与绝对心肺功能水平相比，预计年龄相关心肺适能的百分比可能是 2 型糖尿病事件发生的更强风险指标。
Percentage of Age-Predicted Cardiorespiratory Fitness May Be a Stronger Risk Indicator for Incident Type 2 Diabetes Than Absolute Levels of Cardiorespiratory Fitness.
机构信息
National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, and Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, England (Dr Kunutsor); Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, England (Drs Kunutsor and Seidu); Leon H. Charney Division of Cardiology, New York University Langone Health, New York (Dr Khan); Department of Medicine, Central Finland Health Care District Hospital District, Jyväskylä, Finland District, Jyväskylä, and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, and Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland (Dr Laukkanen).
出版信息
J Cardiopulm Rehabil Prev. 2023 Jan 1;43(1):66-73. doi: 10.1097/HCR.0000000000000720. Epub 2022 Aug 4.
PURPOSE
There are inverse and independent associations between cardiorespiratory fitness (CRF) and several adverse cardiometabolic outcomes. The percentage of age-predicted CRF (%age-predicted CRF) is comparable to absolute CRF as a risk indicator for some of these outcomes, but the association between %age-predicted CRF and risk of type 2 diabetes (T2D) has not been previously investigated. We aimed to assess the association between %age-predicted CRF and T2D in a prospective cohort study.
METHODS
Cardiorespiratory fitness, as measured directly by peak oxygen uptake, was assessed in 1901 men aged 42-60 yr who underwent cardiopulmonary exercise testing. The age-predicted CRF estimated from a regression equation for age was converted to %age-predicted CRF using (achieved CRF/age-predicted CRF) × 100. Hazard ratios (95% CI) were estimated for T2D.
RESULTS
During a median follow-up of 26.8 yr, 227 T2D cases were recorded. The risk of T2D decreased continuously with increasing %age-predicted CRF ( P value for nonlinearity = .30). A 1-SD increase in %age-predicted CRF was associated with a decreased risk of T2D in analysis adjusted for established risk factors (HR = 0.68: 95% CI, 0.59-0.79). The corresponding adjusted risk was (HR = 0.51: 95% CI, 0.35-0.75) comparing extreme tertiles of %age-predicted CRF. The respective estimates for the association between absolute CRF and T2D were-HR (95% CI)-0.71 (0.60-0.83) and 0.64 (0.44-0.95).
CONCLUSIONS
Percentage of age-predicted CRF is linearly, inversely, and independently associated with the risk of incident T2D and may be a stronger risk indicator for T2D compared to absolute CRF in a general population of middle-aged and older men.
目的
心肺适能（CRF）与多种不良心血管代谢结局呈负相关且独立相关。与某些此类结果的风险指标相比，年龄预测心肺适能（%age-predicted CRF）与绝对 CRF 相当，但%age-predicted CRF 与 2 型糖尿病（T2D）风险之间的关系尚未被研究。我们旨在一项前瞻性队列研究中评估%age-predicted CRF 与 T2D 之间的关联。
方法
对 1901 名年龄在 42-60 岁的男性进行心肺运动试验，直接测量其心肺适能。使用回归方程估算年龄预测的 CRF，并将其转换为%age-predicted CRF，方法为（实际 CRF/年龄预测 CRF）×100。使用危险比（95%置信区间）来估计 T2D 的风险。
结果
在中位随访 26.8 年期间，记录到 227 例 T2D 病例。随着%age-predicted CRF 的不断增加，T2D 的风险呈连续下降趋势（非线性 P 值=.30）。在调整了既定危险因素后，%age-predicted CRF 每增加 1 个标准差，T2D 的风险就会降低（HR=0.68：95%CI，0.59-0.79）。比较%age-predicted CRF 的极端三分位时，调整后的风险为（HR=0.51：95%CI，0.35-0.75）。与 T2D 相关的绝对 CRF 的相应调整后的风险为-HR（95%CI）-0.71（0.60-0.83）和 0.64（0.44-0.95）。
结论
%age-predicted CRF 与 T2D 的发病风险呈线性、负相关且独立相关，与绝对 CRF 相比，%age-predicted CRF 可能是中年及以上人群中 T2D 的更强风险指标。
Zotero 插件