Twenty year fitness trends in young adults and incidence of prediabetes and diabetes

the CARDIA study

Lisa S Chow, Andrew O. Odegaard, Tyler A Bosch, Anne E Bantle, Qi Wang, John Hughes, Mercedes Carnethon, Katherine H. Ingram, Nefertiti Durant, Cora E. Lewis, Justin R Ryder, Christina M. Shay, Aaron S Kelly, Pamela J Schreiner

Research output: Contribution to journalArticle

16 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1659-1665
Number of pages7
JournalDiabetologia
Volume59
Issue number8
DOIs
StatePublished - Aug 1 2016

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Prediabetic State
Young Adult
Coronary Vessels
Incidence
Metabolic Equivalent
Glucose Intolerance
Energy Intake
Proportional Hazards Models
Fasting
Smoking
Alcohols
Lipids
Education
Glucose
Cardiorespiratory Fitness
Health

Keywords

  • Cardiorespiratory fitness
  • Diabetes
  • Prediabetes

Cite this

Twenty year fitness trends in young adults and incidence of prediabetes and diabetes : the CARDIA study. / Chow, Lisa S; Odegaard, Andrew O.; Bosch, Tyler A; Bantle, Anne E; Wang, Qi; Hughes, John; Carnethon, Mercedes; Ingram, Katherine H.; Durant, Nefertiti; Lewis, Cora E.; Ryder, Justin R; Shay, Christina M.; Kelly, Aaron S; Schreiner, Pamela J.

In: Diabetologia, Vol. 59, No. 8, 01.08.2016, p. 1659-1665.

Research output: Contribution to journalArticle

Chow, Lisa S ; Odegaard, Andrew O. ; Bosch, Tyler A ; Bantle, Anne E ; Wang, Qi ; Hughes, John ; Carnethon, Mercedes ; Ingram, Katherine H. ; Durant, Nefertiti ; Lewis, Cora E. ; Ryder, Justin R ; Shay, Christina M. ; Kelly, Aaron S ; Schreiner, Pamela J. / Twenty year fitness trends in young adults and incidence of prediabetes and diabetes : the CARDIA study. In: Diabetologia. 2016 ; Vol. 59, No. 8. pp. 1659-1665.
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AU - Odegaard, Andrew O.

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AU - Bantle, Anne E

AU - Wang, Qi

AU - Hughes, John

AU - Carnethon, Mercedes

AU - Ingram, Katherine H.

AU - Durant, Nefertiti

AU - Lewis, Cora E.

AU - Ryder, Justin R

AU - Shay, Christina M.

AU - Kelly, Aaron S

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