Massachusetts Veterans Epidemiology Research and Information Center at the VA Boston Healthcare System, Boston, Mass., USA.
Am J Med. 2009 Dec;122(12):1115-21. doi: 10.1016/j.amjmed.2009.02.008.
Physical activity has been associated with lower diabetes risk, but several prospective studies among women found that activity only slightly attenuated the diabetes risk associated with high body mass index (BMI). We investigated the independent and joint associations between vigorous activity and BMI on diabetes risk in men.
This was a prospective cohort design within the Physicians' Health Study, using Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident diabetes in 20,757 men without diabetes at baseline. Models were based on self-reported BMI and exercise frequency at baseline, first separately and then with a 6-category joint variable combining World Health Organization BMI category (normal/overweight/obese) with activity status (active/inactive) using weekly vigorous activity as the threshold.
After a median follow-up of 23.1 years, there were 1836 cases of incident diabetes. Compared with active participants with normal BMIs, active but overweight and obese men had multivariable-adjusted HRs of 2.39 (95% CI, 2.11-2.71) and 6.22 (95% CI, 5.12-7.56). Inactive men with normal, overweight, or obese BMIs had multivariable-adjusted HRs of 1.41 (95% CI, 1.19-1.67), 3.14 (95% CI, 2.73-3.62), and 6.57 (95% CI, 5.25-8.21).
Active men with normal and overweight BMIs had lower diabetes hazards than their inactive counterparts, but no difference by weekly activity was seen in obese men. Elevated BMI is a key driver of diabetes risk, with relatively modest attenuation by activity.
身体活动与较低的糖尿病风险相关，但几项针对女性的前瞻性研究发现，活动仅略微降低了与高体重指数（BMI）相关的糖尿病风险。我们研究了男性中剧烈活动与 BMI 对糖尿病风险的独立和联合关联。
这是一项在医师健康研究中的前瞻性队列设计，使用 Cox 比例风险模型计算 20757 名基线时无糖尿病的男性中糖尿病发病的风险比（HR）和 95%置信区间（CI）。模型基于基线时的自我报告 BMI 和运动频率，首先分别进行，然后使用每周剧烈活动作为阈值，将世界卫生组织 BMI 类别（正常/超重/肥胖）与活动状态（活跃/不活跃）结合起来，用 6 类联合变量进行组合。
中位随访 23.1 年后，有 1836 例新发糖尿病。与 BMI 正常的活跃参与者相比，超重和肥胖的活跃男性多变量调整后的 HR 分别为 2.39（95%CI，2.11-2.71）和 6.22（95%CI，5.12-7.56）。BMI 正常、超重或肥胖的不活跃男性多变量调整后的 HR 分别为 1.41（95%CI，1.19-1.67）、3.14（95%CI，2.73-3.62）和 6.57（95%CI，5.25-8.21）。
BMI 正常和超重的活跃男性患糖尿病的风险低于不活跃的男性，但肥胖男性每周活动对糖尿病风险没有差异。BMI 升高是糖尿病风险的主要驱动因素，而活动的影响相对较小。
