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Leisure-time physical activity and mortality risk in type 2 diabetes: a nationwide cohort study - 21/07/22

Doi : 10.1016/j.diabet.2022.101378 
Yung-Feng Yen 1, 2, 3, Chun-Chieh Wang 4, 5, Yu-Yen Chen 2, 6, 7, 8, Li-Fei Hsu 9, Kuo-Chuan Hung 10, Li-Jung Chen 11, Po-Wen Ku 12, Chu-Chieh Chen 3, Yun-Ju Lai 3, 6, 11, 13,
1 Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan 
2 Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan 
3 Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan 
4 Division of Chest Medicine, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan 
5 Department of Eldercare, Central Taiwan University of Science and Technology, Taichung, Taiwan 
6 School of Medicine, National Yang-Ming University, Taipei, Taiwan 
7 Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan 
8 School of Medicine, Chung Shan Medical University, Taichung 
9 College of Public Health, National Taiwan University, Taipei, Taiwan 
10 Department of anaesthesiology, Chi Mei medical center, Tainan, Taiwan 
11 Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan 
12 Graduate Institute of Sports and Health Management, National Chung Hsing University, Taichung, Taiwan 
13 Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan 

Correspondence to: Dr. Yun-Ju Lai, Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan, No.1, Rongguang Rd., Puli Township, Nantou County 545, TaiwanDivision of Endocrinology and MetabolismDepartment of Internal MedicinePuli Branch of Taichung Veterans General HospitalTaiwan, No.1, Rongguang Rd., Puli TownshipNantouNantou County545Taiwan
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Highlights

Leisure-time physical activity decreased risk of all-cause death in diabetes.
Leisure-time physical activity decreased cardiovascular death in diabetes.
Proper prescription for physical activity is important to prolong healthy life.

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Abstract

Aim

: Physical activity improves insulin resistance, inhibits inflammation, and decreases the incidence of cardiovascular disease. These are major causes of death in patients with diabetes.

Methods

: The Taiwan National Health Interview Survey collected baseline characteristics of socioeconomic level, education, marriage, and health behaviour, including leisure time physical activity in 2001, 2005, 2009, and 2013. The National Health Insurance research dataset 2000-2016 contained detailed information on medical conditions, including all comorbidities. All-cause and cardiovascular deaths were confirmed by the National Death Registry.

Results

: A total of 4,859 adults with type 2 diabetes were included in the analysis; 2,389 (49 %) were men and the mean±SD age was 60±13 years. Kaplan-Meier curve of all-cause (log-rank P<0.001) and cardiovascular death (log-rank P=0.038) categorized by leisure-time physical activity showed a significant difference. The multivariable Cox regression model showed that those who had more leisure time physical activity had a significantly lower risk of all-cause death than those with no physical activity (physical activity of 1-800 MET-min/week HR = 0.66, 95% CI: 0.54-0.81, physical activity of >800 MET-min/week HR = 0.67, 95% CI: 0.56-0.81). A significant trend was also observed (P <0.001). Similar results were also observed for cardiovascular mortality (physical activity of 1-800 MET-min/week HR = 0.54, 95% CI: 0.36-0.84, physical activity of >800 MET-min/week HR = 0.78, 95% CI: 0.55-1.13).

Conclusion

: For those with diabetes, increased leisure-time physical activity significantly reduced risk of all-cause and cardiovascular death. Further research is warranted to determine the proper prescription for physical activity to prolong healthy life.

Le texte complet de cet article est disponible en PDF.

Key words : leisure-time physical activity, mortality, diabetes, cohort study


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