Bai Pufei, Ning Xiaoqun, Gao Rui, Shao Xian, Zhou Saijun, Li Jing, Lin Yao, Liu Hongyan, Zhang Mianzhi, Yu Pei
NHC Key Laboratory of Hormones and Development, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300134, China; Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin 300134, China.
Special Medical Service Center, Zhujiang Hospital, Southern Medical University, No. 253, Middle Industrial Avenue, Haizhu District, Guangzhou, Guangdong, China.
Prev Med. 2024 Feb;179:107831. doi: 10.1016/j.ypmed.2023.107831. Epub 2023 Dec 23.
Physical activity (PA) has been linked with cancer incidence. However, the effects and mechanisms underpinning circadian PA trajectories on cancer remain elusive. This study aimed to explore the optimal PA patterns in reducing cancer incidence and the associated potential mediators.
Between 2006 and 2010, 502,400 participants were recruited from the UK Biobank. Out of these, 102,323 participants wore accelerometers, which allowed for collecting acceleration data continuously over 7 days. After excluding participants with previous cancer history, 96,687 participants were included in K-means cluster analysis to identify PA trajectories. The association between PA and cancer incidence was assessed using Cox regression analysis. Additionally, we investigated the mediating role of inflammation.
A total of 5995 cancer cases were recorded during a median follow-up of 7.1 years. Four distinct PA trajectories (persistent low, single peak, double peak, and vigorous) were identified. The ideal PA patterns reduced the risk of 7 out of 17 site-specific cancers, with the lowest hazard ratios and 95% confidence intervals of cancer for bladder (0.59, 0.40-0.86), breast (0.73, 0.60-0.89), kidney (0.45, 0.26-0.78), lung (0.59, 0.41-0.84), myeloma (0.49, 0.27-0.88), and oral & pharynx (0.51, 0.26-0.98) in the vigorous pattern and for colorectal (0.71, 0.54-0.93) in the double peak pattern. Moreover, the mediating effects of inflammation were significant.
Optimal PA trajectories reduced cancer incidence, especially in double peak and vigorous patterns. The protective effect was associated with both intensity and circadian rhythm. Crucially, this protection was mediated by inflammation regulation.
身体活动(PA)与癌症发病率有关。然而,昼夜节律性PA轨迹对癌症的影响及其潜在机制仍不清楚。本研究旨在探索降低癌症发病率的最佳PA模式及其相关潜在中介因素。
2006年至2010年期间,从英国生物银行招募了502,400名参与者。其中,102,323名参与者佩戴了加速度计,可连续7天收集加速度数据。在排除有癌症病史的参与者后,96,687名参与者被纳入K均值聚类分析以确定PA轨迹。使用Cox回归分析评估PA与癌症发病率之间的关联。此外,我们研究了炎症的中介作用。
在中位随访7.1年期间共记录了5995例癌症病例。确定了四种不同的PA轨迹(持续低水平、单峰、双峰和剧烈)。理想的PA模式降低了17种特定部位癌症中7种的风险,剧烈模式下膀胱癌(0.59,0.40 - 0.8)、乳腺癌(0.73,0.60 - 0.89)、肾癌(0.45,0.26 - 0.78)、肺癌(0.59,0.41 - 0.84)、骨髓瘤(0.49,0.27 - 0.88)以及口腔和咽部癌(0.51,0.26 - 0.98)的癌症风险最低,危险比和95%置信区间最低;双峰模式下结直肠癌(0.71,0.54 - 0.93)的癌症风险最低。此外,炎症的中介作用显著。
最佳PA轨迹降低了癌症发病率,尤其是双峰和剧烈模式。保护作用与强度和昼夜节律均有关。至关重要的是,这种保护作用是由炎症调节介导的。