Department of Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyväskylä, Finland.
Diabetologia. 2010 Dec;53(12):2531-7. doi: 10.1007/s00125-010-1875-9. Epub 2010 Aug 13.
AIMS/HYPOTHESIS: The study aimed to investigate whether baseline physical activity protects against the occurrence of type 2 diabetes during a 28 year follow-up, after controlling for childhood environment and genetic predisposition.
At baseline in 1975 same-sex twin pairs born in Finland before 1958 were sent a questionnaire including questions on physical activity. The participants (20,487 individuals, including 8,182 complete twin pairs) were divided into quintiles by leisure-time physical activity metabolic equivalent (MET) index (MET h/day). Type 2 diabetes was determined from nationwide registers for the follow-up period (1 January 1976-31 December 2004). Individual and pairwise Cox proportional hazard models were used.
During follow-up, 1,082 type 2 diabetes cases were observed. Among all individuals, participants in MET quintiles (Q) III-V had significantly decreased risk for type 2 diabetes compared with sedentary individuals (QI). The pairwise analysis on pairs discordant for physical activity showed that participants in MET QII to V had significantly lower hazard ratios (0.61, 0.59, 0.61, 0.61) compared with sedentary participants. These findings from the pairwise analysis persisted after adjusting for BMI. In the pairwise analysis, the BMI-adjusted hazard ratio for type 2 diabetes was lower for physically active members of twin pairs (combined QII-V) than for inactive co-twins (HR 0.54; 95% CI 0.37-0.78). Similar results were obtained for both dizygotic and monozygotic pairs, as well as for the subgroup of twin pairs defined as free of co-morbidities in 1981 (HR 0.36; 95% CI 0.17-0.76).
CONCLUSIONS/INTERPRETATION: Leisure-time physical activity protects from type 2 diabetes after taking familial and genetic effects into account.
目的/假设：本研究旨在探讨在 28 年的随访中，在控制儿童时期环境和遗传易感性的情况下，基线体力活动是否可以预防 2 型糖尿病的发生。
1975 年，在芬兰出生于 1958 年前的同性别双胞胎被发送了一份调查问卷，其中包括有关体力活动的问题。根据休闲时间体力活动代谢当量（MET）指数（MET h/天），将参与者（包括 8182 对完整双胞胎在内的 20487 人）分为五组。2 型糖尿病是通过全国登记册在随访期间（1976 年 1 月 1 日-2004 年 12 月 31 日）确定的。使用个体和双样本 Cox 比例风险模型。
在随访期间，观察到 1082 例 2 型糖尿病病例。在所有参与者中，与久坐不动的参与者（QI）相比，MET 五分位数（Q）III-V 组的参与者发生 2 型糖尿病的风险显著降低。对体力活动不一致的双胞胎进行的双样本分析显示，与久坐不动的参与者相比，MET QII 到 V 组的参与者的风险比显著降低（0.61、0.59、0.61、0.61）。在调整 BMI 后，双样本分析仍然存在这种结果。在双样本分析中，与不活跃的同卵双胞胎相比，双胞胎中活跃成员（联合 QII-V）发生 2 型糖尿病的风险比（HR）较低（0.54；95%CI 0.37-0.78）。对于双卵双胞胎和单卵双胞胎，以及在 1981 年定义为无合并症的双胞胎亚组，也得到了类似的结果（HR 0.36；95%CI 0.17-0.76）。
结论/解释：在考虑家族和遗传因素的情况下，休闲时间的体力活动可以预防 2 型糖尿病。
