Consistently High Level of Cardiorespiratory Fitness and Incidence of Type 2 Diabetes
Consistently High Level of Cardiorespiratory Fitness and Incidence of Type 2 Diabetes
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DOI：
10.1249/mss.0000000000001319
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发表时间：
2017-10-01
期刊：
影响因子：
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通讯作者：
Blair, Steven N.
中科院分区：
文献类型：
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作者：
Momma, Haruki;Sawada, Susumu S.;Blair, Steven N.
目的：虽然高心肺功能（CRF）对预防2型糖尿病（T2DM）的益处已被广泛接受，但持续的高CRF是必要的还是短暂的高CRF是足够的尚不清楚。本研究旨在验证持续高水平的CRF比短暂高水平的CRF更有利于预防T2DM的假设。方法：该队列研究纳入了1986 - 1987年间年龄在20 - 60岁的7158名非糖尿病男性。在8年的测量期间（1979-1987），计算了CRF测量的曲线下相对于地面的面积（AUC(G)），作为该期间综合CRF水平的指标。还计算了AUC(G)和峰值AUC（峰值CRF测量周期）之间的差异（δ AUC(P)），作为CRF中“尖峰”存在和大小的指标。T2DM的定义是通过空腹血糖和血液测试参与者自我报告的糖尿病诊断。对于没有血液检查的参与者，T2DM的定义是在非空腹尿检查和自我报告的糖尿病诊断后进行口服葡萄糖测试。直到2009年，2型糖尿病都是通过健康检查确定的。结果：在随访期间，1495名男性发展为T2DM。校正混杂因素后，与CRF的AUC(G)的第一个四分位数相比，第二、第三和第四个四分位数的风险比（95%置信区间）分别为0.87（0.76 ~ 1.00）、0.80（0.68 ~ 0.95）和0.72（0.58 ~ 0.89）。对于CRF尖峰，CRF的δ AUC(P)与T2DM的发生率无相关性。结论：随着时间的推移，持续较高的CRF水平与较低的T2DM风险相关。
Purpose: Although the benefit of high cardiorespiratory fitness (CRF) for the prevention of type 2 diabetes mellitus (T2DM) is widely accepted, whether consistently high CRF is necessary or transiently high CRF is sufficient is unclear. The present study was conducted to examine the hypothesis that consistently high level of CRF is more beneficial than transiently high CRF for the prevention of T2DM. Methods: This cohort study was conducted in nondiabetic 7158 men age 20 to 60 yr, enrolled from 1986 to 1987. The area under the curve with respect to ground (AUC(G)) for CRF measurements during an 8-yr measurement period (1979-1987) was calculated as an index of integrated CRF level during the period. The differences (Delta AUC(P)) between AUC(G) and peak AUC (peak CRF-measurement period) was also calculated as an index of the presence and the size of a "spike'' in CRF. T2DM was defined by fasting blood glucose and a self-reported diagnosis of diabetes for participants with blood tests. For participants without blood tests, T2DM was defined by the result of oral glucose test after a nonfasting urinary test and a self-reported diagnosis of diabetes. T2DM was determined on health checkups until 2009. Results: During the follow-up period, 1495 men developed T2DM. After adjustment for confounders, as compared with the first quartile of AUC(G) for CRF, the hazard ratio (95% confidence interval) for the second, third, and fourth quartiles were 0.87 (0.76 to 1.00), 0.80 (0.68 to 0.95), and 0.72 (0.58 to 0.89), respectively. For CRF spike, there was no association between Delta AUC(P) in CRF and the incidence of T2DM. Conclusions: Consistently higher level of CRF over time was associated with lower risk of T2DM.