Department of Sport Sciences, Faculty of Humanities, Semnan University, Semnan, Iran.
Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Public Health. 2024 Nov 18;24(1):3190. doi: 10.1186/s12889-024-20587-6.
It has been documented that regular physical activity is considered one of the most effective strategies for preventing diabetes; however, it is not the sole contributing factor. Therefore, we decided to evaluate the meditation effect of liver function and anthropometric indices on the relationship between incidence of diabetes and physical activity (PA) in the Azar cohort population.
Subjects who were diabetic in the baseline phase from 15,006 participants in study of azar cohort population were excluded and to follow up, a total of 13,253 people was included in the analysis. Demographic characteristics, physical activity, 10 anthropometric indices (AI) and seven liver indices (LI) were measured. Evaluated and displayed using Pearson correlation heatmap and canonical correlation of liver and anthropometric indices. The Generalized Structural Equation Modeling (GSEM) with the Maximum Likelihood method employed to estimate the model.
During the follow-up years, a total of 685 participants developed diabetes. The measurements of the AI were significantly higher in subjects with diabetes (P < .001). Patients with diabetes were older, had a higher proportion of women, and had lower values of PA (P < .05). Body Roundness Index (BRI) and Waist height ratio (WHtR) exhibited the largest AUCs for predicting diabetes onset risk (both AUC = 0.6989) among these anthropometric measures. The increase in AI (RR [95%CI] = 1.25 [1.22,1.29], P < .001) and liver enzyme (LE) (RR [95%CI] = 1.14 [1.08.1.19], P < .001) increase the risk of diabetes by 25% and 14%, respectively. Despite the mediation effects of AI and Liver Enzymes for an increase of one MET of PA, the risk of developing diabetes decreases by 5% (RR [95% CI] = .95 [.92,.99], P = .013). Around VAF = 53% of the association between PA and diabetes onset (Total effect: RR [95% CI] = .90 [.87,.94], P < .001) was mediated by AI and LE.
A low level of PA was found to be significantly correlated with high levels of AI and LI, all of which are associated with an increased risk of developing diabetes. These analyses provide evidence that when the relationship between PA and diabetes is mediated by AI and LI this association becomes stronger, with AI playing a more significant role than LI.
有文献记载，有规律的体育活动被认为是预防糖尿病最有效的策略之一;然而，它并不是唯一的促成因素。因此，我们决定评估肝功能和人体测量指数的冥想对阿扎尔队列人群中糖尿病发病率和体力活动（PA）之间关系的影响。
排除基线阶段有糖尿病的受试者（来自阿扎尔队列人群研究的 15006 名参与者），对共纳入分析的 13253 人进行随访。测量人口统计学特征、体力活动、10 个人体测量指数（AI）和 7 个肝功能指数（LI）。使用 Pearson 相关热图和肝功能与人体测量指数的典型相关进行评估和显示。采用最大似然法的广义结构方程模型（GSEM）估计模型。
在随访期间，共有 685 名参与者患上了糖尿病。患有糖尿病的受试者的 AI 测量值明显更高（P<.001）。糖尿病患者年龄较大，女性比例较高，体力活动水平较低（P<.05）。在这些人体测量指标中，身体圆度指数（BRI）和腰高比（WHtR）对预测糖尿病发病风险的 AUC 最大（均 AUC=0.6989）。AI（RR[95%CI] = 1.25[1.22，1.29]，P<.001）和肝酶（LE）（RR[95%CI] = 1.14[1.08，1.19]，P<.001）的升高分别使糖尿病的风险增加 25%和 14%。尽管 AI 和肝功能对 PA 每增加一个代谢当量（MET）的风险有中介作用，但糖尿病的发病风险降低了 5%（RR[95%CI] = 0.95[0.92，0.99]，P=.013）。PA 与糖尿病发病之间的关联（总效应：RR[95%CI] = 0.90[0.87，0.94]，P<.001）有 53%左右是由 AI 和 LE 介导的。
低水平的 PA 与高水平的 AI 和 LI 显著相关，所有这些都与糖尿病发病风险增加有关。这些分析表明，当 PA 和糖尿病之间的关系由 AI 和 LI 介导时，这种关联变得更强，AI 比 LI 发挥更重要的作用。
