Associations of Daily Steps and Step Intensity With Incident Diabetes in a Prospective Cohort Study of Older Women: The OPACH Study.

Autor:	Garduno AC; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA.; Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA., LaCroix AZ; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA., LaMonte MJ; Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, NY., Dunstan DW; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia., Evenson KR; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC., Wang G; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA., Di C; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA., Schumacher BT; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA.; Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA., Bellettiere J; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA.
Jazyk:	angličtina
Zdroj:	Diabetes care [Diabetes Care] 2022 Feb 01; Vol. 45 (2), pp. 339-347.
DOI:	10.2337/dc21-1202
Abstrakt:	Objective: The primary aim was to assess associations between total steps per day and incident diabetes, whereas the secondary aim was to assess whether the intensity and/or cadence of steps is associated with incident diabetes. Research Design and Methods: Women without physician-diagnosed diabetes (n = 4,838; mean [SD] age 78.9 [6.7] years) were followed up to 6.9 years; 395 developed diabetes. Hip-worn ActiGraph GT3X+ accelerometers worn for 1 week enabled measures of total, light-intensity, and moderate- to vigorous-intensity (MV-intensity) steps per day. Using Cox proportional hazards analysis we modeled adjusted change in the hazard rate for incident diabetes associated with total, light-intensity, and MV-intensity steps per day. We further estimated the proportion of the steps-diabetes association mediated by BMI. Results: On average, participants took 3,729 (SD 2,114) steps/day, of which 1,875 (791) were light-intensity steps and 1,854 ± 1,762 were MV-intensity. More steps per day were associated with a lower hazard rate for incident diabetes. Confounder-adjusted models for a 2,000 steps/day increment yielded hazard ratio (HR) 0.88 (95% CI 0.78-1.00; P = 0.046). After further adjustment for BMI, HR was 0.90 (95% CI 0.80-1.02; P = 0.11). BMI did not significantly mediate the steps-diabetes association (proportion mediated = 17.7% [95% CI -55.0 to 142.0]; P = 0.09]). The relationship between MV-intensity steps per day (HR 0.86 [95% CI 0.74-1.00]; P = 0.04) and incident diabetes was stronger than for light-intensity steps per day (HR 0.97 [95% CI 0.73-1.29]; P = 0.84). Conclusions: These findings suggest that for older adults, more steps per day are associated with lower incident diabetes and MV-intensity steps are most strongly associated with a lower hazard of diabetes. This evidence supports that regular stepping is an important risk factor for type 2 diabetes prevention in older adults. (© 2022 by the American Diabetes Association.)
Databáze:	MEDLINE
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