Smith Tyler C, Wingard Deborah L, Smith Besa, Kritz-Silverstein Donna, Barrett-Connor Elizabeth
Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego, 9500 Gilman Drive 0607, La Jolla, CA 92093-0607, USA.
J Clin Epidemiol. 2007 Mar;60(3):309-17. doi: 10.1016/j.jclinepi.2006.06.013. Epub 2006 Oct 2.
This study examines the association of walking with mortality in persons with type 2 diabetes compared to those with normal glucose tolerance.
This prospective study included community-dwelling adults from the Rancho Bernardo Study aged 50-90 years in 1984-86 who had type 2 diabetes (n=347) or normal glucose tolerance (n=1,317). During the 10-year follow up, Cox proportional hazards modeling was used to model time until death from all causes (n=538), coronary heart disease (CHD, n=143), other cardiovascular disease (non-CHD CVD, n=138), and other causes (n=257) while adjusting for multiple potential confounders.
After adjusting for sex, age, smoking, body mass index, alcohol, exercise, history of CHD, and other covariates, adults with diabetes who walked > or =1 mile per day were half as likely to die from all causes combined (hazard ratio [HR]=0.54; 95% confidence interval [CI]: 0.33, 0.88), and less than one-fifth as likely to die from non-CHD CVD (HR=0.19; 95% CI: 0.04, 0.86) compared to adults with diabetes who did not walk. Walking was also protective among adults with normal glucose tolerance (HR=0.55; 95% CI: 0.32, 0.96).
Results suggest walking > or =1 mile per day may provide strong protection from all-cause and non-CHD CVD mortality in older adults with diabetes.
本研究旨在探讨2型糖尿病患者与糖耐量正常者相比,步行与死亡率之间的关联。
这项前瞻性研究纳入了1984 - 1986年来自兰乔贝纳多研究的50 - 90岁社区居住成年人,其中2型糖尿病患者(n = 347)或糖耐量正常者(n = 1317)。在10年的随访期间,使用Cox比例风险模型对各种原因导致的死亡时间(n = 538)、冠心病(CHD,n = 143)、其他心血管疾病(非CHD CVD,n = 138)和其他原因(n = 257)进行建模,同时调整多个潜在混杂因素。
在调整了性别、年龄、吸烟、体重指数、饮酒、运动、冠心病史和其他协变量后,每天步行≥1英里的糖尿病成年人因各种原因合并死亡的可能性只有未步行糖尿病成年人的一半(风险比[HR] = 0.54;95%置信区间[CI]:0.33, 0.88),死于非CHD CVD的可能性不到未步行糖尿病成年人的五分之一(HR = 0.19;95% CI:0.04, 0.86)。步行对糖耐量正常的成年人也有保护作用(HR = 0.55;95% CI:0.32, 0.96)。
结果表明,每天步行≥1英里可能为老年糖尿病患者提供强有力的保护,降低全因死亡率和非CHD CVD死亡率。