一贯较高的心肺适能水平与 2 型糖尿病的发病率。
Consistently High Level of Cardiorespiratory Fitness and Incidence of Type 2 Diabetes.
机构信息
1Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, JAPAN; 2Department of Health Promotion and Exercise, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, JAPAN; 3Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA; 4Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; 5Faculty of Sport Sciences, Waseda University, Tokorozawa, JAPAN; 6Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, JAPAN; 7Tokyo Gas Health Promotion Center, Tokyo, JAPAN; and 8Arnold School of Public Health, University of South Carolina, Columbia, SC.
出版信息
Med Sci Sports Exerc. 2017 Oct;49(10):2048-2055. doi: 10.1249/MSS.0000000000001319.
PURPOSE
Although the benefit of high cardiorespiratory fitness (CRF) for the prevention of type 2 diabetes mellitus (T2DM) is widely accepted, whether consistently high CRF is necessary or transiently high CRF is sufficient is unclear. The present study was conducted to examine the hypothesis that consistently high level of CRF is more beneficial than transiently high CRF for the prevention of T2DM.
METHODS
This cohort study was conducted in nondiabetic 7158 men age 20 to 60 yr, enrolled from 1986 to 1987. The area under the curve with respect to ground (AUCG) for CRF measurements during an 8-yr measurement period (1979-1987) was calculated as an index of integrated CRF level during the period. The differences (ΔAUCP) between AUCG and peak AUC (peak CRF-measurement period) was also calculated as an index of the presence and the size of a "spike" in CRF. T2DM was defined by fasting blood glucose and a self-reported diagnosis of diabetes for participants with blood tests. For participants without blood tests, T2DM was defined by the result of oral glucose test after a nonfasting urinary test and a self-reported diagnosis of diabetes. T2DM was determined on health checkups until 2009.
RESULTS
During the follow-up period, 1495 men developed T2DM. After adjustment for confounders, as compared with the first quartile of AUCG for CRF, the hazard ratio (95% confidence interval) for the second, third, and fourth quartiles were 0.87 (0.76 to 1.00), 0.80 (0.68 to 0.95), and 0.72 (0.58 to 0.89), respectively. For CRF spike, there was no association between ΔAUCP in CRF and the incidence of T2DM.
CONCLUSIONS
Consistently higher level of CRF over time was associated with lower risk of T2DM.
目的
虽然心肺适能（CRF）较高对预防 2 型糖尿病（T2DM）有益已被广泛接受，但尚不清楚持续高 CRF 是否必要，还是一过性高 CRF 就足够。本研究旨在检验以下假说，即持续高 CRF 水平比一过性高 CRF 水平更有益于预防 T2DM。
方法
本队列研究纳入了 1986 至 1987 年间招募的 7158 名年龄在 20 至 60 岁之间的非糖尿病男性。在 8 年的测量期间（1979-1987 年），计算 CRF 测量的曲线下面积（AUCG），作为该期间综合 CRF 水平的指标。AUCG 与峰值 AUC（峰值 CRF-测量期间）的差值（ΔAUCP）也被计算出来，作为 CRF 中“尖峰”的存在和大小的指标。T2DM 的定义为空腹血糖和有血糖检测结果的参与者的自我报告的糖尿病诊断。对于没有血糖检测结果的参与者，T2DM 的定义为非空腹尿液检测后口服葡萄糖耐量试验的结果和自我报告的糖尿病诊断。T2DM 是通过 2009 年之前的健康检查来确定的。
结果
在随访期间，1495 名男性发生了 T2DM。在调整混杂因素后，与 CRF 的 AUCG 的第一四分位数相比，第二、第三和第四四分位数的风险比（95%置信区间）分别为 0.87（0.76 至 1.00）、0.80（0.68 至 0.95）和 0.72（0.58 至 0.89）。对于 CRF 尖峰，CRF 中的ΔAUCP 与 T2DM 的发病率之间没有关联。
结论
随着时间的推移，CRF 水平的持续升高与 T2DM 风险的降低相关。
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