LONGITUDINAL STUDY ON THE RELATIVE RISK OF TYPE 2 DIABETES MELLITUS ACCORDING TO OBESITY AND PHYSICAL ACTIVITY
1Department of Sports Science Convergence, Dongguk University, Seoul, Republic of Korea
2Department of Prescription and Rehabilitation of Exercise, Dankook University, Cheonan, Republic of Korea
3Department of Physical Education, Gangneung-Wonju National University, Gangneung-si, Republic of Korea
DOI: 10.15586/jomh.v16i3.272 Vol.16,Issue 3,July 2020 pp.1-10
Published: 16 July 2020
Background and Purpose
Diabetes mellitus is a major cause of death and can lead to complications of cardiovascular disease. High physical activity (HPA) and normal weight play a role in reducing the risk of diabetes. This study analyzed the relative risk (RR) of diabetes according to obesity and physical activity using national health census data.
Nationwide health screening was performed for all adults every 2 years. Data from 5,590,120 men and 4,102,523 women, who were followed up for 10 years, were analyzed. Physical activity questionnaires about weekly exercise frequency were used to define low physical activity (LPA, 0–2 days), moderate physical activity (MPA, 3–5 days), and high physical activity (HPA, 6–7 days). Body mass index (BMI) ≤24.9 kg/m2 was defined as normal, BMI 25.0–29.9 kg/m2 was overweight, and BMI ≥30.0 kg/m2 was obese. The RR was calculated using Cox analysis.
Diabetes incidence rates were 14.8% in overweight men, 20.0% in men with obesity, 17.9% in over-weight women, and 22.7% in women with obesity. The RR increased by 2.5 times in men with obesity and 3.4 times in women with obesity as compared with that of individuals with a normal BMI. Among overweight and obese individuals, those with HPA had decreased risks of developing diabetes compared with those with LPA (adjusted relative risk [ARR] for overweight individuals: 0.976 for men and 0.966 for women; ARR for individuals with obesity: 0.936 for men and 0.931 for women).
A high BMI increases the risk of diabetes; however, as physical activity increases, the risk of diabetes decreases. In the overweight and obese groups, those with higher physical activity had a lower risk of developing diabetes.
body mass index; diabetes mellitus; obesity; physical activity; relative risk
Duk Han Ko,Kun Ho Lee,Yong Hwan Kim. LONGITUDINAL STUDY ON THE RELATIVE RISK OF TYPE 2 DIABETES MELLITUS ACCORDING TO OBESITY AND PHYSICAL ACTIVITY. Journal of Men's Health. 2020. 16(3);1-10.
1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diab Care 2014;37:S81–90. https://doi.org/10.2337/dc14-S081
2. Almigbal TH. Erectile dysfunction in men with type 2 diabetes: Is it associated with poor glycemic control? J Mens Health 2019;15:e12–22. https://doi.org/10.22374/jomh.v15i1.104
3. Centers for Disease Control and Prevention Control. National diabetes statistics report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2020.
4. KCDC. Trends in prevalence of diabetes among Korean adults aged 30 years and over, 2007–2018. Cheongju: Korea Centers for Disease Control and Prevention; 2019. 2005-811X.
5. Robbins JM, Vaccarino V, Zhang H, et al. Socioeconomic status and diagnosed diabe-tes incidence. Diab Res Clin Pract 2005;68: 230–6. https://doi.org/10.1016/j.diabres.2004. 09.007
6. Zheng C, Liu Z. Vascular function, insulin action, and exercise: An intricate interplay. Trends Endocrinol Metab 2015;26:297–304. https://doi. org/10.1016/j.tem.2015.02.002
7. Shin S, Matsuoka T, So W-Y. Influences of short-term normobaric hypoxic training on metabolic syndrome-related markers in overweight and nor-mal-weight men. J Mens Health 2018;14:e44–e52. https://doi.org/10.22374/1875-6818.104.22.168
8. Aune D, Norat T, Leitzmann M, et al. Physical activity and the risk of type 2 diabetes: A system-atic review and dose-response meta-analysis. Eur J Epidemiol 2015;30:529–42. https://doi.org/10.1007/s10654-015-0056-z
9. Kyu HH, Bachman VF, Alexander LT, et al. Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and isch-emic stroke events: Systematic review and dose-re-sponse meta-analysis for the Global Burden of Disease Study 2013. BMJ 2016;354:i3857. https://doi.org/10.1136/bmj.i3857
10. Yang W, Lu J, Weng J, et al. Prevalence of diabe-tes among men and women in China. N Engl J Med 2010;362:1090–101. https://doi.org/10.1056/NEJMoa0908292
11. WHO. International statistical classification of diseases and related health problems 10th revi-sion. Geneva: World Health Organization; 2015.
