PHYSICAL-ACTIVITY AND REDUCED OCCURRENCE OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS
PHYSICAL-ACTIVITY AND REDUCED OCCURRENCE OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS
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DOI：
10.1056/nejm199107183250302
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发表时间：
1991-07-18
影响因子：
158.5
通讯作者：
PAFFENBARGER, RS
中科院分区：
文献类型：
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作者：
HELMRICH, SP;RAGLAND, DR;PAFFENBARGER, RS
背景。医生建议非胰岛素依赖型糖尿病 (NIDDM) 患者进行体力活动，因为它会增加对胰岛素的敏感性。体力活动是否能有效预防这种疾病尚不清楚。我们使用问卷调查了宾夕法尼亚大学 5990 名男性校友的身体活动模式和其他个人特征，这些特征与 NIDDM 的后续发展有关。从 1962 年到 1976 年的 98,524 人年随访中，共有 202 名男性患了这种疾病。 结果。休闲时间的身体活动（以每周步行、爬楼梯和运动消耗的千卡热量表示）与 NIDDM 的发展呈负相关。随着能量消耗从低于 500 kcal 增加到 3500 kcal，发病率下降。能量消耗每增加 500 kcal，NIDDM 的年龄调整风险就会降低 6%（相对风险，0.94；95% 置信区间，0.90 至 0.98）。当根据肥胖、高血压和父母糖尿病史调整数据后，这种关联仍然保持不变。当我们考虑从上大学到 1962 年之间的体重增加时，这种关联性更弱（相对风险，0.95；95% 置信区间，0.90 至 1.00）。对于 NIDDM 风险最高的人群（定义为体重指数高、有高血压病史或父母有糖尿病史的人群），体力活动的保护作用最强。除了大学以来体重增加之外，这些因素也是该疾病的独立预测因素。结论。增加体力活动可有效预防 NIDDM，这种保护作用对于该疾病风险最高的人群尤其明显。
Background. Physical activity is recommended by physicians to patients with non-insulin-dependent diabetes mellitus (NIDDM), because it increases sensitivity to insulin. Whether physical activity is effective in preventing this disease is not known.Methods. We used questionnaires to examine patterns of physical activity and other personal characteristics in relation to the subsequent development of NIDDM in 5990 male alumni of the University of Pennsylvania. The disease developed in a total of 202 men during 98,524 man-years of follow-up from 1962 to 1976.Results. Leisure-time physical activity, expressed in kilocalories expended per week in walking, stair climbing, and sports, was inversely related to the development of NIDDM. The incidence rates declined as energy expenditure increased from less than 500 kcal to 3500 kcal. For each 500-kcal increment in energy expenditure, the age-adjusted risk of NIDDM was reduced by 6 percent (relative risk, 0.94; 95 percent confidence interval, 0.90 to 0.98). This association remained the same when the data were adjusted for obesity, hypertension, and a parental history of diabetes. The association was weaker when we considered weight gain between the time of college attendance and 1962 (relative risk, 0.95; 95 percent confidence interval, 0.90 to 1.00). The protective effect of physical activity was strongest in persons at highest risk for NIDDM, defined as those with a high body-mass index, a history of hypertension, or a parental history of diabetes. These factors, in addition to weight gain since college, were also independent predictors of the disease.Conclusions. Increased physical activity is effective in preventing NIDDM, and the protective benefit is especially pronounced in persons at the highest risk for the disease.