Combined influence of physical activity and C-reactive protein to albumin ratio on mortality among older cancer survivors in the United States: a prospective cohort study

Table 2 Association between CAR and Physical Activity with all-cause, cancer mortality among US cancer survivors aged 40 years or older, NHANES, 1999 to 2010 in multiple regression model

Mortality Outcome	Deaths/no	Non-adjusted Model		Model I^a		Model II^b
Mortality Outcome	Deaths/no	HR (95% CI)	P-value	HR (95% CI)	P-value	HR (95% CI)	P-value
All Causes
CAR
Low	329/739	1 [Reference]		1 [Reference]		1 [Reference]
Medium	407/747	1.30 (1.12 ~ 1.50)	< .001	1.22 (1.06 ~ 1.42)	.007	1.20 (1.04 ~ 1.40)	.014
High	438/746	1.53 (1.33 ~ 1.77)	< .001	1.64 (1.42 ~ 1.90)	< .001	1.59 (1.37 ~ 1.85)	< .001
Per SD increase	NA	1.16 (1.12 ~ 1.22)	< .001	1.14 (1.09 ~ 1.18)	< .001	1.12 (1.08 ~ 1.16)	< .001
Physical Activity(MET-min/week)
None(inactive)	508/759	1 [Reference]		1 [Reference]		1 [Reference]
< 600 (insufficiently active)	318/626	0.52 (0.45 ~ 0.60)	< .001	0.63 (0.54 ~ 0.73)	< 0.001	0.65 (0.56 ~ 0.75)	< .001
≥ 600 (sufficiently active)	348/847	0.47 (0.41 ~ 0.54)	< .001	0.55 (0.47 ~ 0.63)	< 0.001	0.60 (0.52 ~ 0.69)	< .001
Cancer
CAR
Low	83/739	1 [Reference]		1 [Reference]		1 [Reference]
Medium	109/747	1.37 (1.03 ~ 1.82)	.032	1.34 (1.01 ~ 1.79)	.043	1.27 (0.95 ~ 1.7)	.105
High	143/746	1.96 (1.50 ~ 2.57)	< .001	2.07 (1.57 ~ 2.73)	< .001	2.06 (1.55 ~ 2.73)	< .001
Per SD increase	NA	1.21 (1.13 ~ 1.28)	< .001	1.17 (1.1 ~ 1.25)	< .001	1.18 (1.11 ~ 1.26)	< .001
Physical Activity(MET-min/week)
None(inactive)	137/759	1 [Reference]		1 [Reference]		1 [Reference]
< 600 (insufficiently active)	90/626	0.59 (0.45 ~ 0.77)	< .001	0.66 (0.5 ~ 0.88)	.004	0.67 (0.51 ~ 0.88)	.005
≥ 600 (sufficiently active)	108/847	0.56 (0.43 ~ 0.72)	< .001	0.61 (0.47 ~ 0.79)	< .001	0.64 (0.49 ~ 0.84)	.001

Abbreviations: CAR C-reactive protein-to-albumin ratio, US the United States, NHANES National Health and Nutrition Examination Survey, HR Hazard ratio, CI Confidence interval, MET the metabolic equivalent
^a Multivariable model adjusts for age, sex, race (Non-Hispanic White, Non-Hispanic Black, Mexican American, Other Race—including multiracial and other Hispanic), Marital status (Married or living with a partner, Living alone), educational attainment (less than high school, high school or equivalent, and above high school), family poverty income ratio (< 1.30, 1.30–3.49, or ≥ 3.5)
^b Additionally adjusted for BMI (calculated as weight in kilograms divided by height in meters squared), smoking status (never, former, current), alcohol use (never, former, current), Healthy Eating Index-2015, hypertension (yes/no), history of diabetes (yes/no), cardiovascular disease (yes/no)

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