Independent and combined effects of physical activity and body mass index on the development of Type 2 Diabetes - a meta-analysis of 9 prospective cohort studies.
Independent and combined effects of physical activity and body mass index on the development of Type 2 Diabetes - a meta-analysis of 9 prospective cohort studies.
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DOI：
10.1186/s12966-015-0304-3
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发表时间：
2015-12-01
期刊：
影响因子：
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通讯作者：
Bemelmans WJ
中科院分区：
文献类型：
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作者：
Cloostermans L;Wendel-Vos W;Doornbos G;Howard B;Craig CL;Kivimäki M;Tabak AG;Jefferis BJ;Ronkainen K;Brown WJ;Picavet SH;Ben-Shlomo Y;Laukkanen JA;Kauhanen J;Bemelmans WJ
这项协调的荟萃分析的目的是检查体力活动和BMI对2型糖尿病发病率的独立和联合影响。我们在2011年进行的系统性文献综述确定了127项潜在相关的前瞻性研究，其中9项符合纳入标准（总N = 117，878，56.2%为女性，平均年龄= 50.0岁，范围= 25-65岁）。基线体力活动（低，中，高），BMI分类[BMI < 18.4（体重不足），18.5-24.9（正常体重），25.0-29.9（超重），30+（肥胖）]和2型糖尿病事件的测量在研究中是一致的。采用考克斯回归分析法分析体力活动、BMI和2型糖尿病发病率之间的关系，标准化分析方案包括年龄、性别、教育水平和吸烟的调整。在一项随机效应荟萃分析中，将单个研究的风险比合并。平均随访时间为9.1年。共有11，237例2型糖尿病病例被记录在案。在相互调整的模型中，超重或肥胖（与正常体重相比）和体力活动少（与高体力活动相比）与2型糖尿病发病风险增加有关（风险比分别为2.33，95% CI 1.95-2.78; 6.10，95% CI：4.63-8.04和1.23，95% CI：1.09-1.39）。与正常体重、高体力活动的参与者相比，肥胖和低体力活动的个体患2型糖尿病的风险增加7.4倍（95%CI 3.47-15.89）。这项协调的荟萃分析显示了保持健康体重和身体活动在糖尿病预防中的重要性。本文的在线版本（doi：10.1186/s12966-015-0304-3）包含补充材料，可供授权用户使用。
The aim of this harmonized meta-analysis was to examine the independent and combined effects of physical activity and BMI on the incidence of type 2 diabetes. Our systematic literature review in 2011 identified 127 potentially relevant prospective studies of which 9 fulfilled the inclusion criteria (total N = 117,878, 56.2 % female, mean age = 50.0 years, range = 25–65 years). Measures of baseline physical activity (low, intermediate, high), BMI-category [BMI < 18.4 (underweight), 18.5–24.9 (normal weight), 25.0–29.9 (overweight), 30+ (obese)] and incident type 2 diabetes were harmonized across studies. The associations between physical activity, BMI and incident type 2 diabetes were analyzed using Cox regression with a standardized analysis protocol including adjustments for age, gender, educational level, and smoking. Hazard ratios from individual studies were combined in a random-effects meta-analysis. Mean follow-up time was 9.1 years. A total of 11,237 incident type 2 diabetes cases were recorded. In mutually adjusted models, being overweight or obese (compared with normal weight) and having low physical activity (compared with high physical activity) were associated with an increased risk of incident type 2 diabetes (hazard ratios 2.33, 95 % CI 1.95–2.78; 6.10, 95 % CI: 4.63–8.04, and 1.23, 95 % CI: 1.09–1.39, respectively). Individuals who were both obese and had low physical activity had 7.4-fold (95 % CI 3.47–15.89) increased risk of type 2 diabetes compared with normal weight, high physically active participants. This harmonized meta-analysis shows the importance of maintaining a healthy weight and being physically active in diabetes prevention. The online version of this article (doi:10.1186/s12966-015-0304-3) contains supplementary material, which is available to authorized users.