Slaght Jana L, Wicklow Brandy Alexandra, Dart Allison B, Sellers Elizabeth A C, Gabbs Melissa, Carino Marylin, McGavock Jonathan M
Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
BMJ Open Diabetes Res Care. 2021 May;9(1). doi: 10.1136/bmjdrc-2021-002134.
Youth living with type 2 diabetes display increased risk of cardiovascular disease (CVD). It is unclear if regular physical activity (PA) modifies this risk.
We compared CVD risk factors in a cross-sectional study of 164 youth with type 2 diabetes stratified according to weekly vigorous-intensity PA. Outcomes were hemoglobin A1c (HbA1c), ambulatory blood pressure (BP; ambulatory 24-hour readings), plasma lipoproteins, and albuminuria. The main exposure, vigorous-intensity PA, was quantified with the Adolescent Physical Activity Recall Questionnaire.
Youth were 15±3 years, and 78% lived rurally and 68% were female, with a mean body mass index (BMI) Z-score of 2.4±1.1 and a mean HbA1c of 9.6% ±2.6%. Youth who participated in regular vigorous-intensity PA (40%; n=67) achieved nearly twice the dose of PA than peers who did not (62 vs 34 metabolic equivalent score-hour/week, p=0.001). After adjusting for duration of diabetes, BMI Z-score, sex, and smoking, youth who engaged in vigorous-intensity PA displayed lower HbA1c (9.1% vs 9.9%, p=0.052), diastolic BP (70 mm Hg vs 73 mm Hg, p=0.002), diastolic load (20% vs 26%, p=0.023), and mean arterial pressure (87.3 mm Hg vs 90.3 mm Hg, p<0.01), compared with youth who did not. Compared with youth who did not participate in regular vigorous-intensity PA, those who did also displayed lower odds of albuminuria after adjusting for duration of diabetes, sex, smoking, rural residence, and BMI Z-score (adjusted OR: 0.40, 95% CI 0.19 to 0.84).
Among youth with type 2 diabetes, participation in vigorous-intensity PA is associated with lower CVD risk.
患有2型糖尿病的青少年患心血管疾病（CVD）的风险增加。目前尚不清楚规律的体育活动（PA）是否能改变这种风险。
我们在一项横断面研究中比较了164名2型糖尿病青少年的CVD风险因素，这些青少年根据每周剧烈强度PA进行分层。研究结果包括糖化血红蛋白（HbA1c）、动态血压（BP；24小时动态读数）、血浆脂蛋白和蛋白尿。主要暴露因素，即剧烈强度PA，通过青少年体育活动回忆问卷进行量化。
青少年的年龄为15±3岁，78%生活在农村，68%为女性，平均体重指数（BMI）Z评分为2.4±1.1，平均HbA1c为9.6%±2.6%。参与规律剧烈强度PA的青少年（40%；n = 67）达到的PA量几乎是未参与青少年的两倍（62对34代谢当量得分 - 小时/周，p = 0.001）。在调整糖尿病病程、BMI Z评分、性别和吸烟因素后，进行剧烈强度PA的青少年与未进行的青少年相比，HbA1c更低（9.1%对9.9%，p = 0.052），舒张压更低（70 mmHg对73 mmHg，p = 0.002），舒张压负荷更低（20%对26%，p = 0.023），平均动脉压更低（87.3 mmHg对90.3 mmHg，p < 0.01）。与未参与规律剧烈强度PA的青少年相比，在调整糖尿病病程、性别、吸烟、农村居住情况和BMI Z评分后，参与的青少年蛋白尿发生几率也更低（调整后OR：0.40，95%CI 0.19至0.84）。
在患有2型糖尿病的青少年中，参与剧烈强度PA与较低的CVD风险相关。
