Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
Sports Med. 2021 Jul;51(7):1439-1448. doi: 10.1007/s40279-021-01452-7. Epub 2021 Mar 28.
Cycling has been suggested to be related to risk of all-cause and cardiovascular disease (CVD) mortality. However, a quantitative comprehensive assessment of the dose-response association of cycling with risk of all-cause and CVD mortality has not been reported. We performed a meta-analysis of cohort studies assessing the risk of all-cause and CVD mortality with cycling.
PubMed and Embase databases were searched for relevant articles published up to December 13, 2019. Random-effects models were used to estimate the summary relative risk (RR) of all-cause and CVD mortality with cycling. Restricted cubic splines were used to evaluate the dose-response association.
We included 9 articles (17 studies) with 478,847 participants and 27,860 cases (22,415 from all-cause mortality and 5445 from CVD mortality) in the meta-analysis. Risk of all-cause mortality was reduced 23% with the highest versus lowest cycling level [RR 0.77, 95% confidence interval (CI) 0.67-0.88], and CVD mortality was reduced 24% (RR 0.76, 95% CI 0.65-0.89). We found a linear association between cycling and all-cause mortality (P = 0.208); the risk was reduced by 9% (RR 0.91, 95% CI 0.86-0.96) with each five metabolic equivalent of task (MET)-h/week increase in cycling. We found an approximately U-shaped association between cycling and CVD mortality (P = 0.034), with the lowest risk at approximately 15 MET-h/week of cycling.
Our findings based on quantitative data suggest that any level of cycling is better than none for all-cause mortality. However, for CVD mortality, one must choose an appropriate level of cycling, with an approximate optimum of 15 MET-h/week (equal to 130 min/week at 6.8 MET).
骑自行车与全因和心血管疾病（CVD）死亡率相关。然而，尚未有研究定量综合评估骑自行车与全因和 CVD 死亡率风险的剂量反应关系。我们对评估骑自行车与全因和 CVD 死亡率风险的队列研究进行了荟萃分析。
检索截至 2019 年 12 月 13 日的相关文献，包括 PubMed 和 Embase 数据库。使用随机效应模型估计全因和 CVD 死亡率与骑自行车的风险比（RR）。使用限制性立方样条评估剂量反应关系。
我们纳入了 9 篇文献（17 项研究），共 478847 名参与者，27860 例（全因死亡率 22415 例，CVD 死亡率 5445 例）。与最低水平的骑车相比，最高水平的骑车与全因死亡率降低了 23%（RR 0.77，95%置信区间 0.67-0.88），CVD 死亡率降低了 24%（RR 0.76，95%置信区间 0.65-0.89）。我们发现骑车与全因死亡率之间存在线性关系（P=0.208），骑车每增加 5 个代谢当量任务（MET）-h/周，风险降低 9%（RR 0.91，95%置信区间 0.86-0.96）。我们发现骑车与 CVD 死亡率之间存在近似 U 型关系（P=0.034），最佳骑车水平约为 15 MET-h/周。
基于定量数据的研究结果表明，任何水平的骑车都比不骑车更有益于降低全因死亡率。然而，对于 CVD 死亡率，必须选择适当的骑车水平，约 15 MET-h/周（相当于 6.8 MET 时每周 130 分钟）是一个合适的水平。
