Division of Research, Kaiser Permanente, Oakland, CA.
University of Texas, Health Science Center at Houston, School of Public Health in Austin, Austin, TX.
Med Sci Sports Exerc. 2019 Dec;51(12):2498-2505. doi: 10.1249/MSS.0000000000002083.
To estimate risks of incident type 2 diabetes (T2D) and stage 2 and greater hypertension associated with self-reported and accelerometer-determined moderate-vigorous physical activity (MVPA) separately and adjusted for each other.
The sample included 2291 black and white men and women, ages 38-50 yr, in the Coronary Artery Risk Development in Young Adults (CARDIA) fitness study, conducted during the year 20 core CARDIA examination. Accelerometer-determined (Actigraph, LLC. model 7164) MVPA (MVPA-Acc), assessed at year 20, was defined as minutes per day of counts ≥2020 min. Self-reported MVPA (MVPA-SR) was assessed at year 20 using the CARDIA Physical Activity History. Incident T2D was ascertained at years 25 and 30 from fasting glucose, 2 h glucose tolerance test, HbA1c, or diabetes medication; incident hypertension was ascertained at those same times from measured blood pressure or use of antihypertensive medications. Modified Poisson regression models estimated relative risk (RR) of incident (years 25 and 30) T2D or hypertension, associated with middle and high tertiles of year 20 MVPA-Acc alone, year 20 MVPA-SR alone, and both, adjusted for each other, relative to bottom tertile.
In men, MVPA-Acc, but not MVPA-SR, was associated with a 37% to 67% decreased risk of incident T2D in a dose-response relation that persisted with adjustment for BMI, Similar associations were observed in women, although the risk reduction was similar in the second and third tertiles, relative to the bottom tertile. In both men and women, MVPA-Acc was marginally associated with reduced risk of incident stage 2 and greater hypertension, but only after adjustment for BMI, whereas MVPA-SR was not associated in either sex.
Accelerometer-determined MVPA may provide more consistent risk estimates for incident diabetes than self-reported MVPA.
分别估计与自我报告和加速度计确定的中度至剧烈体力活动（MVPA）相关的 2 型糖尿病（T2D）和 2 期及更高阶段高血压的发病风险，并对彼此进行调整。
该样本包括 2291 名年龄在 38-50 岁的黑人和白人男女，他们参加了冠状动脉风险发展在年轻人（CARDIA）健身研究，该研究在核心 CARDIA 检查的第 20 年进行。在第 20 年评估的加速度计确定的（Actigraph，LLC. 模型 7164）MVPA（MVPA-Acc）定义为每分钟计数≥2020 分钟的分钟数。第 20 年使用 CARDIA 体力活动史评估自我报告的 MVPA（MVPA-SR）。在第 25 年和第 30 年，通过空腹血糖、2 小时葡萄糖耐量试验、HbA1c 或糖尿病药物确定 2 型糖尿病的发病情况；在同一时间通过测量血压或使用抗高血压药物确定高血压的发病情况。改良泊松回归模型估计与年 20 MVPA-Acc 单独的中间和高三分位数、年 20 MVPA-SR 单独的中间和高三分位数以及两者之间的相互调整相关的发病（第 25 年和第 30 年）T2D 或高血压的相对风险（RR）。
在男性中，MVPA-Acc 但不是 MVPA-SR 与剂量反应呈负相关，与最低三分位数相比，与 2 型糖尿病发病风险降低 37%至 67%，这种关联在女性中也存在，尽管与最低三分位数相比，第二和第三三分位数的风险降低相似。在男性和女性中，MVPA-Acc 与 2 期及更高阶段高血压的发病风险降低呈边缘相关，但仅在调整 BMI 后，而 MVPA-SR 在两性中均无关联。
与自我报告的 MVPA 相比，加速度计确定的 MVPA 可能为糖尿病发病风险提供更一致的估计。
