Helmrich S P, Ragland D R, Leung R W, Paffenbarger R S
School of Public Health, University of California, Berkeley.
N Engl J Med. 1991 Jul 18;325(3):147-52. doi: 10.1056/NEJM199107183250302.
Physical activity is recommended by physicians to patients with non-insulin-dependent diabetes mellitus (NIDDM), because it increases sensitivity to insulin. Whether physical activity is effective in preventing this disease is not known.
We used questionnaires to examine patterns of physical activity and other personal characteristics in relation to the subsequent development of NIDDM in 5990 male alumni of the University of Pennsylvania. The disease developed in a total of 202 men during 98,524 man-years of follow-up from 1962 to 1976.
Leisure-time physical activity, expressed in kilocalories expended per week in walking, stair climbing, and sports, was inversely related to the development of NIDDM: The incidence rates declined as energy expenditure increased from less than 500 kcal to 3500 kcal. For each 500-kcal increment in energy expenditure, the age-adjusted risk of NIDDM was reduced by 6 percent (relative risk, 0.94; 95 percent confidence interval, 0.90 to 0.98). This association remained the same when the data were adjusted for obesity, hypertension, and a parental history of diabetes. The association was weaker when we considered weight gain between the time of college attendance and 1962 (relative risk, 0.95; 95 percent confidence interval, 0.90 to 1.00). The protective effect of physical activity was strongest in persons at highest risk for NIDDM, defined as those with a high body-mass index, a history of hypertension, or a parental history of diabetes. These factors, in addition to weight gain since college, were also independent predictors of the disease.
Increased physical activity is effective in preventing NIDDM, and the protective benefit is especially pronounced in persons at the highest risk for the disease.
医生建议非胰岛素依赖型糖尿病（NIDDM）患者进行体育锻炼，因为体育锻炼可提高胰岛素敏感性。体育锻炼对预防该病是否有效尚不清楚。
我们使用问卷来调查5990名宾夕法尼亚大学男性校友的体育锻炼模式及其他个人特征与随后NIDDM发病情况之间的关系。在1962年至1976年的98524人年随访期间，共有202名男性发病。
以每周步行、爬楼梯和进行体育运动所消耗的千卡数表示的休闲体育活动与NIDDM的发病呈负相关：随着能量消耗从少于500千卡增加到3500千卡，发病率下降。能量消耗每增加500千卡，NIDDM的年龄调整风险降低6%（相对风险，0.94；95%置信区间，0.90至0.98）。在对肥胖、高血压和糖尿病家族史进行数据调整后，这种关联依然存在。当我们考虑大学入学时到1962年之间的体重增加情况时，这种关联较弱（相对风险，0.95；95%置信区间，0.90至1.00）。体育锻炼的保护作用在NIDDM高危人群中最为显著，这些高危人群定义为体重指数高、有高血压病史或有糖尿病家族史的人。除了大学以来的体重增加外，这些因素也是该病的独立预测因素。
增加体育锻炼对预防NIDDM有效，且这种保护益处在该病高危人群中尤为明显。
