Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study.
Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study.
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DOI：
10.1001/jamainternmed.2014.1795
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发表时间：
2014-07
影响因子：
39
通讯作者：
Zhang, Cuilin
中科院分区：
文献类型：
--
作者：
Bao, Wei;Tobias, Deirdre K.;Bowers, Katherine;Chavarro, Jorge;Vaag, Allan;Grunnet, Louise Groth;Strom, Marin;Mills, James;Liu, Aiyi;Kiely, Michele;Zhang, Cuilin
有妊娠期糖尿病(GDM)病史的女性患2型糖尿病(T2 DM)的风险显著增加。识别重要的可改变因素可能有助于在这一高危人群中预防T2 DM。研究体力活动、看电视和其他久坐行为的作用，以及这些行为在从妊娠期糖尿病到2型糖尿病进展过程中的变化。作为正在进行的糖尿病和妇女健康研究的一部分，对护士健康研究II中4554名有妊娠期糖尿病病史的女性进行了前瞻性队列研究。从1991年到2007年对这些妇女进行了跟踪调查。1991年、1997年、2001年和2005年对体力活动、看电视和其他久坐行为进行了评估。事件T2 DM通过自我报告确定，并通过补充问卷确认。在59287人年的随访中，我们记录了635例T2 DM事件。每周总体力活动每增加5次代谢当量小时(MET-h/wk)，相当于每周100分钟的中等强度体力活动，与T2 DM风险降低9%相关(调整后的相对风险[RR]，0.91；95%CI，0.88-0.94)；在对身体质量指数(BMI)进行额外调整后，这种反向关联仍然显著。此外，体力活动的增加与患T2 DM的风险较低相关。与保持总体力活动水平的女性相比，总体力活动水平增加7.5 Met-h/wk或更多(相当于每周150分钟中等强度体力活动)的女性患T2 DM的风险降低47%(RR，0.53；95%CI，0.38-0.75)；在对BMI进行额外调整后，这种关联仍然显著。每周看电视时间为0~5小时、6~10小时、11~20小时、20小时以上的2型糖尿病患者的多变量调整RRS(95%CI)分别为1(参考)、1.28(1.04-1.59)、1.41(1.11-1.79)和1.77(1.28-2.45)(趋势分析的P值为0.001%)；对BMI的额外调整减弱了这种关联。增加体力活动可能会降低从妊娠期糖尿病进展到T2 DM的风险。这些发现向有妊娠期糖尿病病史的女性发出了一个充满希望的信息，尽管她们患T2 DM的风险非常高，但提倡积极的生活方式可能会降低风险。
Women with a history of gestational diabetes mellitus (GDM) are at substantially increased risk of type 2 diabetes mellitus (T2DM). The identification of important modifiable factors could help prevent T2DM in this high-risk population. To examine the role of physical activity and television watching and other sedentary behaviors, and changes in these behaviors in the progression from GDM to T2DM. Prospective cohort study of 4554 women from the Nurses’ Health Study II who had a history of GDM, as part of the ongoing Diabetes & Women’s Health Study. These women were followed up from 1991 to 2007. Physical activity and television watching and other sedentary behaviors were assessed in 1991, 1997, 2001, and 2005. Incident T2DM identified through self-report and confirmed by supplemental questionnaires. We documented 635 incident T2DM cases during 59287 person-years of follow-up. Each 5–metabolic equivalent hours per week (MET-h/wk) increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity, was related to a 9% lower risk of T2DM (adjusted relative risk [RR], 0.91; 95% CI, 0.88–0.94); this inverse association remained significant after additional adjustment for body mass index (BMI). Moreover, an increase in physical activity was associated with a lower risk of developing T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activity) had a 47% lower risk of T2DM (RR, 0.53; 95% CI, 0.38–0.75); the association remained significant after additional adjustment for BMI. The multivariable adjusted RRs (95% CIs) for T2DM associated with television watching of 0 to 5, 6 to 10, 11 to 20, and 20 or more hours per week were 1 (reference), 1.28 (1.04–1.59), 1.41 (1.11–1.79), and 1.77 (1.28–2.45), respectively (P value for trend <.001); additional adjustment for BMI attenuated the association. Increasing physical activity may lower the risk of progression from GDM to T2DM. These findings suggest a hopeful message to women with a history of GDM, although they are at exceptionally high risk for T2DM, promoting an active lifestyle may lower the risk.
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影响因子：
120.7
作者：
Lee, I-Min;Djousse, Luc;Sesso, Howard D.;Wang, Lu;Buring, Julie E.
通讯作者：
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158.5
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影响因子：
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作者：
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