Jung Wonyoung, Cho In Young, Jung Jinhyung, Cho Mi Hee, Koo Hye Yeon, Park Yong-Moon Mark, Baek Jong-Ha, Han Kyungdo, Shin Dong Wook
Department of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea.
Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Cancer Surviv. 2024 Apr 22. doi: 10.1007/s11764-024-01606-2.
Physical activity has the potential to reduce the risk of diabetes after cancer diagnosis. However, current evidence supporting its effects is limited. This study aims to examine the associations between changes in physical activity and subsequent risk of diabetes among cancer survivors.
A total of 264,250 cancer survivors (mean age 56.7 (12.5) years, 44.2% males) without a prior history of diabetes were assessed for adherence to physical activity both before and after their diagnosis. The primary outcome was incident diabetes. The Fine-Gray proportional sub-distribution hazards model was used to calculate sub-distribution hazard ratios (sHRs) and 95% confidence intervals (CIs) for diabetes risk, considering death as a competing risk.
Over a follow-up of 1,065,802 person-years, maintaining regular physical activity from pre-diagnosis was associated with a 10% reduced risk of diabetes after cancer diagnosis (sHR 0.90, 95% CI 0.85-0.96), considering traditional diabetes risk factors, sociodemographics, and primary cancer sites. Cancer survivors who became active and inactive after their cancer diagnosis exhibited a marginally decreased risk of diabetes (sHR 0.98, 95% CI 0.93-1.03; sHR 0.97, 95% CI 0.92-1.03). The strength and direction of the association varied depending on the primary site of cancer.
Regular physical activity starting before a cancer diagnosis is associated with a lower risk of diabetes following the diagnosis, independent of established diabetes risk factors.
The study underscores the importance of engaging in sufficient physical activity to mitigate the risk of diabetes in cancer survivors.
体育活动有可能降低癌症诊断后患糖尿病的风险。然而，目前支持其效果的证据有限。本研究旨在探讨癌症幸存者体育活动的变化与随后患糖尿病风险之间的关联。
对总共264250名无糖尿病既往史的癌症幸存者（平均年龄56.7（12.5）岁，男性占44.2%）在诊断前后的体育活动依从性进行评估。主要结局是新发糖尿病。采用Fine-Gray比例亚分布风险模型计算糖尿病风险的亚分布风险比（sHRs）和95%置信区间（CIs），将死亡视为竞争风险。
在1065802人年的随访中，考虑到传统糖尿病风险因素、社会人口统计学和原发癌部位，从诊断前就保持规律体育活动与癌症诊断后患糖尿病风险降低10%相关（sHR 0.90，95%CI 0.85 - 0.96）。癌症诊断后开始活跃和变得不活跃的幸存者患糖尿病的风险略有降低（sHR 0.98，95%CI 0.93 - 1.03；sHR 0.97，95%CI 0.92 - 1.03）。关联的强度和方向因癌症的原发部位而异。
癌症诊断前开始的规律体育活动与诊断后患糖尿病风险较低相关，独立于既定的糖尿病风险因素。
该研究强调了进行足够体育活动以降低癌症幸存者患糖尿病风险的重要性。
