Lamb Maxine J E, Westgate Kate, Brage Søren, Ekelund Ulf, Long Gráinne H, Griffin Simon J, Simmons Rebecca K, Cooper Andrew J M
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK.
Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Diabetologia. 2016 Jan;59(1):110-120. doi: 10.1007/s00125-015-3756-8. Epub 2015 Oct 30.
AIMS/HYPOTHESIS: The aim of this study was to examine the prospective associations between objectively measured physical activity energy expenditure (PAEE), sedentary time, moderate-to-vigorous-intensity physical activity (MVPA), cardiorespiratory fitness (CRF) and cardiometabolic risk factors over 4 years in individuals with recently diagnosed diabetes.
Among 308 adults (mean age 61.0 [SD 7.2] years; 34% female) with type 2 diabetes from the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION)-Plus study, we measured physical activity using individually calibrated combined heart rate and movement sensing. Multivariable linear regression models were constructed to examine the associations between baseline PAEE, sedentary time, MVPA, CRF and cardiometabolic risk factors and clustered cardiometabolic risk (CCMR) at follow-up, and change in these exposures and change in CCMR and its components over 4 years of follow-up.
Individuals who increased their PAEE between baseline and follow-up had a greater reduction in waist circumference (-2.84 cm, 95% CI -4.84, -0.85) and CCMR (-0.17, 95% CI -0.29, -0.04) compared with those who decreased their PAEE. Compared with individuals who decreased their sedentary time, those who increased their sedentary time had a greater increase in waist circumference (3.20 cm, 95% CI 0.84, 5.56). Increases in MVPA were associated with reductions in systolic blood pressure (-6.30 mmHg, 95% CI -11.58, -1.03), while increases in CRF were associated with reductions in CCMR (-0.23, 95% CI -0.40,-0.05) and waist circumference (-3.79 cm, 95% CI -6.62, -0.96). Baseline measures were generally not predictive of cardiometabolic risk at follow-up.
CONCLUSIONS/INTERPRETATION: Encouraging people with recently diagnosed diabetes to increase their physical activity and decrease their sedentary time may have beneficial effects on their waist circumference, blood pressure and CCMR.
目的/假设：本研究旨在探讨近期诊断为糖尿病的个体在4年时间里，客观测量的身体活动能量消耗（PAEE）、久坐时间、中等到高强度身体活动（MVPA）、心肺适能（CRF）与心血管代谢危险因素之间的前瞻性关联。
在英-丹-荷初级保健中筛查发现糖尿病患者强化治疗研究（ADDITION）-Plus研究中的308例2型糖尿病成年人（平均年龄61.0[标准差7.2]岁；34%为女性）中，我们使用个体校准的心率和运动感应组合来测量身体活动。构建多变量线性回归模型，以检验基线PAEE、久坐时间、MVPA、CRF与心血管代谢危险因素以及随访时的聚类心血管代谢风险（CCMR）之间的关联，以及这些暴露因素的变化与随访4年期间CCMR及其组成部分的变化之间的关联。
与PAEE降低的个体相比，基线至随访期间PAEE增加的个体腰围（-2.84厘米，95%置信区间-4.84，-0.85）和CCMR（-0.17，95%置信区间-0.
