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.

IF 3.7 1区 医学 Q2 GERIATRICS & GERONTOLOGY European Review of Aging and Physical Activity Pub Date : 2024-10-02 DOI:10.1186/s11556-024-00361-8
Xiaoqin An, Jingyi Li, Yuan Li, Huanxian Liu, Junjun Bai, Qinxiang Guo, Baoping Jiao
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Abstract

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.

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体力活动和 C 反应蛋白与白蛋白比率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。
背景:虽然高 C 反应蛋白-白蛋白比值(CAR)被认为会增加死亡风险,但尚未对癌症幸存者的体力活动(PA)、CAR 和死亡率之间的关系进行调查。本研究旨在调查美国癌症幸存者中的这种关联:这项队列研究使用了 1999 年至 2010 年美国国家健康与营养调查的数据。运动量通过全球运动量问卷进行自我报告,C反应蛋白和白蛋白水平来自实验室数据文件。截至2019年12月31日的死亡率数据是通过将队列数据库与国家死亡指数联系起来获得的。分析时间为 11 月 1 日至 2023 年 12 月 31 日。我们使用 Cox 比例危险多变量回归来评估 PA 和 CAR 导致的总死亡率和癌症特异性死亡率风险的危险比(HRs)和 95% 置信区间(CIs):在 2,232 名癌症幸存者中,有 325 人(14.6%)报告说没有进行过运动,但有较高的 CAR。在长达 20.75 年的随访期间(中位数为 12.3 年;27453 人年),共有 1174 人死亡(癌症 335 人;其他 839 人)。在一系列调整模型中观察到,与低 CAR 相比,高 CAR 始终与最高的总死亡率(HR,1.59;95% CI,1.37-1.85)和癌症特异性死亡率(HR,2.06;95% CI,1.55-2.73)风险相关。多变量模型显示,与无 PA 相比,PA 与较低的全因(HR,0.60;95% CI,0.52-0.69)和癌症特异性(HR,0.64;95% CI,0.49-0.84)死亡风险相关。在联合分析中,PA ≥ 600 代谢当量分钟/周且CAR较低的幸存者更有可能将总死亡率(HR,0.41;95% CI,0.32-0.51)和癌症特异性死亡率(HR,0.32;95% CI,0.20-0.50)降低59%和68%:结论:充足的体育锻炼和低CAR与降低全因死亡率和癌症相关死亡率风险密切相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.60
自引率
1.60%
发文量
29
审稿时长
>12 weeks
期刊介绍: European Review of Aging and Physical Activity (EURAPA) disseminates research on the biomedical and behavioural aspects of physical activity and aging. The main issues addressed by EURAPA are the impact of physical activity or exercise on cognitive, physical, and psycho-social functioning of older people, physical activity patterns in advanced age, and the relationship between physical activity and health.
期刊最新文献
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