PA与CDAI对癌症生存者生存率的联合关联：一项基于人群的队列研究

Joint Association of Physical Activity and Composite Dietary Antioxidant Index on Cancer Survivor Survival: A Population-Based Cohort Study

摘要: 有限的研究探讨了身体活动(PA)和复合膳食抗氧化指数(CDAI)对癌症人群死亡结局的影响。本文的目的是进一步评估PA和CDAI对美国癌症生存者生存率的单独和联合预后影响。癌症生存者的数据(n = 2263，代表2200万癌症生存者)来自2007年至2016年美国国家健康与营养检查调查(NHANES)。PA通过自我报告的全球身体活动问卷(GPAQ)进行评估，CDAI则采用一系列膳食抗氧化剂——如维生素(A, C, E)、硒、锌和类胡萝卜素——来量化个人膳食摄入的总抗氧化能力。Cox比例风险模型用于分析PA和CDAI单独和联合预后影响与癌症生存者死亡结局之间的关系。在联合分析中，与单独的生活方式干预相比，具有充分PA和高CDAI的癌症生存者的全因死亡风险降低。同时，充分的PA和高CDA的联合效应与较低的癌症死亡率和非癌症死亡率相关。这一发现可能有助于完善癌症生存人群的生活方式干预建议。

Abstract: Limited research has explored the impact of physical activity (PA) and composite dietary antioxidant index (CDAI) on mortality outcomes in cancer populations. The purpose of this study was to investigate the separate and joint prognostic effects of PA and CDAI on survival rates among US cancer survivors. Data on cancer survivors (n = 2263, representing 22 million survivors) were obtained from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. PA was assessed using the self-reported Global Physical Activity Questionnaire (GPAQ), and CDAI evaluated total dietary antioxidant capacity through a panel of antioxidants—including vitamins (A, C, E), selenium, zinc, and carotenoids. The Cox proportional hazards model was used to evaluate the separate and joint relationship between the prognostic effects of PA and CDAI with mortality outcomes among cancer survivors. In the joint analysis, cancer survivors with sufficient PA and high CDAI demonstrated reduced all-cause mortality risk compared to those with insufficient PA or low CDAI. Concurrently, the joint effect of sufficient PA and high CDAI was associated with lower cancer mortality and non-cancer mortality. This finding may contribute to refining lifestyle intervention recommendations for cancer survivor populations.