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妊娠早期的 2 型糖尿病高危女性的身体活动与健康相关的生活质量。

Physical activity and health-related quality of life among high-risk women for type 2 diabetes in the early years after pregnancy.

机构信息

City of Vantaa Preventive Medical Services, Communal Maternity Care, Kielotie 40, 01300, Vantaa, Finland.

Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland.

出版信息

BMC Womens Health. 2022 Mar 21;22(1):84. doi: 10.1186/s12905-022-01664-7.

Abstract

BACKGROUND

Previous studies have shown that physical activity (PA) correlates positively with health-related quality of life (HRQoL) in the general population. Few studies have investigated associations between device-measured PA and HRQoL among premenopausal women at risk for type 2 diabetes (T2D). In addition to physical well-being, general well-being improved by PA has been suggested to strengthen PA's benefits in reducing metabolic diseases. The aim of this study was to examine the associations between PA and HRQoL (general and dimensions) among high-risk women in the early post-pregnancy years when T2D risk is highest and to estimate whether current obesity or prior gestational diabetes (GDM) modified these associations.

METHODS

This cross-sectional study of high-risk women [body mass index (BMI) ≥ 30 kg/m and/or prior GDM)]4-6 years after delivery measured sleep, sedentary time, daily steps, and light (LPA), moderate-to-vigorous (MVPA), and vigorous PA (VPA) with the SenseWear ArmbandTM accelerometer for seven days and HRQoL with the 15D instrument.

RESULTS

The analyses included 204 women with a median (IQR) age of 39 (6.0) years and a median BMI of 31.1 kg/m (10.9). 54% were currently obese (BMI ≥ 30 kg/m), and 70% had prior gestational diabetes (GDM+). Women with obesity had lower PA levels than women with normal weight or overweight (p < 0.001) but there was no difference between the GDM+ or GDM- women. Women with both current obesity and GDM+ had highest sedentary time and lowest PA levels. The whole sample's median 15D score was 0.934 (IQR 0.092), lower among women with obesity compared to the others (p < 0.001), but not different between GDM+ or GDM-. There was a positive correlation between VPA (adjusted r = 0.262 p = 0.001) and the 15D score. After grouping according to BMI (< and ≥ 30 kg/m), the associations remained significant only in women without obesity. Among them, sleep, total steps, MVPA, and VPA were positively associated with 15D.

CONCLUSIONS

Higher PA levels are associated with better HRQoL among high-risk women with normal weight and overweight but no differences were found among women affected by obesity in the early years after pregnancy. Trial registration Ethics committees of Helsinki University Hospital (Dnro 300/e9/06) and South Karelian Central Hospital (Dnro 06/08).

摘要

背景

先前的研究表明,体力活动(PA)与一般人群的健康相关生活质量(HRQoL)呈正相关。很少有研究调查过在有患 2 型糖尿病(T2D)风险的绝经前妇女中,设备测量的 PA 与 HRQoL 之间的关联。除了身体健康外,人们还认为通过 PA 提高的整体幸福感会增强 PA 在降低代谢疾病方面的益处。本研究的目的是检验在产后早期(T2D 风险最高)高危妇女中 PA 与 HRQoL(总体和维度)之间的关联,并估计当前肥胖或既往妊娠糖尿病(GDM)是否改变了这些关联。

方法

本横断面研究纳入了高危妇女[体重指数(BMI)≥30 kg/m 2 和/或既往 GDM],在产后 4-6 年内使用 SenseWear ArmbandTM 加速度计测量睡眠、久坐时间、每日步数以及轻(LPA)、中-剧烈(MVPA)和剧烈(VPA)PA 活动,并使用 15D 工具测量 HRQoL。

结果

分析纳入了 204 名中位(IQR)年龄为 39(6.0)岁、中位 BMI 为 31.1 kg/m 2(10.9)的妇女。54%的妇女目前肥胖(BMI≥30 kg/m 2 ),70%的妇女既往有妊娠糖尿病(GDM+)。肥胖妇女的 PA 水平低于体重正常或超重的妇女(p<0.001),但 GDM+和 GDM-妇女之间没有差异。同时患有肥胖症和 GDM+的妇女久坐时间最长,PA 水平最低。全样本的中位 15D 评分为 0.934(IQR 0.092),肥胖妇女的评分低于其他妇女(p<0.001),但 GDM+和 GDM-妇女之间没有差异。VPA(调整后 r=0.262,p=0.001)与 15D 评分呈正相关。根据 BMI(<和≥30 kg/m 2 )分组后,仅在体重正常和超重的高危妇女中,关联仍然显著。其中,睡眠、总步数、MVPA 和 VPA 与 15D 呈正相关。

结论

在产后早期肥胖的高危妇女中,较高的 PA 水平与更好的 HRQoL 相关,但在体重正常的妇女中没有发现差异。本研究已在赫尔辛基大学医院伦理委员会(注册号 300/e9/06)和南卡累利阿中央医院伦理委员会(注册号 06/08)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab7/8939162/506440372850/12905_2022_1664_Fig1_HTML.jpg

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