Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410078, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410078, China; Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Boston, USA.
Diabetes Metab Syndr. 2024 Mar;18(3):102975. doi: 10.1016/j.dsx.2024.102975. Epub 2024 Mar 13.
OBJECTIVE: To investigate the relationship of moderate physical activity (MPA), vigorous physical activity (VPA), and muscle strengthening activity (MSA), independently and jointly, with all-cause, cardiovascular disease (CVD), and non-CVD mortality in individuals with type 2 diabetes (T2D). MATERIAL AND METHODS: This cohort study included 47,538 adults with T2D and 561,963 adults without T2D from the National Health Interview Survey 1997-2018 who provided data on self-reported physical activity (PA). Mortality data were obtained from the National Death Index through 2019. Cox regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI). RESULTS: In analyses mutually adjusted, versus no MPA adults with T2D, performing the recommendations of MPA (150-299 min/week) associated with lower all-cause mortality (HR, 0.72; 95% CI, 0.66-0.78), CVD mortality (HR, 0.68; 95% CI, 0.58-0.79), and non-CVD mortality (HR, 0.72; 95% CI, 0.65-0.79). Similar benefits were observed in those meeting recommendations for VPA and MSA. Higher levels of PA beyond current recommendations may provide a few additional benefits without adverse effects on mortality risk, regardless of diabetes onset age, duration of diabetes, and medication status. The joint analysis indicates that combining MSA with aerobic PA could further lower mortality risk, and lowest all-cause mortality was observed among individuals engaging in either 75-150 min/week of VPA and 1 time/week of MSA (HR, 0.30; 95% CI, 0.13-0.70) or 150-299 min/week of MPA and 1 time/week of MSA (HR, 0.33; 95% CI, 0.20-0.55). CONCLUSION: Our study supports the current PA guidelines and suggests that there may be limited benefits gained from exercising beyond recommended levels in adults with T2D, combining recommended levels of aerobic and resistance exercises could yield the greatest benefits.
目的:研究中等强度体力活动(MPA)、高强度体力活动(VPA)和肌肉强化活动(MSA)独立和联合与 2 型糖尿病(T2D)患者全因、心血管疾病(CVD)和非 CVD 死亡率的关系。
材料和方法:这项队列研究纳入了 1997 年至 2018 年国家健康访谈调查中 47538 名患有 T2D 的成年人和 561963 名没有 T2D 的成年人,这些参与者提供了关于自我报告体力活动(PA)的数据。通过 2019 年国家死亡指数获得死亡率数据。使用 Cox 回归估计风险比(HR)和 95%置信区间(CI)。
结果:在相互调整的分析中,与没有 MPA 的 T2D 成年人相比,进行 MPA(150-299 分钟/周)推荐量与全因死亡率降低相关(HR,0.72;95%CI,0.66-0.78)、CVD 死亡率(HR,0.68;95%CI,0.58-0.79)和非 CVD 死亡率(HR,0.72;95%CI,0.65-0.79)。在符合 VPA 和 MSA 推荐量的人群中也观察到了类似的益处。在不增加死亡率风险的情况下,超过当前建议水平的更高体力活动水平可能会带来一些额外的益处,无论糖尿病发病年龄、糖尿病持续时间和药物状态如何。联合分析表明,将 MSA 与有氧运动相结合可以进一步降低死亡率风险,而最低的全因死亡率见于每周进行 75-150 分钟 VPA 和每周 1 次 MSA(HR,0.30;95%CI,0.13-0.70)或每周进行 150-299 分钟 MPA 和每周 1 次 MSA(HR,0.33;95%CI,0.20-0.55)的个体中。
结论:本研究支持当前的 PA 指南,并表明在 T2D 成年人中,进行超过建议水平的运动可能益处有限,将推荐水平的有氧运动和抗阻运动相结合可能会带来最大的益处。
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