PT - JOURNAL ARTICLE AU - Yuanjie Pang AU - Jun Lv AU - Christiana Kartsonaki AU - Canqing Yu AU - Yu Guo AU - Huaidong Du AU - Derrick Bennett AU - Zheng Bian AU - Yiping Chen AU - Ling Yang AU - Iain Turnbull AU - Hao Wang AU - Hui Li AU - Michael V Holmes AU - Junshi Chen AU - Zhengming Chen AU - Liming Li TI - Association of physical activity with risk of hepatobiliary diseases in China: a prospective cohort study of 0.5 million people AID - 10.1136/bjsports-2020-102174 DP - 2020 Aug 21 TA - British Journal of Sports Medicine PG - bjsports-2020-102174 4099 - http://bjsm.bmj.com/content/early/2020/08/20/bjsports-2020-102174.short 4100 - http://bjsm.bmj.com/content/early/2020/08/20/bjsports-2020-102174.full AB - Objective There is limited prospective evidence on the association of physical activity with hepatobiliary cancer subtypes and other major hepatobiliary diseases, especially in China. We aimed to quantify the associations with risk of these diseases.Methods The study population involved 460 937 participants of the prospective China Kadoorie Biobank aged 30–79 years from 10 diverse areas in China without history of cancer or hepatobiliary disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with self-reported total and domain-specific physical activity (occupational and non-occupational, ie, leisure time, household and commuting).Results During ~10 years of follow-up, 22 012 incident cases of hepatobiliary diseases were recorded. The overall mean (SD) total physical activity was 21.2 (13.9) metabolic equivalent of task (MET)-hours/day, with 62% from occupational activity. Total physical activity was inversely associated with hospitalised non-alcoholic fatty liver disease (HR comparing top vs bottom quintile: 0.62, 95% confidence interval (CI) 0.53 to 0.72), viral hepatitis (0.73, 95% CI 0.62 to 0.87), cirrhosis (0.76, 95% CI 0.66 to 0.88) and liver cancer (0.81, 95% CI 0.71 to 0.93), as well as gallstone disease (0.86, 95% CI 0.81 to 0.90), gallbladder cancer (0.51, 95% CI 0.32 to 0.80) and biliary tract cancer (0.55, 95% CI 0.38 to 0.78). The associations for occupational physical activity were similar to those for total physical activity, but for non-occupational physical activity they differed by disease subtype. For leisure-time physical activity, there was an inverse association with liver cancer and an inverse trend for gallstone disease (HR comparing ≥7.5 MET-hours/day with none: 0.83, 95% CI 0.75 to 0.91 and 0.82, 95% CI 0.66 to 1.01).Conclusion Among Chinese adults, high total physical activity, particularly occupational physical activity, was inversely associated with risk of major hepatobiliary cancers and diseases, including non-alcoholic fatty liver disease, cirrhosis and certain types of cancer.