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Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults

OBJECTIVE: Aim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated by adiposity. RESEARCH DESIGN AND METHODS: The prospective China Kadoorie Biobank recruite...

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Autores principales: Bennett, Derrick A, Du, Huaidong, Bragg, Fiona, Guo, Yu, Wright, Neil, Yang, Ling, Bian, Zheng, Chen, Yiping, YU, Canqing, Wang, Sisi, Meng, Fanwen, Lv, Jun, Chen, Junshi, Li, Liming, Clarke, Robert, Chen, Zhengming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936425/
https://www.ncbi.nlm.nih.gov/pubmed/31908799
http://dx.doi.org/10.1136/bmjdrc-2019-000835
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author Bennett, Derrick A
Du, Huaidong
Bragg, Fiona
Guo, Yu
Wright, Neil
Yang, Ling
Bian, Zheng
Chen, Yiping
YU, Canqing
Wang, Sisi
Meng, Fanwen
Lv, Jun
Chen, Junshi
Li, Liming
Clarke, Robert
Chen, Zhengming
author_facet Bennett, Derrick A
Du, Huaidong
Bragg, Fiona
Guo, Yu
Wright, Neil
Yang, Ling
Bian, Zheng
Chen, Yiping
YU, Canqing
Wang, Sisi
Meng, Fanwen
Lv, Jun
Chen, Junshi
Li, Liming
Clarke, Robert
Chen, Zhengming
author_sort Bennett, Derrick A
collection PubMed
description OBJECTIVE: Aim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated by adiposity. RESEARCH DESIGN AND METHODS: The prospective China Kadoorie Biobank recruited ~512 000 adults from 10 diverse areas across China. Self-reported PA was estimated based on type, frequency and duration of specific types of PA, covering four domains (occupation, leisure, household and commuting). SLT was defined as hours per day spent watching television, reading or playing card games. Stratified Cox proportional hazards models were used to estimate adjusted HRs (aHRs) for PA and SLT associated with incident diabetes. Analyses were stratified by age-at-risk (5-year intervals), sex and region and adjusted for household income, education, alcohol consumption, smoking, fresh fruit intake, self-reported general health status, family history of diabetes and body mass index (BMI) status. Analyses of total PA, occupational and non-occupational PA and SLT were mutually adjusted for each other, as appropriate. RESULTS: After ~9 years of follow-up, there were 14 940 incident diabetes cases among 460 736 participants without prior diabetes or cardiovascular diseases at baseline. The mean (SD) age at baseline was 51 (10.6) years, 59% were women and 43% resided in urban areas. Overall, the mean BMI was 23.5 (3.3) kg/m(2), which differed by ~0.5 kg/m(2) among individuals in the highest compared with the lowest PA and SLT groups. PA was inversely associated the risk of diabetes 16% (aHR: 0.84, 95% CI 0.81 to 0.88) lower in top than bottom fifth. After further adjustment for BMI this was attenuated to 0.99 (95% CI 0.98 to 1.00). SLT was positively associated with diabetes and each 1 hour per day higher usual level was associated with aHR of 1.13 (95% CI 1.09 to 1.17) for diabetes, attenuated to 1.05 (95% CI 1.01 to 1.09) after further adjustment for BMI. CONCLUSIONS: Among Chinese adults, higher levels of PA and lower levels of SLT were associated with lower risks of diabetes with no evidence of effect modification by each other. These associations appeared to arise mainly through adiposity.
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spelling pubmed-69364252020-01-06 Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults Bennett, Derrick A Du, Huaidong Bragg, Fiona Guo, Yu Wright, Neil Yang, Ling Bian, Zheng Chen, Yiping YU, Canqing Wang, Sisi Meng, Fanwen Lv, Jun Chen, Junshi Li, Liming Clarke, Robert Chen, Zhengming BMJ Open Diabetes Res Care Epidemiology/Health Services Research OBJECTIVE: Aim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated by adiposity. RESEARCH DESIGN AND METHODS: The prospective China Kadoorie Biobank recruited ~512 000 adults from 10 diverse areas across China. Self-reported PA was estimated based on type, frequency and duration of specific types of PA, covering four domains (occupation, leisure, household and commuting). SLT was defined as hours per day spent watching television, reading or playing card games. Stratified Cox proportional hazards models were used to estimate adjusted HRs (aHRs) for PA and SLT associated with incident diabetes. Analyses were stratified by age-at-risk (5-year intervals), sex and region and adjusted for household income, education, alcohol consumption, smoking, fresh fruit intake, self-reported general health status, family history of diabetes and body mass index (BMI) status. Analyses of total PA, occupational and non-occupational PA and SLT were mutually adjusted for each other, as appropriate. RESULTS: After ~9 years of follow-up, there were 14 940 incident diabetes cases among 460 736 participants without prior diabetes or cardiovascular diseases at baseline. The mean (SD) age at baseline was 51 (10.6) years, 59% were women and 43% resided in urban areas. Overall, the mean BMI was 23.5 (3.3) kg/m(2), which differed by ~0.5 kg/m(2) among individuals in the highest compared with the lowest PA and SLT groups. PA was inversely associated the risk of diabetes 16% (aHR: 0.84, 95% CI 0.81 to 0.88) lower in top than bottom fifth. After further adjustment for BMI this was attenuated to 0.99 (95% CI 0.98 to 1.00). SLT was positively associated with diabetes and each 1 hour per day higher usual level was associated with aHR of 1.13 (95% CI 1.09 to 1.17) for diabetes, attenuated to 1.05 (95% CI 1.01 to 1.09) after further adjustment for BMI. CONCLUSIONS: Among Chinese adults, higher levels of PA and lower levels of SLT were associated with lower risks of diabetes with no evidence of effect modification by each other. These associations appeared to arise mainly through adiposity. BMJ Publishing Group 2019-12-18 /pmc/articles/PMC6936425/ /pubmed/31908799 http://dx.doi.org/10.1136/bmjdrc-2019-000835 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Epidemiology/Health Services Research
Bennett, Derrick A
Du, Huaidong
Bragg, Fiona
Guo, Yu
Wright, Neil
Yang, Ling
Bian, Zheng
Chen, Yiping
YU, Canqing
Wang, Sisi
Meng, Fanwen
Lv, Jun
Chen, Junshi
Li, Liming
Clarke, Robert
Chen, Zhengming
Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults
title Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults
title_full Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults
title_fullStr Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults
title_full_unstemmed Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults
title_short Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults
title_sort physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 chinese adults
topic Epidemiology/Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936425/
https://www.ncbi.nlm.nih.gov/pubmed/31908799
http://dx.doi.org/10.1136/bmjdrc-2019-000835
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