Kaizu Shinako, Kishimoto Hiro, Iwase Masanori, Fujii Hiroki, Ohkuma Toshiaki, Ide Hitoshi, Jodai Tamaki, Kikuchi Yohei, Idewaki Yasuhiro, Hirakawa Yoichiro, Nakamura Udai, Kitazono Takanari
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
PLoS One. 2014 Jun 4;9(6):e98768. doi: 10.1371/journal.pone.0098768. eCollection 2014.
AIMS/HYPOTHESIS: The effects of leisure-time physical activity (LTPA) on glycemia and cardiovascular risk factors are not fully understood in Asian type 2 diabetic patients, who are typically non-obese. We studied associations between LTPA and glycemia and cardiovascular risk factors in Japanese type 2 diabetic patients.
A total of 4,870 Japanese type 2 diabetic patients aged ≥ 20 years were divided into eight groups according to their LTPA. We investigated associations between the amount and intensity levels of physical activity (PA) and glycemic control, insulin sensitivity, cardiovascular risk factors, and low-grade systemic inflammation in a cross-sectional study.
LTPA was dose-dependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, high density lipoprotein cholesterol, high sensitivity C-reactive protein, and prevalence of metabolic syndrome, but not with blood pressure, low density lipoprotein cholesterol or adiponectin. The amount of PA required to lower HbA1c was greater than that required to improve cardiovascular risk factors. LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustments for age, sex, duration of diabetes, current smoking, current drinking, energy intake, cardiovascular diseases, depressive symptoms, and treatment of diabetes. Higher-intensity LTPA, not lower-intensity LTPA was associated with HbA1c after multivariate adjustments with further adjustment including BMI.
CONCLUSIONS/INTERPRETATION: LTPA was dose-dependently associated with better glycemic control and amelioration of some cardiovascular risk factors in Japanese type 2 diabetic patients. In addition, increased higher-intensity LTPA may be appropriate for glycemic control.
目的/假设：在通常不肥胖的亚洲2型糖尿病患者中，休闲时间体力活动（LTPA）对血糖及心血管危险因素的影响尚未完全明确。我们研究了日本2型糖尿病患者中LTPA与血糖及心血管危险因素之间的关联。
共有4870名年龄≥20岁的日本2型糖尿病患者根据其LTPA被分为八组。在一项横断面研究中，我们调查了体力活动（PA）的量和强度水平与血糖控制、胰岛素敏感性、心血管危险因素及低度全身炎症之间的关联。
LTPA与体重指数（BMI）、腰围、糖化血红蛋白（HbA1c）、空腹血糖、胰岛素抵抗稳态模型评估、甘油三酯、高密度脂蛋白胆固醇、高敏C反应蛋白及代谢综合征患病率呈剂量依赖性相关，但与血压、低密度脂蛋白胆固醇或脂联素无关。降低HbA1c所需的PA量大于改善心血管危险因素所需的量。在对年龄、性别、糖尿病病程、当前吸烟、当前饮酒、能量摄入、心血管疾病、抑郁症状及糖尿病治疗进行多变量调整后，LTPA与非肥胖参与者的HbA1c呈负相关，但与肥胖参与者无关。在进一步调整包括BMI在内的多变量后，高强度LTPA而非低强度LTPA与HbA1c相关。
结论/解读：在日本2型糖尿病患者中，LTPA与更好的血糖控制及某些心血管危险因素的改善呈剂量依赖性相关。此外，增加高强度LTPA可能适合血糖控制。
