Abstract：
OBJECTIVE: To investigate the association between walking speed and the risk of type 2 diabetes.
METHODS: Systematic review and meta-analysis.
METHODS: PubMed, Scopus, CENTRAL and Web of Science to 30 May 2023.
METHODS: We included cohort studies that explored the association between walking speed and the risk of type 2 diabetes in adults. We used random-effects meta-analyses to calculate relative risk (RR) and risk difference (RD). We rated the credibility of subgroup differences and the certainty of evidence using the Instrument to assess the Credibility of Effect Modification ANalyses (ICEMAN) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools, respectively.
RESULTS: Ten cohort studies were included. Compared with easy/casual walking (<3.2 km/hour), the RR of type 2 diabetes was 0.85 (95% CI 0.70 to 1.00); RD=0.86 (95% CI 1.72 to 0) fewer cases per 100 patients; n=4, GRADE=low) for average/normal walking (3.2-4.8 km/hour), 0.76 (95% CI 0.65 to 0.87); RD=1.38 (95% CI 2.01 to 0.75) fewer cases per 100 patients; n=10, GRADE=low) for fairly brisk walking (4.8-6.4 km/hour) and 0.61 (95% CI 0.49 to 0.73; RD=2.24 (95% CI 2.93 to 1.55) fewer cases per 100 patients; n=6, GRADE=moderate) for brisk/striding walking (>6.4 km/hour). There was no significant or credible difference across subgroups based on adjustment for the total volume of physical activity and time spent walking per day. Dose-response analysis suggested that the risk of type 2 diabetes decreased significantly at a walking speed of 4 km/h and above.
CONCLUSIONS: Low to moderate certainty evidence, mainly from studies with a high risk of bias, suggests that walking at faster speeds is associated with a graded decrease in the risk of type 2 diabetes.
UNASSIGNED: CRD42023432795.
METHODS: Systematic review and meta-analysis.
METHODS: PubMed, Scopus, CENTRAL and Web of Science to 30 May 2023.
METHODS: We included cohort studies that explored the association between walking speed and the risk of type 2 diabetes in adults. We used random-effects meta-analyses to calculate relative risk (RR) and risk difference (RD). We rated the credibility of subgroup differences and the certainty of evidence using the Instrument to assess the Credibility of Effect Modification ANalyses (ICEMAN) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools, respectively.
RESULTS: Ten cohort studies were included. Compared with easy/casual walking (<3.2 km/hour), the RR of type 2 diabetes was 0.85 (95% CI 0.70 to 1.00); RD=0.86 (95% CI 1.72 to 0) fewer cases per 100 patients; n=4, GRADE=low) for average/normal walking (3.2-4.8 km/hour), 0.76 (95% CI 0.65 to 0.87); RD=1.38 (95% CI 2.01 to 0.75) fewer cases per 100 patients; n=10, GRADE=low) for fairly brisk walking (4.8-6.4 km/hour) and 0.61 (95% CI 0.49 to 0.73; RD=2.24 (95% CI 2.93 to 1.55) fewer cases per 100 patients; n=6, GRADE=moderate) for brisk/striding walking (>6.4 km/hour). There was no significant or credible difference across subgroups based on adjustment for the total volume of physical activity and time spent walking per day. Dose-response analysis suggested that the risk of type 2 diabetes decreased significantly at a walking speed of 4 km/h and above.
CONCLUSIONS: Low to moderate certainty evidence, mainly from studies with a high risk of bias, suggests that walking at faster speeds is associated with a graded decrease in the risk of type 2 diabetes.
UNASSIGNED: CRD42023432795.
摘要：
目的：探讨步行速度与2型糖尿病风险之间的关系。
方法：系统评价和荟萃分析。
方法：PubMed，Scopus,CENTRAL和WebofScience至2023年5月30日。
方法：我们纳入了探索步行速度与成人2型糖尿病风险之间关系的队列研究。我们使用随机效应荟萃分析来计算相对风险(RR)和风险差异(RD)。我们使用评估效应修正分析可信度(ICEMAN)和建议评估等级的工具对亚组差异的可信度和证据的确定性进行了评估。开发和评估（等级）工具，分别。
结果：纳入10项队列研究。与轻松/休闲步行(<3.2公里/小时)相比，2型糖尿病的RR为0.85（95％CI0.70至1.00）；RD=0.86（95％CI1.72至0），每100例患者中减少病例；n=4，GRADE=低），平均/正常步行（3.2-4.8km/h），0.76（95％CI0.65至0.87）；RD=1.38（95％CI2.01至0.75），每100名患者的病例数减少；n=10，等级=低），步行相当快（4.8-6.4km/小时）和0.61（95％CI0.49至0.73；RD=2.24（95％CI2.93至1.55），每100名患者的病例数减少；n=6，等级=中度根据对体力活动总量和每天行走时间的调整，亚组之间没有显着或可信的差异。剂量反应分析表明，在4km/h及以上的步行速度下，2型糖尿病的风险显着降低。
结论：低到中等确定性证据，主要来自具有高偏见风险的研究，这表明，以更快的速度行走与2型糖尿病风险的分级降低有关。
■CRD42023432795。
方法：系统评价和荟萃分析。
方法：PubMed，Scopus,CENTRAL和WebofScience至2023年5月30日。
方法：我们纳入了探索步行速度与成人2型糖尿病风险之间关系的队列研究。我们使用随机效应荟萃分析来计算相对风险(RR)和风险差异(RD)。我们使用评估效应修正分析可信度(ICEMAN)和建议评估等级的工具对亚组差异的可信度和证据的确定性进行了评估。开发和评估（等级）工具，分别。
结果：纳入10项队列研究。与轻松/休闲步行(<3.2公里/小时)相比，2型糖尿病的RR为0.85（95％CI0.70至1.00）；RD=0.86（95％CI1.72至0），每100例患者中减少病例；n=4，GRADE=低），平均/正常步行（3.2-4.8km/h），0.76（95％CI0.65至0.87）；RD=1.38（95％CI2.01至0.75），每100名患者的病例数减少；n=10，等级=低），步行相当快（4.8-6.4km/小时）和0.61（95％CI0.49至0.73；RD=2.24（95％CI2.93至1.55），每100名患者的病例数减少；n=6，等级=中度根据对体力活动总量和每天行走时间的调整，亚组之间没有显着或可信的差异。剂量反应分析表明，在4km/h及以上的步行速度下，2型糖尿病的风险显着降低。
结论：低到中等确定性证据，主要来自具有高偏见风险的研究，这表明，以更快的速度行走与2型糖尿病风险的分级降低有关。
■CRD42023432795。
