不同强度职业性体力活动对子宫肌瘤的影响

目的 探讨职业性体力活动与中老年女性子宫肌瘤(UL)危险性的关系.方法 采用以医院为基础的病例对照研究方法.病例由35～62岁的292例UL患者组成,对照由同期入住相同医院按年龄进行频数匹配的292例非UL患者组成.采用自行设计的健康状况调查表对研究对象进行调查,内容包括人口学特征、生活方式以及疾病既往史等.同时还采用国际体力活动调查表(IPAQ)对研究对象的体力活动情况进行调查,将每周进行的不同强度的体力活动所花费的时间转换成代谢当量(MET)和能量消耗.应用多因素Logistic回归分析估计不同强度的职业性体力活动与UL关联的比值比(OR)及其相应的95％可信区间(CI).结果 两组研究对象年龄、婚姻状况、文化程度及家庭经济收入差异均无统计学意义(P＞0.05).不过,初潮年龄≥17岁组的病例(30.82％)显著地低于对照(43.49％) (P=0.007)；并且经常参加体育锻炼的病例(28.42％)也明显低于对照组(40.41％) (P=0.01).调整了多种潜在性混杂因素后,总能量消耗增加可使发生UL的危险性降低,与能量消耗为最低四分位数相比较,第3个四分位数发生UL的OR为0.456 (95％CI:0.280～0.743,P=0.002).在轻度体力活动中,能量消耗为最高四分位数发生UL的危险性显著降低(OR=0.657,95％CI:0.073～0.899,P=0.036).同样,中度体力活动的能量消耗也与UL呈负相关(OR=0.501,95％CI:0.332-0.997,P=0.002).然而,在重度体力活动中,能量消耗与发生UL的危险性无关(P=0.911).结论 倡导中老年女性进行适度的体力活动,可有效地预防UL的发生.

Influence of different occupational physical activity levels on uterine leiomyoma

OBJECTIVE To evaluate the association between occupational physical activity and uterine leiomyoma(UL) in middle aged and elderly women.METHODS A hospital-based case control study was conducted.Cases(n = 292) were patients with UL 35-62 years old,and controls(n = 292) were patients who had been admitted to the same hospital for diseases not related with UL.Cases and controls were matched with 1: 1.All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics,lifestyle habits and detailed medical history.Simultaneously,physical activities were investigated using international physical activity questionnaire(IPAQ).Time spent per week in different occupational activities was converted to metabolic equivalents(MET) and energy expended.The odds ratios(OR) and 95% confidence intervals(CI) of UL were estimated using multiple Logistic regression models.RESULTS Socio-demographic characteristics(age,marriage state,educational level,and economic income of family) were not statistically significant between two groups(P﹥0.05).However,the percentage of cases(30.82%) with age of menarche for those ≥17 years was significantly lower than controls(43.49%)(P = 0.007),and more controls(40.41%) took exercises usually than cases(28.42%)(P = 0.01).After adjusting for multiple potential confounders,higher energy expended was associated with a decreased risk of UL.Compared to the lowest quartile,the OR in third quartile of energy expended was 0.456(95%CI:0.280-0.743,P = 0.002).In light physical activity,participants in the highest quartile of energy expended had lower risk(OR = 0.657,95%CI:0.073-0.899,P = 0.036).Similarly,there was a negative association between energy expended and UL(OR = 0.501,95%CI:0.332-0.997,P = 0.002) for those with moderate physical activity.Nevertheless,energy expended showed no association with UL for those with vigorous physical activity(P = 0.911).CONCLUSION UL could be effectively prevented through moderate physical activity to middle aged and elderly women.