为三组：耐力组（END）、混合/团队组或力量组（POW）。获取或计算标准化死亡率（SMR）和标准化比例死亡率（SPMR），并合并用于荟萃分析。
运动员的寿命明显长于普通人群（男性SMR为0.69 [95%CI 0.61 - 0.78]；女性SMR为0.51 [95%CI 0.40 - 0.65]；两者p < 0.01）。与普通人群相比，男性力量组运动员没有生存优势（SMR为l.04 [95%CI 0.91 - 1.12]）。尽管男性运动员的心血管疾病死亡率（SMR为0.73 [95%CI 0.62 - 0.85]）和癌症死亡率（SMR为0.75 [95%CI 0.63 - 0.89]）与普通人群相比显著降低，但力量组运动员的心血管疾病死亡率（SMR为1.10 [0.86 - 1.40]）或耐力组运动员的癌症死亡率（SMR为0.73 [0.50 - 1.07]）没有降低风险。没有足够的数据来计算女性特定运动项目的SMR。
总体而言，与普通人群相比，运动员寿命更长，心血管疾病和癌症死亡率的发生率更低，这反驳了“J”形假说。然而，根据运动分类和性别，可能会出现不同的健康风险，值得进一步研究。试验注册PROSPERO（注册号：CRD42019130688）。
