身体活动与C反应蛋白与白蛋白比值对美国老年癌症幸存者死亡率的综合影响：一项前瞻性队列研究
Combined influence of physical activity and C-reactive protein to albumin ratio on mortality among older cancer survivors in the United States: a prospective cohort study.
作者信息
An Xiaoqin, Li Jingyi, Li Yuan, Liu Huanxian, Bai Junjun, Guo Qinxiang, Jiao Baoping
机构信息
Department of Respiratory Medicine, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan City, Shanxi Province, China.
Department of Gastroenterology, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan City, Shanxi Province, China.
出版信息
Eur Rev Aging Phys Act. 2024 Oct 2;21(1):26. doi: 10.1186/s11556-024-00361-8.
BACKGROUND
Although a high C-reactive protein-to-albumin ratio (CAR) is believed to increase mortality risk, the association between the physical activity (PA), CAR, and mortality among cancer survivors has not been investigated. This study aimed to examine this association among cancer survivors in the United States.
METHODS
This cohort study used data from the National Health and Nutrition Examination Survey from 1999 to 2010. PA was self-reported using the Global Physical Activity Questionnaire, and C-reactive protein and albumin levels were obtained from laboratory data files. Mortality data were obtained by linkage of the cohort database to the National Death Index as of December 31, 2019. The analysis was conducted from November 1 to December 31, 2023. We used Cox proportional hazards multivariable regression to assess hazard ratios (HRs) and 95% confidence interval (CIs) for total and cancer-specific mortality risks attributable to PA and CAR.
RESULTS
Among 2,232 cancer survivors, 325 (14.6%) reported no PA with a high CAR. During a follow-up of up to 20.75 years (median, 12.3 years; 27,453 person-years), 1,174 deaths occurred (cancer, 335; other, 839). A high CAR was observed to be consistently associated with the highest risks of total (HR, 1.59; 95% CI, 1.37-1.85) and cancer-specific (HR, 2.06; 95% CI, 1.55-2.73) mortality compared with a low CAR in a series of adjusted models. Multivariable models showed that PA was associated with a lower risk of all-cause (HR, 0.60; 95% CI, 0.52-0.69) and cancer-specific (HR, 0.64; 95% CI, 0.49-0.84) mortality compared with no PA. In the joint analyses, survivors with PA ≥ 600 metabolic equivalent min/wk and a low CAR were more likely to reduce the risk of total (HR, 0.41; 95% CI, 0.32-0.51) and cancer-specific (HR, 0.32; 95% CI, 0.20-0.50) mortality by 59% and 68% compared with those with no PA and a high CAR.
CONCLUSION
The pairing of adequate PA and a low CAR was significantly associated with reduced all-cause and cancer-related mortality risks.
背景
尽管高C反应蛋白与白蛋白比值（CAR）被认为会增加死亡风险，但身体活动（PA）、CAR与癌症幸存者死亡率之间的关联尚未得到研究。本研究旨在调查美国癌症幸存者中的这种关联。
方法
这项队列研究使用了1999年至2010年美国国家健康和营养检查调查的数据。PA通过全球身体活动问卷进行自我报告，C反应蛋白和白蛋白水平从实验室数据文件中获取。截至2019年12月31日，通过将队列数据库与国家死亡指数相链接获得死亡率数据。分析于20日至23年12月31日进行。我们使用Cox比例风险多变量回归来评估PA和CAR导致的全因和癌症特异性死亡风险的风险比（HR）和95%置信区间（CI）。
结果
在2232名癌症幸存者中，325人（14.6%）报告无PA且CAR高。在长达20.75年的随访期（中位数为12.3年；27453人年）内，发生了1174例死亡（癌症335例；其他839例）。在一系列调整模型中，与低CAR相比，高CAR始终与全因（HR，1.59；95%CI，1.37 - 1.85）和癌症特异性（HR，2.06；95%CI，1.55 - 2.73）死亡的最高风险相关。多变量模型显示，与无PA相比，PA与全因（HR，0.60；95%CI，0.52 - 0.69）和癌症特异性（HR，0.64；95%CI，0.49 - 0.84）死亡风险较低相关。在联合分析中，与无PA且CAR高的幸存者相比，PA≥600代谢当量分钟/周且CAR低的幸存者全因（HR，0.41；95%CI，0.32 - 0.51）和癌症特异性（HR，0.32；95%CI，0.20 - 0.50）死亡风险分别降低59%和68%。
结论
充足的PA与低CAR相结合与降低全因和癌症相关死亡风险显著相关。
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