Villegas R, Shu X O, Yang G, Matthews C E, Li H, Cai H, Gao Y, Zheng W
Department of Medicine, Vanderbilt Epidemiology Center, 2525 West End Avenue, Suite 600, Nashville, TN 37203, USA.
Nutr Metab Cardiovasc Dis. 2009 Mar;19(3):190-7. doi: 10.1016/j.numecd.2008.06.003. Epub 2008 Sep 6.
The combined effect of the components of energy balance (energy intake and physical activity) and the development of type 2 diabetes (T2D) has not been adequately investigated. The aim of this study was to examine the components of energy balance and the incidence of T2D in a cohort of middle-aged women.
A population-based prospective study of 64,227 middle-aged Chinese women who had no prior history of diabetes or chronic disease at study recruitment. Participants completed in-person interviews at baseline and follow-up surveys that collected information on diabetes risk factors including dietary and physical activity habits and disease occurrence. Anthropometric measurements were taken by trained interviewers at recruitment. Average follow-up time was 4.6 years. During 297,755 person-years of follow-up, 1608 new cases of T2D were documented. Body mass index (BMI) and weight gain (since age 20) were strongly associated with T2D incidence. Energy intake (EI) was associated with modestly increased risk, while physical activity (PA) was associated with decreased risk of T2D. Less active women with higher EI had higher risk of T2D (RR=1.96; 95% CI: 1.44, 2.67) than active women with lower EI (P(interaction)=0.02). The EI to PA (EI:PA) ratio was positively associated with T2D risk; the association was more evident among overweight and obese women (BMI > or = 23 kg/m(2)).
These data suggest that energy balance plays an important role in the development of T2D, and this effect may be modified by BMI.
能量平衡各组成部分（能量摄入和身体活动）与2型糖尿病（T2D）发生之间的联合效应尚未得到充分研究。本研究旨在调查一组中年女性的能量平衡组成部分及T2D发病率。
一项基于人群的前瞻性研究，纳入64227名在研究招募时无糖尿病或慢性病病史的中国中年女性。参与者在基线和随访调查时进行了面对面访谈，收集了包括饮食和身体活动习惯以及疾病发生情况等糖尿病危险因素信息。在招募时由经过培训的访谈人员进行人体测量。平均随访时间为4.6年。在297755人年的随访期间，记录了1608例T2D新发病例。体重指数（BMI）和（自20岁起的）体重增加与T2D发病率密切相关。能量摄入（EI）与风险适度增加相关，而身体活动（PA）与T2D风险降低相关。与低EI的活跃女性相比，高EI的不活跃女性患T2D的风险更高（RR = 1.96；95% CI：1.44，2.67）（交互作用P = 0.02）。EI与PA的比值（EI:PA）与T2D风险呈正相关；在超重和肥胖女性（BMI≥23 kg/m²）中这种关联更为明显。
这些数据表明能量平衡在T2D发生中起重要作用，且这种效应可能受BMI影响。
