Tikkanen-Dolenc Heidi, Wadén Johan, Forsblom Carol, Harjutsalo Valma, Thorn Lena M, Saraheimo Markku, Elonen Nina, Rosengård-Bärlund Milla, Gordin Daniel, Tikkanen Heikki O, Groop Per-Henrik
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.
Diabetologia. 2017 Mar;60(3):574-580. doi: 10.1007/s00125-016-4189-8. Epub 2016 Dec 24.
AIMS/HYPOTHESIS: Cardiovascular disease (CVD) is the most common cause of premature death and disability among patients with type 1 diabetes. Diabetic nephropathy accounts for the increased cardiovascular morbidity and mortality of these patients. We recently showed that the intensity of exercise predicts the incidence and progression of diabetic nephropathy in patients with type 1 diabetes. Little is known about the relationship between physical activity and CVD. Therefore, we studied how physical activity affects the risk of CVD events in patients with type 1 diabetes.
A 10 year follow-up study including 2180 type 1 diabetes patients from the nationwide multicentre Finnish Diabetic Nephropathy Study (FinnDiane). Leisure time physical activity (LTPA) was assessed by a previously validated self-report questionnaire. A CVD event was defined as a verified myocardial infarction, coronary procedure or stroke. Patients were analysed separately for the risk of developing a first ever CVD event and for the risk of a recurrent CVD event following a baseline event.
A total of 206 patients had an incident CVD event during follow-up. A higher total LTPA and higher intensity, frequency and duration of activity were associated with a lower risk of incident CVD events. The observed association between exercise frequency and incident CVD remained significant when adjusted for classic risk factors. Exercise intensity also had a borderline effect on the recurrence-free time in patients with a major CVD event at baseline.
CONCLUSIONS/INTERPRETATION: This study suggests that exercise, particularly high frequency and high intensity exercise, may reduce the risk of CVD events in patients with type 1 diabetes.
目的/假设：心血管疾病（CVD）是1型糖尿病患者过早死亡和残疾的最常见原因。糖尿病肾病导致这些患者心血管发病率和死亡率增加。我们最近发现，运动强度可预测1型糖尿病患者糖尿病肾病的发生和进展。关于体力活动与CVD之间的关系知之甚少。因此，我们研究了体力活动如何影响1型糖尿病患者发生CVD事件的风险。
一项为期10年的随访研究，纳入了来自全国多中心芬兰糖尿病肾病研究（FinnDiane）的2180例1型糖尿病患者。通过先前验证的自我报告问卷评估休闲时间体力活动（LTPA）。CVD事件定义为经证实的心肌梗死、冠状动脉手术或中风。分别分析患者首次发生CVD事件的风险以及基线事件后复发性CVD事件的风险。
共有206例患者在随访期间发生了CVD事件。较高的总LTPA以及较高的活动强度、频率和持续时间与较低的首次发生CVD事件的风险相关。在对经典危险因素进行校正后，观察到的运动频率与首次发生CVD事件之间的关联仍然显著。运动强度对基线时有重大CVD事件的患者的无复发时间也有临界影响。
结论/解读：本研究表明，运动，尤其是高频和高强度运动，可能会降低1型糖尿病患者发生CVD事件的风险。
