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Association of Physical Activity and Inflammation With All-Cause, Cardiovascular-Related, and Cancer-Related Mortality

Published:October 25, 2016DOI:



      To investigate the association between physical activity (PA) and risk of mortality in a large middle-aged cohort stratified by inflammatory status.

      Patients and Methods

      A total of 336,560 individuals (mean age, 39.7 years; 58% male) who underwent comprehensive health screenings were enrolled in this prospective cohort study. They were grouped according to self-reported PA level using a questionnaire: no regular PA with a sedentary lifestyle, regular but insufficient PA (below the guidelines), sufficient PA (concordant with the guidelines), and health-enhancing PA. Inflammation was assessed via high-sensitivity C-reactive protein (hsCRP) level. Study end points were all-cause, cardiovascular-related, and cancer-related mortality.


      During the 1,976,882 person-years of follow-up (median follow-up duration, 6.17 years), 2062 deaths occurred. Compared with a sedentary lifestyle, the hazard ratios (95% CIs) on the multivariable Cox proportional hazards regression analyses for all-cause mortality by PA level were 0.95 (0.84-1.07), 0.85 (0.72-0.99), and 0.75 (0.60-0.93) (P for trend=.003), and those for cardiovascular- and cancer-related mortality were 0.95, 0.80, and 0.55 (P for trend=.05) and 0.82, 0.83, and 0.78 (P for trend=.01), respectively. Compared with participants with low hsCRP levels and any regular PA, those with high hsCRP levels and no regular PA had a significantly higher risk of mortality (1.59 [1.38-1.84]).


      Higher PA levels were associated with a dose-dependent reduced risk of cardiovascular-related, cancer-related, and all-cause mortality. Individuals with high hsCRP levels and no regular PA had the highest risk of mortality.

      Abbreviations and Acronyms:

      BMI (body mass index), BP (blood pressure), CVD (cardiovascular disease), HDL-C (high-density lipoprotein cholesterol), HOMA-IR (homeostatic model assessment of insulin resistance), HR (hazard ratio), hsCRP (high-sensitivity C-reactive protein), IPAQ-SF (International Physical Activity Questionnaire Short Form), IQR (interquartile range), LDL-C (low-density lipoprotein cholesterol), MET (metabolic equivalent), PA (physical activity)
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