Physical Activity Reduces Risk of Premature Mortality in Patients With Type 1 Diabetes With and Without Kidney Disease
| Autor: | Lena M. Thorn, Carol Forsblom, Johan Wadén, Per-Henrik Groop, Nina Elonen, Valma Harjutsalo, Markku Saraheimo, Heikki O. Tikkanen, Heidi Tikkanen-Dolenc |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Kaplan-Meier Estimate 030204 cardiovascular system & hematology Lower risk Nephropathy Diabetic nephropathy 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Internal Medicine medicine Humans Diabetic Nephropathies Prospective Studies Prospective cohort study Exercise Proportional Hazards Models Glycated Hemoglobin Advanced and Specialized Nursing Type 1 diabetes Mortality Premature business.industry Middle Aged medicine.disease 3. Good health Diabetes Mellitus Type 1 Multivariate Analysis Exercise intensity Physical therapy Female business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Diabetes Care. 40:1727-1732 |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE The aims of the study were to assess how baseline leisure-time physical activity (LTPA) and its exercise components intensity, duration, and frequency are associated with all-cause and cardiovascular mortality in patients with type 1 diabetes 1) overall, 2) stratified by presence or absence of chronic kidney disease (CKD), and 3) stratified by sex. RESEARCH DESIGN AND METHODS The study design was prospective and observational and included 2,639 patients with type 1 diabetes from the ongoing nationwide multicenter Finnish Diabetic Nephropathy (FinnDiane) Study. Mean follow-up time was 11.4 ± 3.5 years. LTPA was assessed by using a validated self-report questionnaire. Three hundred ten patients (11.7%) had CKD defined as an estimated glomerular filtration rate of ≤60 mL/min/1.73 m2. RESULTS During follow-up, 270 deaths occurred. LTPA and all its components were associated with all-cause mortality, even after adjustment for the potential confounders sex, diabetic nephropathy, duration of diabetes, age at onset of diabetes, systolic blood pressure, triglycerides, BMI, and HbA1c. Only exercise intensity was associated with cardiovascular mortality after adjustment for the confounders. Of the patients with CKD, 127 died during follow-up. The total amount of LTPA and exercise frequency were independently associated with lower risk of all-cause mortality when adjusted for covariates. CONCLUSIONS Exercise is associated with a lower risk of premature all-cause and cardiovascular mortality in patients with type 1 diabetes. This study also demonstrates that physical activity is associated with a lower risk of mortality in patients with type 1 diabetes and CKD. |
| Databáze: | OpenAIRE |
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