Department of Cardiology, Guangdong Provincial Key Laboratory of Heart Function and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Cardiovascular Center, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan 528200, China.
J Clin Endocrinol Metab. 2024 Nov 18;109(12):3156-3165. doi: 10.1210/clinem/dgae323.
Both physical activity (PA) and sedentary behavior (SB) exert an important impact on type 2 diabetes, but it remains unclear regarding how the maximum impact on improving mortality by an optimized proportion of the two lifestyles can be achieved.
To explore the impacts of PA/SB combinations on mortality in patients with diabetes.
Patients with type 2 diabetes samplings were collected from the National Health and Nutrition Examination Survey dataset. Their lifestyles were categorized into 8 groups based on combinations of the PA and SB levels. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals.
During the follow-up period, 1148 deaths (18.94%) were recorded. High SB (sedentary time ≥6 hours/day) was significantly associated with higher all-cause mortality [hazards ratio (HR) 1.65]. In participants with low SB (<6 hours/day), low PA was associated with lower all-cause mortality (HR 0.43), while a further increase of PA level did not show further reductions in either all-cause or cardiovascular mortality. In contrast, in participants with high SB, all levels of PA were associated with lower all-cause mortality (P < .05), but only moderate PA was associated with lower cardiovascular mortality (HR 0.30).
In patients with type 2 diabetes, different combinations of various levels of PA and SB are associated with different degrees of risk for all-cause or cardiovascular mortality.
体力活动（PA）和久坐行为（SB）都对 2 型糖尿病有重要影响，但对于如何通过优化两种生活方式的比例来最大限度地提高死亡率，目前仍不清楚。
探讨 PA/SB 组合对糖尿病患者死亡率的影响。
从国家健康和营养调查数据集收集了 2 型糖尿病患者的样本。根据 PA 和 SB 水平的组合，将他们的生活方式分为 8 组。使用 Cox 比例风险模型计算风险比和 95%置信区间。
在随访期间，记录了 1148 例死亡（18.94%）。高 SB（久坐时间≥6 小时/天）与全因死亡率升高显著相关[风险比（HR）1.65]。在 SB 水平较低（<6 小时/天）的参与者中，低 PA 与全因死亡率降低相关（HR 0.43），而进一步增加 PA 水平并没有进一步降低全因或心血管死亡率。相比之下，在 SB 水平较高的参与者中，所有 PA 水平都与全因死亡率降低相关（P<0.05），但只有中度 PA 与心血管死亡率降低相关（HR 0.30）。
在 2 型糖尿病患者中，不同水平的 PA 和 SB 的不同组合与全因或心血管死亡率的风险程度不同相关。
