Abstract：
OBJECTIVE: Observational studies have demonstrated an increased amyotrophic lateral sclerosis (ALS) risk among professional athletes in various sports. For moderately increased levels of physical activity and fitness, the results are diverging. Through a cohort study, we aimed to assess the relationship between indicators of physical activity and fitness (self-reported physical activity and resting heart rate) and long-term ALS risk.
METHODS: From a large Norwegian cardiovascular health survey (1985-1999), we collected information on self-reported physical activity in leisure time, resting heart rate, and other cardiovascular risk factors. Patients with ALS were identified through health registries covering the whole population. We fitted Cox proportional hazard models to assess the risk of ALS according to levels of self-reported physical activity in 3 categories (1: sedentary; 2: minimum 4 hours per week of walking or cycling; 3: minimum 4 hours per week of recreational sports or hard training), and resting heart rate modeled both on the continuous scale and as quartiles of distribution.
RESULTS: Out of 373,696 study participants (mean 40.9 [SD 1.1] years at inclusion), 504 (41.2% women) developed ALS during a mean follow-up time of 27.2 (SD 5.0) years. Compared with participants with the lowest level of physical activity, the hazard ratio was 0.71 (95% CI 0.53-0.95) for those with the highest level. There were no clear associations between resting heart rate and ALS in the total sample. In men, the hazard ratio of ALS was 0.71 (95% CI 0.53-0.95) for those reporting moderate levels of physical activity and 0.59 (95% CI 0.42-0.84) for those reporting high levels, compared with those reporting low levels. Men with resting heart rate in the lowest quartile had 32% reduced risk of ALS (hazard ratio 0.68, 95% CI 0.49-0.94) compared with those in the second highest quartile. In women, no association was detected between neither self-reported levels of physical activity nor resting heart rate and ALS risk.
CONCLUSIONS: Indicators of high levels of physical activity and fitness are associated with a reduced risk of ALS more than 30 years later in men, but not in women.
METHODS: From a large Norwegian cardiovascular health survey (1985-1999), we collected information on self-reported physical activity in leisure time, resting heart rate, and other cardiovascular risk factors. Patients with ALS were identified through health registries covering the whole population. We fitted Cox proportional hazard models to assess the risk of ALS according to levels of self-reported physical activity in 3 categories (1: sedentary; 2: minimum 4 hours per week of walking or cycling; 3: minimum 4 hours per week of recreational sports or hard training), and resting heart rate modeled both on the continuous scale and as quartiles of distribution.
RESULTS: Out of 373,696 study participants (mean 40.9 [SD 1.1] years at inclusion), 504 (41.2% women) developed ALS during a mean follow-up time of 27.2 (SD 5.0) years. Compared with participants with the lowest level of physical activity, the hazard ratio was 0.71 (95% CI 0.53-0.95) for those with the highest level. There were no clear associations between resting heart rate and ALS in the total sample. In men, the hazard ratio of ALS was 0.71 (95% CI 0.53-0.95) for those reporting moderate levels of physical activity and 0.59 (95% CI 0.42-0.84) for those reporting high levels, compared with those reporting low levels. Men with resting heart rate in the lowest quartile had 32% reduced risk of ALS (hazard ratio 0.68, 95% CI 0.49-0.94) compared with those in the second highest quartile. In women, no association was detected between neither self-reported levels of physical activity nor resting heart rate and ALS risk.
CONCLUSIONS: Indicators of high levels of physical activity and fitness are associated with a reduced risk of ALS more than 30 years later in men, but not in women.
摘要：
目的：观察性研究表明，在各种运动中，职业运动员的肌萎缩侧索硬化症（ALS）风险增加。对于适度增加的身体活动和健身水平，结果大相径庭。通过一项队列研究，我们旨在评估体力活动和体能指标(自我报告的体力活动和静息心率)与长期ALS风险之间的关系.
方法：来自挪威大型心血管健康调查（1985-1999），我们收集了有关休闲时间自我报告的体育锻炼的信息，静息心率,和其他心血管危险因素。ALS患者是通过覆盖整个人群的健康登记来确定的。我们使用Cox比例风险模型，根据自我报告的3类体力活动水平评估ALS的风险（1：久坐；2：每周最少4小时步行或骑自行车；3：每周最少4小时休闲运动或艰苦训练）。静息心率在连续尺度和分布的四分位数上建模。
结果：在373,696名研究参与者中（纳入时平均40.9[SD1.1]年），504（41.2％的女性）在平均27.2（SD5.0）年的随访时间内发展为ALS。与体力活动水平最低的参与者相比，最高水平的风险比为0.71(95%CI0.53-0.95).在总样本中静息心率和ALS之间没有明显的关联。在男人中，ALS的风险比为0.71(95%CI0.53-0.95)，对于那些报告中等体力活动水平的患者，ALS的风险比为0.59(95%CI0.42-0.84)，与那些报告低水平的人相比。与第二高四分位数的男性相比，静息心率在最低四分位数的男性的ALS风险降低了32％（风险比0.68，95％CI0.49-0.94）。在女性中，未检测到自我报告的体力活动水平和静息心率与ALS风险之间存在关联.
结论：高水平的体力活动和健康指标与男性30多年后的ALS风险降低相关，但不是女人。
方法：来自挪威大型心血管健康调查（1985-1999），我们收集了有关休闲时间自我报告的体育锻炼的信息，静息心率,和其他心血管危险因素。ALS患者是通过覆盖整个人群的健康登记来确定的。我们使用Cox比例风险模型，根据自我报告的3类体力活动水平评估ALS的风险（1：久坐；2：每周最少4小时步行或骑自行车；3：每周最少4小时休闲运动或艰苦训练）。静息心率在连续尺度和分布的四分位数上建模。
结果：在373,696名研究参与者中（纳入时平均40.9[SD1.1]年），504（41.2％的女性）在平均27.2（SD5.0）年的随访时间内发展为ALS。与体力活动水平最低的参与者相比，最高水平的风险比为0.71(95%CI0.53-0.95).在总样本中静息心率和ALS之间没有明显的关联。在男人中，ALS的风险比为0.71(95%CI0.53-0.95)，对于那些报告中等体力活动水平的患者，ALS的风险比为0.59(95%CI0.42-0.84)，与那些报告低水平的人相比。与第二高四分位数的男性相比，静息心率在最低四分位数的男性的ALS风险降低了32％（风险比0.68，95％CI0.49-0.94）。在女性中，未检测到自我报告的体力活动水平和静息心率与ALS风险之间存在关联.
结论：高水平的体力活动和健康指标与男性30多年后的ALS风险降低相关，但不是女人。
