2 型糖尿病患者的步行速度与微血管并发症：来自英国生物银行的队列研究。
Walking pace and microvascular complications among individuals with type 2 diabetes: A cohort study from the UK Biobank.
机构信息
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
出版信息
Scand J Med Sci Sports. 2024 Jan;34(1):e14501. doi: 10.1111/sms.14501. Epub 2023 Sep 23.
INTRODUCTION
Walking pace is associated with various health-related outcomes. The aim of this study was to investigate the association between self-reported walking pace and the incidences of diabetic microvascular complications among participants with type 2 diabetes (T2D).
METHODS
Self-reported walking pace was classified as brisk, average, or slow. The outcomes were the incidences of diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. COX proportional hazards models adjusted for sociodemographic, lifestyle, and health-related factors were used to estimate hazard ratios (HRs) and 95% CIs.
RESULTS
A total of 14 518 participants with T2D in the UK Biobank (mean age 59.7 ± 7.0 years, 5028 [34.6%] women) were included. During a median follow-up of 12.5 (interquartile range: 11.6-13.4) years, 2980 participants developed diabetic microvascular complications. After adjusting for confounding factors, and compared with brisk walkers, slow walkers had a multivariable-adjusted HR of 1.98 (95% CI 1.58, 2.47) for composite diabetic microvascular complications, 1.54 (95% CI 1.11, 2.14) for diabetic retinopathy, 3.26 (95% CI 2.08, 5.11) for diabetic neuropathy, and 2.32 (95% CI 1.91, 2.82) for diabetic nephropathy. Average walking pace was associated with a higher risk for diabetic nephropathy (HR 1.51, 95 CI% 1.27-1.79) compared with brisk walking. Additionally, ≥1 diabetic microvascular complication occurred in 447 (14.7%) of participants with brisk walking pace, 1702 (19.5%) with average walking pace, and 831 (30.4%) with slow walking pace. Time from study recruitment to first diagnosis was shorter in participants who reported a slow walking pace, compared with brisk or average walkers. Among participants who had diabetic nephropathy as their first diagnosis, slow walking pace was associated with subsequent risk of a second diabetic microvascular complication (HR 3.88, 95 CI% 2.27-6.60).
CONCLUSIONS
Self-reported slow walking pace is associated with a higher risk of diabetic microvascular complications among participants with T2D in this population-based cohort study.
简介
行走速度与各种与健康相关的结果有关。本研究的目的是调查 2 型糖尿病（T2D）患者自我报告的行走速度与糖尿病微血管并发症发生率之间的关系。
方法
自我报告的行走速度分为轻快、平均和缓慢。结果为糖尿病视网膜病变、糖尿病神经病变和糖尿病肾病的发生率。使用 Cox 比例风险模型调整了社会人口统计学、生活方式和健康相关因素，以估计风险比（HR）和 95%置信区间（CI）。
结果
在英国生物库中共有 14518 名 T2D 患者（平均年龄 59.7±7.0 岁，5028 [34.6%] 名女性）被纳入研究。在中位随访 12.5 年（四分位距：11.6-13.4）期间，2980 名患者发生了糖尿病微血管并发症。在调整了混杂因素后，与轻快步行者相比，慢步行者发生复合糖尿病微血管并发症的多变量调整 HR 为 1.98（95%CI 1.58，2.47），糖尿病视网膜病变为 1.54（95%CI 1.11，2.14），糖尿病神经病变为 3.26（95%CI 2.08，5.11），糖尿病肾病为 2.32（95%CI 1.91，2.82）。平均步行速度与糖尿病肾病的风险增加相关（HR 1.51，95%CI% 1.27-1.79），与轻快步行相比。此外，在轻快步行者中，有 447 名（14.7%）参与者发生了≥1 种糖尿病微血管并发症，在平均步行速度者中，有 1702 名（19.5%）参与者发生了≥1 种糖尿病微血管并发症，在缓慢步行速度者中，有 831 名（30.4%）参与者发生了≥1 种糖尿病微血管并发症。与轻快或平均步行者相比，报告慢步行速度的参与者从研究招募到首次诊断的时间更短。在患有糖尿病肾病的参与者中，慢步行速度与随后发生第二种糖尿病微血管并发症的风险相关（HR 3.88，95%CI 2.27-6.60）。
结论
在这项基于人群的队列研究中，自我报告的慢步行速度与 T2D 患者发生糖尿病微血管并发症的风险增加有关。
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