Relationship between baseline physical activity assessed by pedometer count and new-onset diabetes in the NAVIGATOR trial.
Relationship between baseline physical activity assessed by pedometer count and new-onset diabetes in the NAVIGATOR trial.
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DOI：
10.1136/bmjdrc-2018-000523
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发表时间：
2018
影响因子：
4.1
通讯作者：
Holman RR
中科院分区：
文献类型：
--
作者：
Kraus WE;Yates T;Tuomilehto J;Sun JL;Thomas L;McMurray JJV;Bethel MA;Holman RR
身体活动与临床结果相关，即使在调整体重后，但很少在随机临床试验中进行评估。我们对来自那格列奈和缬沙坦在糖耐量受损结局研究试验中的数据进行了观察性分析，在该试验中，来自40个国家的9306名患有糖耐量受损和心血管疾病或心血管危险因素的患者被随机分配接受那格列奈或安慰剂，采用2 × 2析因设计，缬沙坦或安慰剂。所有人都被要求参加一个详细的生活方式改变计划，并随访中位数为6.4年，进展为糖尿病作为共同主要终点。使用研究级计步器在基线时评估7天的步行活动。我们评估了基线体力活动量是否与糖耐量受损个体随后发生糖尿病有关。获得了7118名参与者的计步器数据，35.0%的人患上了糖尿病。在一项未校正的分析中，每日平均步数每增加2000步，最多10000步，与糖尿病进展风险降低5.5%相关（HR 0.95，95%CI 0.92 - 0.97），校正后相对风险降低>6%。在药理学试验中应客观地测量体力活动，因为它是糖尿病结局的重要但未被充分认识的贡献者。它也应该成为临床实践的一部分。
Physical activity is related to clinical outcomes, even after adjusting for body mass, but is rarely assessed in randomized clinical trials. We conducted an observational analysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial, in which a total of 9306 people from 40 countries with impaired glucose tolerance and either cardiovascular disease or cardiovascular risk factors were randomized to receive nateglinide or placebo, in a 2-by-2 factorial design with valsartan or placebo. All were asked to also participate in a detailed lifestyle modification programme and followed-up for a median of 6.4 years with progression to diabetes as a co-primary end point. Seven-day ambulatory activity was assessed at baseline using research-grade pedometers. We assessed whether the baseline amount of physical activity was related to subsequent development of diabetes in individuals with impaired glucose tolerance. Pedometer data were obtained on 7118 participants and 35.0% developed diabetes. In an unadjusted analysis each 2000-step increment in the average number of daily steps, up to 10 000, was associated with a 5.5% lower risk of progression to diabetes (HR 0.95, 95%CI 0.92 to 0.97), with >6% relative risk reduction after adjustment. Physical activity should be measured objectively in pharmacologic trials as it is a significant but underappreciated contributor to diabetes outcomes. It should be a regular part of clinical practice as well.
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影响因子：
16.2
作者：
Kodama S;Tanaka S;Heianza Y;Fujihara K;Horikawa C;Shimano H;Saito K;Yamada N;Ohashi Y;Sone H
通讯作者：
Sone H
影响因子：
7.7
作者：
Laaksonen, DE;Lindström, J;Uusitupa, M
通讯作者：
Uusitupa, M
影响因子：
7.7
作者：
LEON, AS;CONNETT, J
通讯作者：
CONNETT, J
影响因子：
120.7
作者：
BLAIR, SN;KOHL, HW;MACERA, CA
通讯作者：
MACERA, CA
影响因子：
120.7
作者：
BLAIR, SN;KOHL, HW;GIBBONS, LW
通讯作者：
GIBBONS, LW