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Article
Twenty Year Fitness Trends in Young Adults and Incidence of Prediabetes and Diabetes: The CARDIA Study
Diabetologia
  • Lisa S. Chow, University of Minnesota
  • Andrew O. Odegaard, University of California Irvine
  • Tyler A. Bosch, University of Minnesota
  • Katherine H. Ingram, Kennesaw State University
Document Type
Article
Publication Date
5-16-2016
Abstract

Aims/hypothesis - The prospective association between cardiorespiratory fitness (CRF) measured in young adulthood and middle age on development of prediabetes, defined as impaired fasting glucose and/or impaired glucose tolerance, or diabetes by middle age remains unknown. We hypothesised that higher fitness levels would be associated with reduced risk for developing incident prediabetes/diabetes by middle age. Methods - Participants were from the Coronary Artery Risk Development in Young Adults (CARDIA) study who were free from prediabetes/diabetes at baseline (year 0 [Y0]: 1985–1986). CRF was quantified by treadmill duration (converted to metabolic equivalents [METs]) at Y0, Y7 and Y20 and prediabetes/diabetes status was assessed at Y0, Y7, Y10, Y15, Y20 and Y25. We use an extended Cox model with CRF as the primary time-varying exposure. BMI was included as a time-varying covariate. The outcome was development of either prediabetes or diabetes after Y0. Model 1 included age, race, sex, field centre, CRF and BMI. Model 2 additionally included baseline (Y0) smoking, energy intake, alcohol intake, education, systolic BP, BP medication use and lipid profile. Results - Higher fitness was associated with lower risk for developing incident prediabetes/diabetes (difference of 1 MET: HR 0.99898 [95% CI 0.99861, 0.99940], p < 0.01), which persisted (difference of 1 MET: HR 0.99872 [95% CI 0.99840, 0.99904], p < 0.01] when adjusting for covariates. Conclusions/interpretation - Examining participants who had fitness measured from young adulthood to middle age, we found that fitness was associated with lower risk for developing prediabetes/diabetes, even when adjusting for BMI over this time period. These findings emphasise the importance of fitness in reducing the health burden of prediabetes and diabetes.

Digital Object Identifier (DOI)
10.1007/s00125-016-3969-5
Citation Information
Lisa S. Chow, Andrew O. Odegaard, Tyler A. Bosch and Katherine H. Ingram. "Twenty Year Fitness Trends in Young Adults and Incidence of Prediabetes and Diabetes: The CARDIA Study" Diabetologia (2016) p. 1 - 7 ISSN: 1432-0428
Available at: http://works.bepress.com/katherine-h-ingram/10/