A Prospective Study of Cardiorespiratory Fitness and Risk of Type 2 Diabetes in Women (original) (raw)
Cardiovascular and Metabolic Risk| March 01 2008
1Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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1Department of Exercise Science, University of South Carolina, Columbia, South Carolina
2Prevention Research Center, University of South Carolina, Columbia, South Carolina
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3Department of Medicine and Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts
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Timothy S. Church, MD, PHD
4Pennington Biomedical Research Center, Baton Rouge, Louisiana
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2Prevention Research Center, University of South Carolina, Columbia, South Carolina
5Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
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6Department of Exercise and Wellness, Arizona State University, Mesa, Arizona
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1Department of Exercise Science, University of South Carolina, Columbia, South Carolina
5Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
7Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas
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Address correspondence and reprint requests to Xuemei Sui, 921 Assembly St., Columbia, SC 29208. E-mail: [email protected]
Diabetes Care 2008;31(3):550–555
OBJECTIVE—The purpose of this study was to determine the independent and joint associations of cardiorespiratory fitness (CRF) and BMI with the incidence of type 2 diabetes in women.
RESEARCH DESIGN AND METHODS—An observational cohort of 6,249 women aged 20–79 years was free of baseline cardiovascular disease, cancer, and diabetes. CRF was measured using a maximal treadmill exercise test. BMI was computed from measured height and weight. The incidence of type 2 diabetes was identified primarily by 1997 American Diabetes Association criteria.
RESULTS—During a 17-year follow-up, 143 cases of type 2 diabetes occurred. Compared with the least fit third, the multivariate (including BMI)-adjusted hazard ratio (HR) (95% CI) was 0.86 (0.59–1.25) for the middle third and 0.61 (0.38–0.96) for the upper third of CRF. For BMI, the multivariate (including CRF)-adjusted HR (95% CI) was 2.34 (1.55–3.54) for overweight individuals and 3.70 (2.12–6.44) for obese individuals, compared with normal-weight patients. In the combined analyses, overweight/obese unfit (the lowest one-third of CRF) women had significantly higher risks compared with normal-weight fit (the upper two-thirds of CRF) women.
CONCLUSIONS—Low CRF and higher BMI were independently associated with incident type 2 diabetes. The protective effect of CRF was observed in individuals who were overweight or obese, but CRF did not eliminate the increased risk in these groups. These findings underscore the critical importance of promoting regular physical activity and maintaining normal weight for diabetes prevention.
Published ahead of print at http://care.diabetesjournals.org on 10 December 2007. DOI: 10.2337/dc07-1870.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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