1Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy.
2Diabetes Unit, Sant'Andrea University Hospital, Rome, Italy.
Diabetes Care. 2022 Jan 1;45(1):213-221. doi: 10.2337/dc21-1505.
In the Italian Diabetes and Exercise Study_2 (IDES_2), behavioral counseling promoted a sustained increase in physical activity (PA) volume (+3.3 MET h ⋅ week-1), moderate- to vigorous-intensity PA (MVPA) (+6.4 min ⋅ day-1), and light-intensity PA (LPA) (+0.8 h ⋅ day-1) and decrease in sedentary time (SED-time) (-0.8 h ⋅ day-1). Here, we investigated the relationships of changes in PA/SED-time with changes in physical fitness and cardiometabolic risk profile in individuals with type 2 diabetes.
In this 3-year randomized clinical trial, 300 physically inactive and sedentary patients were randomized 1:1 to receive 1-month theoretical and practical counseling once a year or standard care. Changes in physical fitness and cardiovascular risk factors/scores according to quartiles of accelerometer-measured changes in PA/SED-time were assessed, together with univariate and multivariable associations between these parameters, in the whole cohort and by study arm.
Physical fitness increased and HbA1c and coronary heart disease 10-year risk scores decreased with quartiles of MVPA and SED-time change. In quartile IV of MVPA increase and SED-time decrease, cardiorespiratory fitness increased by 5.23 and 4.49 mL ⋅ min-1 ⋅ kg-1 and HbA1c decreased by 0.73 and 0.85%, respectively. Univariate correlations confirmed these relationships, and mean changes in both MPVA and SED-time predicted changes in physical fitness and cardiovascular risk factors/scores independently of one another and of other confounders. Similar findings were observed with LPA and PA volume and in each group separately.
Even modest increments in MVPA may have a clinically meaningful impact, and reallocating SED-time to LPA may also contribute to improved outcomes, possibly by increasing total energy expenditure.
在意大利糖尿病与运动研究 2 期（IDES_2）中，行为咨询促进了体力活动（PA）量的持续增加（+3.3 MET h ⋅ week-1）、中高强度 PA（MVPA）（+6.4 min ⋅ day-1）和低强度 PA（LPA）（+0.8 h ⋅ day-1），以及久坐时间（SED-time）的减少（-0.8 h ⋅ day-1）。在此，我们研究了 2 型糖尿病患者 PA/SED-time 变化与身体适应性和心血管代谢风险特征变化的关系。
在这项为期 3 年的随机临床试验中，300 名身体不活跃和久坐的患者按 1:1 比例随机分为接受每年 1 次的 1 个月理论和实践咨询组或标准护理组。根据加速度计测量的 PA/SED-time 变化的四分位数，评估身体适应性和心血管风险因素/评分的变化，并评估整个队列和研究组中这些参数之间的单变量和多变量关联。
随着 MVPA 和 SED-time 变化的四分位数增加，心肺适应性增加，HbA1c 和冠心病 10 年风险评分降低。在 MVPA 增加和 SED-time 减少的四分位数 IV 中，心肺适应性分别增加了 5.23 和 4.49 mL ⋅ min-1 ⋅ kg-1，HbA1c 分别降低了 0.73 和 0.85%。单变量相关性证实了这些关系，MVPA 和 SED-time 的平均变化可独立于彼此和其他混杂因素预测身体适应性和心血管风险因素/评分的变化。类似的发现也见于 LPA 和 PA 量，并且在每个组中都有观察到。
即使 MVPA 略有增加也可能具有重要的临床意义，重新分配 SED-time 到 LPA 也可能有助于改善结果，这可能是通过增加总能量消耗来实现的。
