Hu Lan, Wang Lu, Zhang Yunquan, Wang Ke, Wang Yaqi, Tan Huiyue, Zhang Yin
Department of Nursing, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China.
Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, China.
Int J Environ Res Public Health. 2023 Jan 5;20(2):987. doi: 10.3390/ijerph20020987.
The health benefits of sport and physical exercise (SPE) have been well documented, while the influence of household physical activity (HPA) on health has received much less research attention. This study aims to provide epidemiologic insight into the role HPA plays in the development of all-cause, cardiovascular disease (CVD), respiratory disease (RESP), and cancer mortality in a nationwide cohort of Chinese adults. We conceived a prospective cohort comprising 30,791 participants aged ≥16 years from 25 provinces of China using data derived from baseline (2010) and 4 waves of follow-up (2012-2018) investigations of the China Family Panel Studies. Self-reported times of HPA and SPE were collected by interviewing participants with a standard questionnaire. Cox proportional hazard models were used to assess the associations of HPA and SPE with all-cause, CVD, RESP, and cancer mortality, adjusting for demographic and socioeconomic factors, lifestyle behaviors, and health status. A restricted cubic spline smoother was used to investigate the dose-response relationships of HPA and SPE with mortality outcomes. Sex subgroup analyses were conducted to examine the potential effect disparity between men and women. To investigate the interactive effects of HPA and SPE, we calculated the relative excess risk due to the interaction and attributable proportion of additive effects to the total observed effects. During a median follow-up of 7.2 years, a total of 1,649 deaths occurred, with 209 cases from CVD, 123 from RESP, and 323 from cancer. HPA was identified to be associated with reduced mortality outcomes, suggesting remarkably reduced risks of 43-60% in all-cause mortality, 42-50% in CVD mortality, 36-71% in RESP mortality, and 38-46% in cancer mortality. In general, higher levels of HPA tended to be associated with lower risks. An approximately inverted J-shape association was identified between HPA and all-cause and cause-specific mortality, suggesting strong evidence for potential nonlinearity. Women performing HPA had a lower risk of all-cause, CVD, and cancer mortality. We did not identify significant evidence for additive interaction between HPA and SPE. HPA is independently associated with a reduced risk of mortality in Chinese women and men. More biological studies are needed to validate our findings and clarify the mechanisms underlying the association.
体育活动和体育锻炼(SPE)对健康的益处已有充分记录,而家庭体育活动(HPA)对健康的影响却很少受到研究关注。本研究旨在对中国成年人群体中HPA在全因、心血管疾病(CVD)、呼吸系统疾病(RESP)和癌症死亡率发展中所起的作用提供流行病学见解。我们利用中国家庭追踪调查2010年基线和2012 - 2018年4次随访调查的数据,构建了一个前瞻性队列,该队列包括来自中国25个省份的30791名年龄≥16岁的参与者。通过使用标准问卷对参与者进行访谈,收集自我报告的HPA和SPE次数。采用Cox比例风险模型评估HPA和SPE与全因、CVD、RESP和癌症死亡率之间的关联,并对人口统计学和社会经济因素、生活方式行为及健康状况进行调整。使用受限立方样条平滑器研究HPA和SPE与死亡率结局之间的剂量反应关系。进行性别亚组分析以检验男性和女性之间潜在的效应差异。为研究HPA和SPE的交互作用,我们计算了交互作用导致的相对超额风险以及相加效应在总观察效应中所占的归因比例。在中位随访7.2年期间,共发生1649例死亡,其中209例死于CVD,123例死于RESP,323例死于癌症。研究发现HPA与死亡率降低相关,提示全因死亡率显著降低43 - 60%,CVD死亡率降低42 - 50%,RESP死亡率降低36 - 71%,癌症死亡率降低38 - 46%。总体而言,较高水平的HPA往往与较低风险相关。在HPA与全因及特定病因死亡率之间发现了近似倒J形的关联,这表明有强有力的证据支持潜在的非线性关系。进行HPA的女性全因、CVD和癌症死亡率风险较低。我们未发现HPA和SPE之间存在相加交互作用的显著证据。HPA与中国男性和女性的死亡率降低独立相关。需要更多生物学研究来验证我们的发现并阐明这种关联背后的机制。