The Association Between Physical Activity And Type 2 Diabetes

Aim: Many studies have explored the association between physical activity and the risk of diabetes.But the number of the studies about the association between physical activity and the risk of pre-diabetes is limited.And the results are controversal.The present study examines the association between the various types of physical activity and the risk of pre-diabetes and diabetes systematically.Methods: Data from the National Health and Nutrition Examination Survey 2007-2012 were used in our analyses.Chi-square tests were used to compare the prevalence of categorical variables between subjects with normal blood sugar level,pre-diabetes and diabetes.The average level of blood sugar were calculated by median(upper quartile,lower quartile).The prevalance of pre-diabetes and diabetes between different characteristic(age,gender,BMI,different level of physical activity)were calculated.The correlativity between physical activity and glycosylated hemoglobin was calculated by rank correlation coefficient.Univariate chi-square test and Mantel-Haenszel chi-square test analysis were used to analyze the association of different types of physical activity and risk of pre-diabetes and diabetes.Univariate logistic regression,multivariate logistic regression and multinomial logistic regression were conducted to estimate the odds ratios(ORs)with 95% confidence intervals(CIs)of pre-diabetes and diabetes associated with physical activity.Results: A total of 9962 subjects(2483 subjects with pre-diabetes and 472 with diabetes)were eligible for our analyses.The prevalence of pre-diabetes and diabetes increased with age and BMI,but decreased with the increase of physical activity.The level of glycosylated hemoglobin was different between different level of physical activity,except total work-related physical activity and vigorous work-related physical activity.Compared with 0 MET-hours/week,high level of total leisure-time physical activity(?=-0.244,P=0.003,OR = 0.783,95% CI: 0.666,0.921)and low level of vigorous leisure-time physical activity(?=-0.209,P=0.038,OR = 0.811,95% CI: 0.666,0.988)were inversely associated with the risk of pre-diabetes in multivariate-adjusted logistic regression.High level of total physical activity(OR = 0.582,95% CI: 0.426,0.795),low(OR = 0.673,95% CI: 0.505,0.899),moderate(OR = 0.625,95% CI: 0.426,0.916)and high(OR = 0.467,95% CI: 0.306,0.712)level of total leisure-time physical activity,moderate(OR = 0.502,95% CI: 0.269,0.936)and high(OR = 0.504,95% CI: 0.255,0.996)level of vigorous leisure-time physical activity and low(OR = 0.551,95% CI: 0.269,0.936)and high(OR = 0.655,95% CI: 0.447,0.959)level of moderate leisure-time physical activity were inversely associated with the risk of diabetes in multivariate-adjusted model.For subjects with BMI?30kg/m2,high level of total leisure-time physical activity(OR = 0.740,95% CI: 0.572,0.958)and low(OR = 0.671,95% CI: 0.488,0.924)and moderate(OR = 0.601,95% CI: 0.419,0.862)level of vigorous leisure-time physical activity were associated with a decreased risk of pre-diabetes.High level of total physical activity(OR = 0.605,95% CI: 0.410,0.893),high level of total leisure-time physical activity(OR = 0.376,95% CI: 0.211,0.670),moderate level of vigorous leisure-time physical activity(OR = 0.349,95% CI: 0.147,0.833)and low level of moderate leisure-time physical activity(OR = 0.602,95% CI: 0.369,0.982)had protective effect on diabetes in subjects with BMI?30kg/m2.Conclusion: Physical activity may be associated with a decreased risk of pre-diabetes and diabetes.Compared with work-related physical activity,leisure-time physical activity may have more protective effect on pre-diabetes and diabetes.What's more,the protective effect on pre-diabetes and diabetes was more pronounced in subjects with BMI?30kg/m2.Large cohort studies are needed to verify the potential causal association.