Applied Sport, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, UK.
Swansea University Medical School, Institute of Life Science, Swansea University, Swansea, Wales, UK.
Pediatr Diabetes. 2021 Mar;22(2):320-328. doi: 10.1111/pedi.13159. Epub 2020 Dec 22.
Little is known about the role of physical activity accumulation in cardiovascular disease risk for children with type 1 diabetes. Improved insight to identify factors of influence in key health outcomes could be provided by considering the entire physical activity profile.
Pulse wave velocity (PWV), augmentation index and heart rate variability (HRV) were assessed cross-sectionally in children with (n = 29, 12.1 ± 2.1 years) and without (n = 19, 12.1 ± 2.1 years) type 1 diabetes. Time spent sedentary and in each physical activity intensity, intensity gradient and average acceleration were derived from seven consecutive days of monitoring with wrist-worn accelerometry. Comparison between groups and influence of physical activity accumulation on cardiovascular metrics were explored with linear mixed models.
Diabetic children demonstrated a higher PWV and a greater volume of light physical activity (p < 0.01), a more negative intensity gradient (p < 0.01), a lower average acceleration and less time in bouted moderate-to-vigorous physical activity (MVPA; p < 0.05). Overall, intensity gradient was strongly correlated with average acceleration, MVPA and bouted MVPA (r = 0.89, r = 0.80, r = 0.79, respectively; all p < 0.05), while average acceleration was correlated with MVPA and bouted MVPA (r = 0.85, r = 0.83, respectively; p < 0.05). Accounting for disease status, intensity gradient and average acceleration were significant predictors of HRV indices (p < 0.05) and PWV (p < 0.01, p < 0.05, respectively).
Overall, MVPA was most associated with central stiffness, highlighting the importance of meeting activity guidelines. Diabetic children demonstrated poorer cardiovascular health than their counterparts, likely attributable to a lower intensity and physical activity volume, identifying physical activity intensity as a key target for future interventions.
对于 1 型糖尿病患儿，人们对体力活动积累在心血管疾病风险中的作用知之甚少。通过考虑整个体力活动概况，可以更好地了解影响关键健康结果的因素。
本研究在 29 名（年龄 12.1±2.1 岁）和 19 名（年龄 12.1±2.1 岁）1 型糖尿病患儿中进行了横断面研究，评估了脉搏波速度（PWV）、增强指数和心率变异性（HRV）。使用腕戴加速度计连续 7 天监测，得出久坐时间和各体力活动强度、强度梯度和平均加速度。采用线性混合模型比较两组之间的差异，并探讨体力活动积累对心血管指标的影响。
糖尿病患儿的 PWV 较高，轻体力活动量较大（p<0.01），强度梯度更负（p<0.01），平均加速度较低，中高强度体力活动（MVPA）的爆发时间较短（p<0.05）。总体而言，强度梯度与平均加速度、MVPA 和爆发性 MVPA 密切相关（r = 0.89、r = 0.80、r = 0.79，均 p<0.05），而平均加速度与 MVPA 和爆发性 MVPA 相关（r = 0.85、r = 0.83，均 p<0.05）。考虑到疾病状态，强度梯度和平均加速度是 HRV 指数（p<0.05）和 PWV（p<0.01、p<0.05）的显著预测因子。
总体而言，MVPA 与中心僵硬度的相关性最强，突出了达到活动指南的重要性。与对照组相比，糖尿病患儿的心血管健康状况较差，这可能归因于较低的强度和体力活动量，表明体力活动强度是未来干预的关键目标。
