Leitzmann M F, Giovannucci E L, Rimm E B, Stampfer M J, Spiegelman D, Wing A L, Willett W C
Harvard School of Public Health, and Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Ann Intern Med. 1998 Mar 15;128(6):417-25. doi: 10.7326/0003-4819-128-6-199803150-00001.
Gallstone disease is a major source of morbidity in the United States. Gallstones are twice as common in women as in men, but severe biliary events leading to surgery occur with equal frequency in the two sexes.
To determine whether physical activity decreases risk for symptomatic gallstone disease in men.
Prospective cohort study.
U.S. male health professionals.
45,813 men 40 to 75 years of age were followed from 1986 to 1994.
Questionnaires mailed in 1986, 1988, 1990, 1992, and 1994 asked about physical activity, incidence of gallstone disease, age, body weight, dietary and alcohol intake, smoking habits, use of medications, and occurrence of diagnosed medical conditions other than gallstone disease.
828 men reported having newly symptomatic gallstones (diagnosed by ultrasonography or radiography) or undergoing cholecystectomy for recent symptoms. After adjustment for multiple confounders, increased physical activity was inversely related to risk for symptomatic gallstone disease. When extreme quintiles were compared, men younger than 65 years of age had a stronger inverse association (multivariate relative risk, 0.58 [95% CI, 0.44 to 0.78]) with risk than did men 65 years of age or older (relative risk, 0.75 [CI, 0.52 to 1.09]). In contrast, sedentary behavior was positively related to risk for symptomatic gallstone disease. Men who watched television more than 40 hours per week had a higher risk for symptomatic gallstones than men who watched less than 6 hours per week (relative risk for older men, 3.32 [CI, 1.51 to 7.27]; relative risk for younger men, 1.58 [CI, 0.38 to 6.48]).
Physical activity may play an important role in the prevention of symptomatic gallstone disease in men even beyond its benefit for control of body weight. The results of this study indicate that 34% of cases of symptomatic gallstone disease in men could be prevented by increasing exercise to 30 minutes of endurance-type training five times per week.
在美国，胆结石病是发病的主要原因之一。胆结石在女性中的发病率是男性的两倍，但导致手术的严重胆道疾病在两性中的发生频率相同。
确定体育活动是否会降低男性患症状性胆结石病的风险。
前瞻性队列研究。
美国男性健康专业人员。
1986年至1994年对45813名年龄在40至75岁之间的男性进行随访。
1986年、1988年、1990年、1992年和1994年邮寄的问卷询问了体育活动、胆结石病发病率、年龄、体重、饮食和酒精摄入量、吸烟习惯、药物使用情况以及除胆结石病以外已确诊的疾病情况。
828名男性报告患有新出现症状的胆结石（通过超声或放射学诊断）或因近期症状接受胆囊切除术。在对多个混杂因素进行调整后，体育活动增加与症状性胆结石病风险呈负相关。比较极端五分位数时，65岁以下男性与风险的负相关关系（多变量相对风险，0.58 [95%可信区间，0.44至0.78]）比65岁及以上男性更强（相对风险，0.75 [可信区间，0.52至1.09]）。相比之下，久坐行为与症状性胆结石病风险呈正相关。每周看电视超过40小时的男性患症状性胆结石的风险高于每周看电视少于6小时的男性（老年男性相对风险，3.32 [可信区间，1.51至7.27]；年轻男性相对风险，1.58 [可信区间，0.38至6.48]）。
体育活动可能在预防男性症状性胆结石病中发挥重要作用，甚至超出其对控制体重的益处。这项研究结果表明，通过将锻炼增加到每周五次、每次30分钟的耐力型训练，可以预防男性34%的症状性胆结石病病例。
