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美国癌症幸存者的体力活动与久坐时间平衡指数与全因死亡率和特定病因死亡率的关联:一项队列研究

Association of Physical Activity and Sitting Time Balance Index with all-cause and cause-specific mortality among cancer survivors in the USA: a cohort study.

作者信息

Lian Yanxue, Luo Pincheng

机构信息

School of Medicine, University of Galway, Galway, Ireland.

出版信息

Support Care Cancer. 2025 Jul 2;33(7):653. doi: 10.1007/s00520-025-09709-x.

Abstract

PURPOSE

This study examined the relationship between Physical Activity and Sitting Time Balance Index (PASTBI) and mortality outcomes, including all-cause, cardiovascular diseases (CVD)-, and cancer-specific mortality, in a nationally representative cohort of US cancer survivors.

METHODS

Data were derived from the National Health and Nutrition Examination Survey 2007-2018. The PASTBI was calculated using information from the Global Physical Activity Questionnaire, with mortality data obtained through linked databases. Cox proportional hazards models with survey sample weights were applied to estimate hazard ratios (HRs) for all-cause, CVD-related, and cancer-related mortality, adjusting for potential confounders.

RESULTS

The analysis included 3334 cancer survivors, with an average follow-up of 72.02 months. Compared with quartile 1, participants in quartile 4 (highest PASTBI) had significantly lower mortality risks, including 62% lower all-cause mortality [HR = 0.38; 95% CI = 0.29-0.50], 55% lower CVD mortality [HR = 0.45; 95% CI = 0.23-0.86], and 56% lower cancer mortality [HR = 0.44; 95% CI = 0.27-0.71]. Additionally, while both quartile 1 and quartile 2 reported no physical activity time, individuals in quartile 2, who had shorter sedentary time, exhibited lower mortality risks [all-cause mortality HR = 0.62; 95% CI = 0.49, 0.79; CVD mortality HR = 0.54; 95% CI = 0.35, 0.84; cancer mortality HR = 0.75; 95% CI = 0.54, 1.06].

CONCLUSION

A higher PASTBI score, reflecting a better balance of physical activity and sedentary time, was associated with lower risks of all-cause, CVD-, and cancer-related mortality. Reducing sedentary time, even modestly, offers significant health benefits, independent of physical activity levels.

摘要

目的

本研究在美国具有全国代表性的癌症幸存者队列中,考察了体力活动与久坐时间平衡指数(PASTBI)之间的关系,以及包括全因死亡率、心血管疾病(CVD)死亡率和癌症特异性死亡率在内的死亡结局。

方法

数据来源于2007 - 2018年美国国家健康与营养检查调查。PASTBI采用全球体力活动问卷中的信息进行计算,死亡率数据通过关联数据库获得。应用带有调查样本权重的Cox比例风险模型来估计全因死亡率、CVD相关死亡率和癌症相关死亡率的风险比(HR),并对潜在混杂因素进行调整。

结果

分析纳入了3334名癌症幸存者,平均随访72.02个月。与第1四分位数相比,第4四分位数(PASTBI最高)的参与者死亡风险显著降低,包括全因死亡率降低62%[HR = 0.38;95%CI = 0.29 - 0.50],CVD死亡率降低55%[HR = 0.45;95%CI = 0.23 - 0.86],癌症死亡率降低56%[HR = 0.44;95%CI = 0.27 - 0.71]。此外,虽然第1四分位数和第2四分位数的参与者均报告没有体力活动时间,但久坐时间较短的第2四分位数个体的死亡风险较低[全因死亡率HR = 0.62;95%CI = 0.49,0.79;CVD死亡率HR = 0.54;95%CI = 0.35,0.84;癌症死亡率HR = 0.75;95%CI = 0.54,1.06]。

结论

较高的PASTBI得分反映了体力活动和久坐时间的更好平衡,与全因死亡率、CVD死亡率和癌症相关死亡率的较低风险相关。即使适度减少久坐时间也能带来显著的健康益处,且与体力活动水平无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/436e/12222415/aa5d091e035d/520_2025_9709_Fig1_HTML.jpg

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