Leisure-Time Physical Activity and Risk of Microvascular Complications in Individuals With Type 2 Diabetes: A UK Biobank Study.

IF 14.8 1区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes Care Pub Date : 2023-10-01 DOI:10.2337/dc23-0937

Frederik Pagh Bredahl Kristensen, Miguel Adriano Sanchez-Lastra, Knut Eirik Dalene, Borja Del Pozo Cruz, Mathias Ried-Larsen, Reimar Wernich Thomsen, Ding Ding, Ulf Ekelund, Jakob Tarp

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引用次数: 1

Abstract

Objective: The aim of this study was to determine dose-response associations, including the minimal effective level, between leisure-time physical activity and risk of incident neuropathy, nephropathy, and retinopathy.

Research design and methods: This cohort study included 18,092 individuals with type 2 diabetes from the UK Biobank. Self-reported leisure-time physical activity was converted into MET-hours per week. Participants were categorized into no physical activity (0 MET-h/week), below recommendations (0-7.49 MET-h/week), at recommendations (7.5-14.9 MET-h/week), and above recommendations (≥15 MET-h/week). Microvascular complications were identified from hospital inpatient records using diagnosis codes. We used Cox proportional hazards regression analysis to calculate adjusted hazard ratios (aHRs) and restricted cubic splines to identify the minimal effective level of physical activity.

Results: During a median follow-up of 12.1 years, 672 individuals (3.7%) were diagnosed with neuropathy, 1,839 (10.2%) with nephropathy, and 2,099 (11.7%) with retinopathy. Any level of physical activity was associated with a lower risk of neuropathy and nephropathy but not retinopathy. Compared with those reporting no physical activity, the aHR of neuropathy was 0.71 (95% CI 0.53, 0.90) below recommendations, 0.73 (0.56, 0.96) at recommendations, and 0.67 (0.52, 0.87) above recommendations. Corresponding aHRs for nephropathy were 0.79 (0.68, 0.92), 0.80 (0.67, 0.95), and 0.80 (0.68, 0.95). The association with retinopathy was weaker, with aHRs of 0.91 (0.78, 1.06), 0.91 (0.77, 1.08), and 0.98 (0.84, 1.15), respectively.

Conclusions: Any level of leisure-time physical activity was associated with a lower risk of neuropathy and nephropathy but not retinopathy in individuals with type 2 diabetes. For both neuropathy and nephropathy, the minimal effective physical activity level may correspond to <1.5 h of walking per week.

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2型糖尿病患者闲暇时间的体育活动与微血管并发症的风险：英国生物库研究。

目的：本研究的目的是确定休闲时间体育活动与神经病变、肾病和视网膜病变发病风险之间的剂量反应相关性，包括最低有效水平。研究设计和方法：这项队列研究包括来自英国生物银行的18092名2型糖尿病患者。自我报告的休闲时间体力活动被转换为每周MET小时数。参与者被分为无体力活动（0 MET-h/周）、低于建议（0-7.49 MET-h/周）、处于建议（7.5-14.9 MET-h/每周）和高于建议（≥15 MET-h/星期）。使用诊断代码从医院住院记录中识别出微血管并发症。我们使用Cox比例风险回归分析来计算调整后的风险比（aHR），并使用限制三次样条来确定体力活动的最小有效水平。结果：在12.1年的中位随访中，672人（3.7%）被诊断为神经病变，1839人（10.2%）被确诊为肾病，2099人（11.7%）被误诊为视网膜病变。任何水平的体育活动都与神经病变和肾病的风险较低有关，但与视网膜病变无关。与那些报告没有体力活动的人相比，神经病变的aHR比建议低0.71（95%CI 0.53,0.90），比建议高0.73（0.56,0.96），比推荐高0.67（0.52，0.87）。肾病的相应aHRs分别为0.79（0.68，0.92）、0.80（0.67，0.95）和0.80（0.65，0.95）。与视网膜病变的相关性较弱，aHRs为0.91（0.78，1.06）、0.91（0.7，1.08）和0.98（0.84，1.15）。结论：在2型糖尿病患者中，任何水平的休闲体育活动都与较低的神经病变和肾病风险有关，但与视网膜病变无关。对于神经病变和肾病，最低有效体力活动水平可能对应于

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Care 医学-内分泌学与代谢

CiteScore

27.80

自引率

4.90%

发文量

449

审稿时长

1 months

期刊介绍： The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.