Quantifying the Relationship Between Physical Activity Energy Expenditure and Incident Type 2 Diabetes: A Prospective Cohort Study of Device-Measured Activity in 90,096 Adults.
Quantifying the Relationship Between Physical Activity Energy Expenditure and Incident Type 2 Diabetes: A Prospective Cohort Study of Device-Measured Activity in 90,096 Adults.
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在一个中年人队列和亚组中研究加速度计得出的体力活动能量消耗（PAEE）与2型糖尿病（T2 D）发病之间的关系。数据来自90，096名英国生物银行参与者，他们没有普遍的糖尿病（平均年龄62岁; 57%为女性），他们戴了7天的手腕加速计。PAEE来自手腕加速度，使用针对双标记水验证的人群特异性方法。使用Logistic回归评估PAEE、其潜在强度与T2 D事件之间的相关性，使用截至2020年11月的医院发作和死亡率数据确定。模型根据人口统计学、生活方式因素和BMI进行逐步调整。PAEE与T2 D之间的相关性大致呈线性（n = 2，018起事件）。我们观察到PAEE中每5 kJ · kg−1 ·d −1 T2 D的几率降低19%（95%CI 17-21），未调整BMI，调整BMI后降低11%（9-13）。这种关联在男性中比女性更强，而在肥胖和肥胖遗传易感性较高的人群中则较弱。没有证据表明对T2 D或胰岛素抵抗的遗传易感性会改变效应。对于给定水平的PAEE，T2 D的几率在那些从事更多中度到剧烈活动的人中较低。PAEE和T2 D事件之间存在很强的线性关系。PAEE的差异相当于每天额外的20分钟快走，与T2 D的几率降低19%相关。该关联在人群亚组中大致相似，支持整个人群中预防糖尿病的体力活动。
To investigate the association between accelerometer-derived physical activity energy expenditure (PAEE) and incident type 2 diabetes (T2D) in a cohort of middle-aged adults and within subgroups. Data were from 90,096 UK Biobank participants without prevalent diabetes (mean 62 years of age; 57% women) who wore a wrist accelerometer for 7 days. PAEE was derived from wrist acceleration using a population-specific method validated against doubly labeled water. Logistic regressions were used to assess associations between PAEE, its underlying intensity, and incident T2D, ascertained using hospital episode and mortality data up to November 2020. Models were progressively adjusted for demographic, lifestyle factors, and BMI. The association between PAEE and T2D was approximately linear (n = 2,018 events). We observed 19% (95% CI 17–21) lower odds of T2D per 5 kJ · kg−1 · day−1 in PAEE without adjustment for BMI and 11% (9–13) with BMI adjustment. The association was stronger in men than women and weaker in those with obesity and higher genetic susceptibility to obesity. There was no evidence of effect modification by genetic susceptibility to T2D or insulin resistance. For a given level of PAEE, odds of T2D were lower among those engaging in more moderate-to-vigorous activity. There was a strong linear relationship between PAEE and incident T2D. A difference in PAEE equivalent to an additional daily 20-min brisk walk was associated with 19% lower odds of T2D. The association was broadly similar across population subgroups, supporting physical activity for diabetes prevention in the whole population.