Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
Ministry of Education Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.
J Am Med Dir Assoc. 2024 Nov;25(11):105130. doi: 10.1016/j.jamda.2024.105130. Epub 2024 Jul 4.
This study explores the impact of leisure activity and the association between childhood starvation and the risk of diabetes in older Chinese adults.
Prospective cohort study based on the Chinese Longitudinal Healthy Longevity Study (CLHLS), a nationwide cohort study in China.
A total of 4637 older adults aged ≥65 years, all with documented diabetes history, experiences of childhood starvation, and participation in leisure activities were recruited.
Childhood starvation exposure was assessed via self-reported responses from a structured questionnaire. The leisure activities were measured by 9 distinctive components and categorized into 3 distinct categories: productive activity, recreational activity, and sedentary activity. Diabetes status was determined by self-reported, physician-diagnosed cases during the follow-up period. Nonparametric survival models were employed for analysis.
Over an average follow-up period of 4.3 years, 215 of 4637 participants (4.6%) reported a confirmed diagnosis of diabetes. Nonparametric survival models showed that those reporting childhood starvation had a higher risk of late-life diabetes [hazard ratio (HR) 1.72, 95% CI 1.21-2.44]. Engaging in productive activity (HR 0.90, 95% CI 0.83-0.99) and recreational activity (HR 0.88, 95% CI 0.77-1.00) was linked with a reduced risk of late-life diabetes. Sedentary activity did not show a significant effect. Further analysis highlighted the interactions effects of leisure activities on diabetes risk across different demographic and historical exposure subgroups.
Engaging in productive and recreational leisure activities was inversely associated with the risk of diabetes in older adults who experienced childhood starvation. Promoting such activities could be beneficial in mitigating long-term diabetes risk related to early-life nutritional deficiencies.
本研究旨在探讨休闲活动对老年人糖尿病风险的影响，以及儿童期饥饿与糖尿病风险之间的关联。
基于中国长寿纵向研究（CLHLS）的前瞻性队列研究，该研究是中国的一项全国性队列研究。
共纳入 4637 名年龄≥65 岁的老年人，所有参与者均有明确的糖尿病史、儿童期饥饿经历，并参与了休闲活动。
儿童期饥饿暴露情况通过结构化问卷的自我报告进行评估。休闲活动通过 9 个不同组成部分进行测量，并分为 3 个不同类别：生产性活动、娱乐性活动和久坐性活动。糖尿病状态通过随访期间的自我报告和医生诊断确定。采用非参数生存模型进行分析。
在平均 4.3 年的随访期间，4637 名参与者中有 215 人（4.6%）报告确诊为糖尿病。非参数生存模型显示，报告儿童期饥饿的人晚年患糖尿病的风险更高[风险比（HR）1.72，95%置信区间（CI）1.21-2.44]。参与生产性活动（HR 0.90，95%CI 0.83-0.99）和娱乐性活动（HR 0.88，95%CI 0.77-1.00）与降低晚年患糖尿病的风险相关。久坐性活动没有显示出显著的影响。进一步的分析强调了休闲活动对不同人口统计学和历史暴露亚组糖尿病风险的交互作用。
参与生产性和娱乐性休闲活动与经历儿童期饥饿的老年人糖尿病风险呈负相关。促进这些活动可能有助于减轻与早期营养缺乏相关的长期糖尿病风险。
