Abstract：
OBJECTIVE: To investigate the relationship of moderate physical activity (MPA), vigorous physical activity (VPA), and muscle strengthening activity (MSA), independently and jointly, with all-cause, cardiovascular disease (CVD), and non-CVD mortality in individuals with type 2 diabetes (T2D).
METHODS: This cohort study included 47,538 adults with T2D and 561,963 adults without T2D from the National Health Interview Survey 1997-2018 who provided data on self-reported physical activity (PA). Mortality data were obtained from the National Death Index through 2019. Cox regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI).
RESULTS: In analyses mutually adjusted, versus no MPA adults with T2D, performing the recommendations of MPA (150-299 min/week) associated with lower all-cause mortality (HR, 0.72; 95% CI, 0.66-0.78), CVD mortality (HR, 0.68; 95% CI, 0.58-0.79), and non-CVD mortality (HR, 0.72; 95% CI, 0.65-0.79). Similar benefits were observed in those meeting recommendations for VPA and MSA. Higher levels of PA beyond current recommendations may provide a few additional benefits without adverse effects on mortality risk, regardless of diabetes onset age, duration of diabetes, and medication status. The joint analysis indicates that combining MSA with aerobic PA could further lower mortality risk, and lowest all-cause mortality was observed among individuals engaging in either 75-150 min/week of VPA and 1 time/week of MSA (HR, 0.30; 95% CI, 0.13-0.70) or 150-299 min/week of MPA and 1 time/week of MSA (HR, 0.33; 95% CI, 0.20-0.55).
CONCLUSIONS: Our study supports the current PA guidelines and suggests that there may be limited benefits gained from exercising beyond recommended levels in adults with T2D, combining recommended levels of aerobic and resistance exercises could yield the greatest benefits.
METHODS: This cohort study included 47,538 adults with T2D and 561,963 adults without T2D from the National Health Interview Survey 1997-2018 who provided data on self-reported physical activity (PA). Mortality data were obtained from the National Death Index through 2019. Cox regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI).
RESULTS: In analyses mutually adjusted, versus no MPA adults with T2D, performing the recommendations of MPA (150-299 min/week) associated with lower all-cause mortality (HR, 0.72; 95% CI, 0.66-0.78), CVD mortality (HR, 0.68; 95% CI, 0.58-0.79), and non-CVD mortality (HR, 0.72; 95% CI, 0.65-0.79). Similar benefits were observed in those meeting recommendations for VPA and MSA. Higher levels of PA beyond current recommendations may provide a few additional benefits without adverse effects on mortality risk, regardless of diabetes onset age, duration of diabetes, and medication status. The joint analysis indicates that combining MSA with aerobic PA could further lower mortality risk, and lowest all-cause mortality was observed among individuals engaging in either 75-150 min/week of VPA and 1 time/week of MSA (HR, 0.30; 95% CI, 0.13-0.70) or 150-299 min/week of MPA and 1 time/week of MSA (HR, 0.33; 95% CI, 0.20-0.55).
CONCLUSIONS: Our study supports the current PA guidelines and suggests that there may be limited benefits gained from exercising beyond recommended levels in adults with T2D, combining recommended levels of aerobic and resistance exercises could yield the greatest benefits.
摘要：
目的：探讨适度体力活动(MPA)与剧烈的体力活动（VPA），和肌肉加强活动（MSA），独立和联合，所有的事业，心血管疾病（CVD），2型糖尿病（T2D）患者的非CVD死亡率。
方法：这项队列研究包括1997-2018年全国健康访谈调查中的47,538名患有T2D的成年人和561,963名没有T2D的成年人，他们提供了自我报告的身体活动（PA）数据。死亡率数据来自2019年的国家死亡指数。Cox回归用于估计风险比（HR）和95％置信区间（CI）。
结果：在相互调整的分析中，与没有MPA成人T2D相比，执行MPA的建议（150-299分钟/周）与较低的全因死亡率（HR，0.72；95%CI，0.66-0.78），CVD死亡率（HR，0.68；95%CI，0.58-0.79），和非CVD死亡率(HR，0.72；95%CI，0.65-0.79）。在针对VPA和MSA的会议建议中观察到类似的益处。超过当前建议的较高水平的PA可能会提供一些额外的益处，而不会对死亡风险产生不利影响。无论糖尿病的发病年龄，糖尿病的持续时间，和药物状态。联合分析表明，将MSA与有氧PA结合使用可以进一步降低死亡风险，在每周75-150分钟的VPA和1次/周的MSA的个体中观察到最低的全因死亡率(HR，0.30；95%CI，0.13-0.70）或150-299分钟/周的MPA和1次/周的MSA（HR，0.33；95%CI，0.20-0.55）。
结论：我们的研究支持当前的PA指南，并表明在T2D成人中，锻炼超过推荐水平的益处可能有限。将推荐水平的有氧运动和阻力运动结合起来可能会产生最大的好处。
方法：这项队列研究包括1997-2018年全国健康访谈调查中的47,538名患有T2D的成年人和561,963名没有T2D的成年人，他们提供了自我报告的身体活动（PA）数据。死亡率数据来自2019年的国家死亡指数。Cox回归用于估计风险比（HR）和95％置信区间（CI）。
结果：在相互调整的分析中，与没有MPA成人T2D相比，执行MPA的建议（150-299分钟/周）与较低的全因死亡率（HR，0.72；95%CI，0.66-0.78），CVD死亡率（HR，0.68；95%CI，0.58-0.79），和非CVD死亡率(HR，0.72；95%CI，0.65-0.79）。在针对VPA和MSA的会议建议中观察到类似的益处。超过当前建议的较高水平的PA可能会提供一些额外的益处，而不会对死亡风险产生不利影响。无论糖尿病的发病年龄，糖尿病的持续时间，和药物状态。联合分析表明，将MSA与有氧PA结合使用可以进一步降低死亡风险，在每周75-150分钟的VPA和1次/周的MSA的个体中观察到最低的全因死亡率(HR，0.30；95%CI，0.13-0.70）或150-299分钟/周的MPA和1次/周的MSA（HR，0.33；95%CI，0.20-0.55）。
结论：我们的研究支持当前的PA指南，并表明在T2D成人中，锻炼超过推荐水平的益处可能有限。将推荐水平的有氧运动和阻力运动结合起来可能会产生最大的好处。
