Physical Fitness Among Swedish Military Conscripts and Long-Term Risk for Type 2 Diabetes Mellitus: A Cohort Study.
Physical Fitness Among Swedish Military Conscripts and Long-Term Risk for Type 2 Diabetes Mellitus: A Cohort Study.
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DOI：
10.7326/m15-2002
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发表时间：
2016-05-03
影响因子：
39.2
通讯作者：
Sundquist K
中科院分区：
文献类型：
--
作者：
Crump C;Sundquist J;Winkleby MA;Sieh W;Sundquist K
由于需要长时间的随访，早期的身体健康很少与成年后的2型糖尿病（T2 DM）相关。在年轻时阐明可改变的风险因素可能有助于促进更早和更有效的干预措施。我们研究了18岁时的有氧能力和肌肉力量与成年期T2 DM风险的关系。国家队列研究。瑞典. 1969年至1997年期间所有1，534，425名应征入伍者（占全国所有18岁男性的97-98%）既往无T2 DM。根据1987-2012年期间（最大年龄62岁）门诊和住院诊断中确定的T2 DM，分别检查了有氧能力和肌肉力量（以瓦特/kg体重和牛顿/kg体重测量）。在3940万人年的随访中，34,008名男性被诊断为T2 DM。低有氧能力和低肌肉力量与T2 DM风险增加独立相关。比较有氧能力和肌肉力量的最低与最高三分位数，T2 DM累积发生率的绝对差异在20年随访时为0.22%（95% CI，0.20-0.25），30年时为0.76%（0.71-0.81），40年时为3.97%（3.87-4.06）。总的来说，有氧能力低和肌肉力量低的组合与T2 DM的3倍风险相关（校正的风险比，3.07; 95%CI，2.88-3.27; P<0.001），具有正的加性相互作用（P<0.001）。甚至在BMI正常的男性中也观察到了这些关联。该队列不包括女性或老年人的身体健康测量。在这个大型的瑞典男性应征入伍者队列中，18岁时的低有氧能力和低肌肉力量与T2 DM的长期风险增加相关，即使在BMI正常的人群中也是如此。国家卫生研究院
Early-life physical fitness rarely has been examined in relation to type 2 diabetes mellitus (T2DM) in adulthood, because of the lengthy follow-up required. Elucidation of modifiable risk factors at young ages may help facilitate earlier and more effective interventions. We examined aerobic capacity and muscular strength at age 18 in relation to T2DM risk in adulthood. National cohort study. Sweden. All 1,534,425 military conscripts during 1969-1997 (97-98% of all 18-year-old males nationwide) without prior T2DM. Aerobic capacity and muscular strength measured in Watts and Newtons per kg of body weight, respectively, were examined in relation to T2DM identified from outpatient and inpatient diagnoses during 1987-2012 (maximum age 62 years). 34,008 men were diagnosed with T2DM in 39.4 million person-years of follow-up. Low aerobic capacity and low muscular strength were independently associated with increased risk of T2DM. Comparing lowest vs. highest tertiles of both aerobic capacity and muscular strength, the absolute difference in cumulative incidence of T2DM was 0.22% at 20 years of follow-up (95% CI, 0.20-0.25), 0.76% at 30 years (0.71-0.81), and 3.97% at 40 years (3.87-4.06). Overall, the combination of low aerobic capacity and low muscular strength was associated with a 3-fold risk of T2DM (adjusted hazard ratio, 3.07; 95% CI, 2.88-3.27; P<0.001), with a positive additive interaction (P<0.001). These associations were observed even among men with normal BMI. This cohort did not include women or physical fitness measurements at older ages. In this large cohort of Swedish male military conscripts, low aerobic capacity and low muscular strength at age 18 were associated with increased long-term risk of T2DM, even among those with normal BMI. NIH.