目的 探讨体力活动水平与中老年女性子宫肌瘤发生的关系.方法 采用以医院为基础的病例对照研究方法.病例组是由35~62岁的382例子宫肌瘤患者组成,对照组是由同期入住相同医院按年龄进行频数匹配的382例非子宫肌瘤患者组成.采用自行设计的健康状况调查表对两组人群进行调查,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)对两组人群的体力活动情况进行调查,将每周进行的不同体力活动所花费的时间转换成代谢当量(MET).应用多因素Logistic回归分析估计不同体力活动与子宫肌瘤关联的比值比(OR)及其相应的95%可信区间(CI).结果 调整了多种潜在性混杂因素后,与总体力活动量≤137.20 MET-h/周相比较,总体力活动量为178.11~229.35 MET-h/周发生子宫肌瘤的危险性降低(OR=0.586,95%CI(0.453,0.946),P=0.002).在职业性体力活动中,与体力活动量为最低四分位数相比较,体力活动量为第三个四分位数发生子宫肌瘤的危险性降低(OR=0.622,95%CI(0.415,0.960),P=0.003).而在家务劳动中,体力活动量≥28.81 MET-h/周发生子宫肌瘤的危险性是体力活动量≤8.70 MET-h/周的近1.5倍(OR=1.492,95%CI(1.006,2.049),P=0.030).娱乐性体力活动和交通性运动与发生子宫肌瘤的危险性无关(P＞0.05).但是,高强度体力活动(＞6 METs)每周活动时间为≥4.51 h能降低发生子宫肌瘤的危险性(OR=0.601,95%CI(0.402,0.997),P=0.011).结论 进行适度的体力活动,可能有助于预防子宫肌瘤.%Objective To examine the association between the level of physical activity and the appearance of uterine leiomyoma in middle aged and elderly women. Methods A hospital - based case control study was conducted. Case group ( n = 382 ) consisted of patients with uterine leiomyoma 35 ~62 years old, and control group ( n =382 ) consisted of patients who had been admitted to the same hospital for diseases not related with uterine leiomyoma and who were recruited according to frequency matching for ages. All subjects were interviewed by using a self - designed health condition questionnaire, including socio - demographic characteristics, lifestyle habits and detailed medical history. Simultaneously, the conditions of their physical activities were investigated by using international physical activity questionnaire ( IPAQ ). Time spent per week in different physical activities was converted to metabolic equivalents ( MET ). The odds ratios ( OR ) and 95% confidence intervals ( CI) of uterine leiomyoma were estimated by using multiple Logistic regression models. Results After adjusting for multiple potential confounders, compared with total physical activity ≤ 137. 20 MET - h/w, the OR for uterine leiomyoma in 178. 11 ~ 229. 35 MET - h/w was 0. 586 [ 95% CI ( 0. 453 , 0. 946 ), P = 0. 002 ]. In occupational physical activity, women in the third quartile of physical activity compared with those in the lowest quartile of physical activity had lower risk [ OR =0. 622, 95% CI ( 0. 415 , 0. 960 ), P = 0. 03 ]. In housework, the risk of uterine leiomyoma in participants with physical activity ≥28. 81 MET - h/w was 1. 5 times that in those with physical activity ≤8. 70 MET - h/w did [ OR = 1. 492 , 95% CI ( 1. 006, 2. 049 ), P = 0. 030 ]. Recreational and communicational physical activities were not associated with uterine leiomyoma ( P >0. 05 ). However, vigorous physical activity ( >6 METs ) and the physical activity ≥4. 51 h/w could decrease the risk of uterine leiomyoma [ OR = 0. 601 , 95% CI ( 0.402, 0.997 ), P=0. 011 ] . Conclusion Moderate physical activity can contribute to prevention of uterine leiomyoma.
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