Publicación: ASSOCIATION BETWEEN WALKING PACE AND INCIDENT TYPE 2 DIABETES BY ADIPOSITY LEVEL: A PROSPECTIVE COHORT STUDY FROM THE UK BIOBANK
Fecha
2023
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DIABETES OBESITY & METABOLISM
Resumen
TO INVESTIGATE THE COMBINED ASSOCIATION OF ADIPOSITY AND WALKING PACE WITH INCIDENT TYPE 2 DIABETES.
METHODS WE UNDERTOOK A PROSPECTIVE COHORT STUDY IN 194?304 WHITE-EUROPEAN PARTICIPANTS (MEAN AGE 56.5?YEARS, 55.9% WOMEN). PARTICIPANTS' WALKING PACE WAS SELF-REPORTED AS BRISK, AVERAGE OR SLOW. ADIPOSITY MEASURES INCLUDED BODY MASS INDEX (BMI), WAIST CIRCUMFERENCE (WC) AND BODY FAT PERCENTAGE (BF%). ASSOCIATIONS WERE INVESTIGATED USING COX PROPORTIONAL HAZARD MODELS, WITH A 2-YEAR LANDMARK ANALYSIS. A FOUR-WAY DECOMPOSITION ANALYSIS WAS USED FOR MEDIATION AND ADDITIVE INTERACTION.
RESULTS
THE MEDIAN (INTERQUARTILE RANGE) FOLLOW-UP WAS 5.4 (4.8-6.3) YEARS. DURING THE FOLLOW-UP PERIOD, 4564 PARTICIPANTS DEVELOPED TYPE 2 DIABETES. COMPARED TO BRISK-WALKING PARTICIPANTS WITH NORMAL BMI, THOSE WITH OBESITY WHO WALKED BRISKLY WERE AT AN APPROXIMATELY 10- TO 12-FOLD HIGHER RISK OF TYPE 2 DIABETES (HAZARD RATIO [HR] 9.64, 95% CONFIDENCE INTERVAL [CI] 7.24-12.84, IN WOMEN; HR 11.91, 95% CI 8.80-16.12, IN MEN), WHEREAS THOSE WITH OBESITY AND WALKED SLOWLY HAD AN APPROXIMATELY 12- TO 15-FOLD HIGHER RISK (HR 12.68, 95% CI 9.62-16.71, IN WOMEN; HR 15.41, 95% CI 11.27-21.06, IN MEN). THERE WAS EVIDENCE OF AN ADDITIVE INTERACTION BETWEEN WC AND BF% AND WALKING PACE AMONG WOMEN, EXPLAINING 17.8% AND 47.9% EXCESS RISK RESPECTIVELY. OBESITY MEDIATED THE ASSOCIATION IN WOMEN AND MEN, ACCOUNTING FOR 60.1% AND 44.9%, RESPECTIVELY.
SLOW WALKING PACE IS A RISK FACTOR FOR TYPE 2 DIABETES INDEPENDENT OF ADIPOSITY. PROMOTING BRISK WALKING AS WELL AS WEIGHT MANAGEMENT MIGHT BE AN EFFECTIVE TYPE 2 DIABETES PREVENTION STRATEGY GIVEN THEIR SYNERGISTIC EFFECTS.
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type 2, obesity, mediation, gait, diabetes mellitus, body fat
