Dose-response associations of cardiorespiratory fitness with all-cause mortality and incidence and mortality of cancer and cardiovascular and respiratory diseases: the UK Biobank cohort study

Steell, L. et al. (2019) Dose-response associations of cardiorespiratory fitness with all-cause mortality and incidence and mortality of cancer and cardiovascular and respiratory diseases: the UK Biobank cohort study. British Journal of Sports Medicine, 53(21), pp. 1371-1378. (doi: 10.1136/bjsports-2018-099093) (PMID:30796106)

Abstract

Objective: To investigate the association of cardiorespiratory fitness with all-cause mortality, and cardiovascular, respiratory, COPD and cancer mortality and incidence. Design: Prospective population based study. Setting: UK Biobank. Participants: Of the 502,628 (5.5% response rate) participants recruited by UK Biobank, we included 73,259 (14.6%) participants with available data in this analysis. Of these, 1,374 participants died and 4,210 developed circulatory diseases, 1,293 respiratory diseases and 4,281 cancer, over a median of 5.0 years [IQR 4.3–5.7] follow-up. Main outcome measures - All-cause mortality and circulatory disease, respiratory disease, chronic obstructive e pulmonary disease (COPD) and cancer (any-type, colorectal, lung, breast and prostate) mortality/incidence. Fitness was estimated with a submaximal cycle ergometer test. Results: The hazard ratio for all-cause mortality for each MET higher fitness was 0.96 ([95% CI 0.93–0.98]). Similar results were observed for incident circulatory (HR 0.96 [0.95–0.97]), respiratory disease (HR 0.96 [0.94–0.98]), COPD (HR 0.90 [0.86–0.95]), and colorectal cancer (HR 0.96 [0.92–1.00]). Nonlinear analysis revealed that a high level of fitness (>10 METs) was associated with a greater incidence of atrial fibrillation (HR 1.24 [1.07–1.44]) and prostate cancer (HR 1.16 [1.02–1.32]) compared with average fitness. All results were adjusted for sociodemographic, lifestyle, and dietary factors, body composition, and morbidity at baseline and excluded events in the first 2 years of follow up. Conclusions: Higher cardiorespiratory fitness was associated with lower risk of premature mortality and incidence of cardiovascular, respiratory disease and colorectal cancer.

• Item Type: Articles
• Additional Information: The UK Biobank was supported by the Wellcome Trust, Medical Research Council, Department of Health, Scottish government, and Northwest Regional Development Agency. It has also had funding from the Welsh Assembly government and British Heart Foundation. The research was designed, conducted, analysed, and interpreted by the authors entirely independently of the funding sources.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gill, Professor Jason and Sillars, Dr Anne and Ho, Dr Frederick and Anderson, Dr Jana and Steell, Dr Lewis and Mackay, Professor Daniel and Welsh, Professor Paul and Celis, Dr Carlos and Gray, Professor Stuart and Iliodromiti, Dr Stamatina and Pell, Professor Jill and Petermann-Rocha, Mrs Fanny and Sattar, Professor Naveed and Lyall, Dr Donald
• Authors: Steell, L., Ho, F. K., Sillars, A., Petermann, F., Li, H., Lyall, D. M., Iliodromiti, S., Welsh, P., Anderson, J., Mackay, D. F., Pell, J. P., Sattar, N., Gill, J. M.R., Gray, S. R., and Celis-Morales, C. A.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: British Journal of Sports Medicine
• Publisher: BMJ Publishing Group
• ISSN: 0306-3674
• ISSN (Online): 1473-0480
• Published Online: 22 February 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in British Journal of Sports Medicine 53(21): 1371-1378
• Publisher Policy: Reproduced in accordance with the publisher copyright policy