Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Big Data Institute, Nuffield Department of Population Health, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom.
JAMA Netw Open. 2023 Feb 1;6(2):e2256186. doi: 10.1001/jamanetworkopen.2022.56186.
IMPORTANCE: Higher physical activity levels are associated with lower risks of cancer, cardiovascular disease, and diabetes, but associations with many common and less severe health conditions are not known. These conditions impose large health care burdens and reduce quality of life. OBJECTIVES: To investigate the association between accelerometer-measured physical activity and the subsequent risk of hospitalization for 25 common reasons for hospitalization and to estimate the proportion of these hospitalizations that might have been prevented if participants had higher levels of physical activity. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study used data from a subset of 81 717 UK Biobank participants aged 42 to 78 years. Participants wore an accelerometer for 1 week (between June 1, 2013, and December 23, 2015) and were followed up over a median (IQR) of 6.8 (6.2-7.3) years; follow-up for the current study ended in 2021 (exact date varied by location). EXPOSURES: Mean total and intensity-specific accelerometer-measured physical activity. MAIN OUTCOMES AND MEASURES: Hospitalization for the most common health conditions. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) and 95% CIs for mean accelerometer-measured physical activity (per 1-SD increment) and risks of hospitalization for 25 conditions. Population-attributable risks were used to estimate the proportion of hospitalizations for each condition that might be prevented if participants increased their moderate to vigorous physical activity (MVPA) by 20 minutes per day. RESULTS: Among 81 717 participants, the mean (SD) age at accelerometer assessment was 61.5 (7.9) years; 56.4% were female, and 97.0% self-identified as White. Higher levels of accelerometer-measured physical activity were associated with lower risks of hospitalization for 9 conditions: gallbladder disease (HR per 1 SD, 0.74; 95% CI, 0.69-0.79), urinary tract infections (HR per 1 SD, 0.76; 95% CI, 0.69-0.84), diabetes (HR per 1 SD, 0.79; 95% CI, 0.74-0.84), venous thromboembolism (HR per 1 SD, 0.82; 95% CI, 0.75-0.90), pneumonia (HR per 1 SD, 0.83; 95% CI, 0.77-0.89), ischemic stroke (HR per 1 SD, 0.85; 95% CI, 0.76-0.95), iron deficiency anemia (HR per 1 SD, 0.91; 95% CI, 0.84-0.98), diverticular disease (HR per 1 SD, 0.94; 95% CI, 0.90-0.99), and colon polyps (HR per 1 SD, 0.96; 95% CI, 0.94-0.99). Positive associations were observed between overall physical activity and carpal tunnel syndrome (HR per 1 SD, 1.28; 95% CI, 1.18-1.40), osteoarthritis (HR per 1 SD, 1.15; 95% CI, 1.10-1.19), and inguinal hernia (HR per 1 SD, 1.13; 95% CI, 1.07-1.19), which were primarily induced by light physical activity. Increasing MVPA by 20 minutes per day was associated with reductions in hospitalization ranging from 3.8% (95% CI, 1.8%-5.7%) for colon polyps to 23.0% (95% CI, 17.1%-28.9%) for diabetes. CONCLUSIONS AND RELEVANCE: In this cohort study of UK Biobank participants, those with higher physical activity levels had lower risks of hospitalization across a broad range of health conditions. These findings suggest that aiming to increase MVPA by 20 minutes per day may be a useful nonpharmaceutical intervention to reduce health care burdens and improve quality of life.
重要性:更高的身体活动水平与癌症、心血管疾病和糖尿病风险降低有关,但与许多常见且不太严重的健康状况的关联尚不清楚。这些疾病给医疗保健带来了巨大的负担,并降低了生活质量。
目的:研究加速度计测量的身体活动与 25 种常见住院原因的住院风险之间的关联,并估计如果参与者的身体活动水平更高,可能预防的这些住院治疗的比例。
设计、地点和参与者:这是一项前瞻性队列研究,使用了英国生物银行(UK Biobank)参与者的一个子集中 81717 人的数据。参与者佩戴加速度计一周(2013 年 6 月 1 日至 2015 年 12 月 23 日),并在中位(IQR)6.8 年(6.2-7.3 年)后进行随访;目前的研究随访截止日期为 2021 年(具体日期因地点而异)。
暴露:平均总活动量和强度特定的加速度计测量的身体活动。
主要结果和测量:最常见健康状况的住院治疗。使用 Cox 比例风险回归分析估计了平均加速度计测量的身体活动(每 1-SD 增量)与 25 种疾病住院风险的危险比(HR)和 95%置信区间(CI)。人群归因风险用于估计如果参与者将中度至剧烈体力活动(MVPA)增加 20 分钟/天,每种疾病住院治疗的比例可能会降低。
结果:在 81717 名参与者中,加速度计评估时的平均(SD)年龄为 61.5(7.9)岁;56.4%为女性,97.0%自我认定为白人。更高水平的加速度计测量的身体活动与 9 种疾病的住院风险降低相关:胆囊疾病(每 1-SD,0.74;95%CI,0.69-0.79)、尿路感染(每 1-SD,0.76;95%CI,0.69-0.84)、糖尿病(每 1-SD,0.79;95%CI,0.74-0.84)、静脉血栓栓塞(每 1-SD,0.82;95%CI,0.75-0.90)、肺炎(每 1-SD,0.83;95%CI,0.77-0.89)、缺血性中风(每 1-SD,0.85;95%CI,0.76-0.95)、缺铁性贫血(每 1-SD,0.91;95%CI,0.84-0.98)、憩室疾病(每 1-SD,0.94;95%CI,0.90-0.99)和结肠息肉(每 1-SD,0.96;95%CI,0.94-0.99)。总体身体活动与腕管综合征(每 1-SD,1.28;95%CI,1.18-1.40)、骨关节炎(每 1-SD,1.15;95%CI,1.10-1.19)和腹股沟疝(每 1-SD,1.13;95%CI,1.07-1.19)之间存在正相关,这些疾病主要由轻度体力活动引起。每天增加 20 分钟的 MVPA 与住院治疗的减少有关,范围从结肠息肉的 3.8%(95%CI,1.8%-5.7%)到糖尿病的 23.0%(95%CI,17.1%-28.9%)。
结论和相关性:在这项英国生物银行参与者的队列研究中,身体活动水平较高的参与者在广泛的健康状况下住院的风险较低。这些发现表明,每天增加 20 分钟的 MVPA 可能是一种有用的非药物干预措施,可以减轻医疗保健负担并提高生活质量。
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