Department of Health Management Center, Mito Kyodo General Hospital, Mito City, Japan.
Diabetes Care. 2013 Feb;36(2):471-9. doi: 10.2337/dc12-0783.
The association between habitual physical activity (PA) and lowered risk of all-cause mortality (ACM) and cardiovascular disease (CVD) has been suggested in patients with diabetes. This meta-analysis summarizes the risk reduction in relation to PA, focusing on clarifying dose-response associations.
Electronic literature searches were conducted for cohort studies that examined relative risk (RR) of ACM or CVD in relation to PA in patients with diabetes. For the qualitative assessment, RR for the highest versus the lowest PA category in each study was pooled with a random-effects model. We added linear and spline regression analyses to assess the quantitative relationship between increases in PA and ACM and CVD risk.
There were 17 eligible studies. Qualitatively, the highest PA category had a lower RR [95% CI] for ACM (0.61 [0.52-0.70]) and CVD (0.71 [0.60-0.84]) than the lowest PA category. The linear regression model indicated a high goodness of fit for the risk of ACM (adjusted R(2) = 0.44, P = 0.001) and CVD (adjusted R(2) = 0.51, P = 0.001), with the result that a 1 MET-h/day incrementally higher PA was associated with 9.5% (5.0-13.8%) and 7.9% (4.3-11.4%) reductions in ACM and CVD risk, respectively. The spline regression model was not significantly different from the linear model in goodness of fit (P = 0.14 for ACM risk; P = 0.60 for CVD risk).
More PA was associated with a larger reduction in future ACM and CVD risk in patients with diabetes. Nevertheless, any amount of habitual PA was better than inactivity.
有研究表明，习惯性体力活动（PA）与糖尿病患者全因死亡率（ACM）和心血管疾病（CVD）风险降低有关。本荟萃分析总结了与 PA 相关的风险降低情况，重点阐明了剂量反应关系。
对评估糖尿病患者 PA 与 ACM 或 CVD 风险相关性的队列研究进行电子文献检索。对于定性评估，使用随机效应模型对每个研究中 PA 最高与最低类别之间的 RR 进行汇总。我们还进行了线性和样条回归分析，以评估 PA 增加与 ACM 和 CVD 风险之间的定量关系。
共有 17 项符合条件的研究。定性分析显示，PA 最高类别 ACM（0.61 [0.52-0.70]）和 CVD（0.71 [0.60-0.84]）的 RR 低于 PA 最低类别。线性回归模型表明 ACM 风险（调整 R² = 0.44，P = 0.001）和 CVD 风险（调整 R² = 0.51，P = 0.001）的拟合优度较高，结果表明，PA 每增加 1 MET-h/天，ACM 和 CVD 风险分别降低 9.5%（5.0-13.8%）和 7.9%（4.3-11.4%）。样条回归模型在拟合优度方面与线性模型无显著差异（ACM 风险的 P = 0.14；CVD 风险的 P = 0.60）。
更多的 PA 与糖尿病患者未来 ACM 和 CVD 风险的降低幅度更大相关。然而，任何习惯性 PA 的量都优于不活动。