12. WHO. Obesity: Preventing and managing the global epidemic. Geneva: World Health Organization; 2000.
13. Choi SH, Kwon SO, Kim DW, et al. Development of high-obesity reality analysis and management measures. Seoul: Korean National Health Insurance Service; 2015.
14. ACSM. ACSM’s exercise testing and prescription. Philadelphia, PA: Lippincott Williams & Wilkins; 2017.
15. WHO. International guide for monitoring alcohol consumption and related harm. Geneva: World Health Organization; 2000.
16. Statistics. 2018 causes of death statistics. Daejeon: Statistics Korea; 2018.
17. Almdal T, Scharling H, Jensen JS, et al. The independent effect of type 2 diabetes mellitus on ischemic heart disease, stroke, and death: A popu-lation-based study of 13 000 men and women with 20 years of follow-up. Arch Intern Med 2004;164:1422–6. https://doi.org/10.1001/archinte. 164.13.1422
18. Ferrannini E, Cushman WC. Diabetes and h ypertension: The bad companions. Lancet 2012;380:601–10. https://doi.org/10.1016/S0140-6736(12) 60987-8
19. Meyer MR, Clegg DJ, Prossnitz ER, et al. Obesity, insulin resistance and diabetes: Sex differences and role of oestrogen receptors. Acta Physiol 2011;203:259–69. https://doi.org/10.1111/j. 1748-1716. 2010.02237.x
20. Koloverou E, Panagiotakos DB, Pitsavos C, et al.
10- year incidence of diabetes and associated risk factors in Greece: The ATTICA study (2002–2012). Rev Diab Stud RDS 2014;11:181. https://doi. org/10.1900/RDS.2014.11.181
21. Marinou K, Tousoulis D, Antonopoulos AS, et al. Obesity and cardiovascular disease: From patho-physiology to risk stratification. Int J Cardiol 2010;138:3–8. https://doi.org/10.1016/j.ijcard. 2009.03.135
22. Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diab Care 2011;34:1481–6. https://doi.org/10.2337/dc10-2415
23. Guthold R, Stevens GA, Riley LM, et al. Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 popu-lation-based surveys with 1 9 million participants. Lancet Glob Health 2018;6:e1077–86. https://doi. org/10.1016/S2214-109X(18)30357-7
24. KMCST. 2018 Korean participation in sports and physical activity. Sejong: Korean Ministrty of Culture, Sports and Tourism; 2018.
25. Trapp EG, Chisholm DJ, Freund J, et al. The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women. Int J Obes 2008;32:684–91. https://doi.org/10.1038/sj.ijo.0803781
26. Church TS, Thomas DM, Tudor-Locke C, et al. Trends over 5 decades in US occupation-related physical activity and their associations with obesity. PLoS One 2011;6:e19657. https://doi.org/ 10.1371/journal.pone.0019657
27. Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet 2012;380:611–19. https://doi.org/10.1016/S0140-6736(12)60861-7
28. Ramachandran A, Snehalatha C, Shetty AS, et al. Trends in prevalence of diabetes in Asian coun-tries. World J Diab 2012;3:110. https://doi.org/ 10.4239/wjd.v3.i6.110
29. Goryakin Y, Suhrcke M. Economic develop-ment, urbanization, technological change and overweight: What do we learn from 244 demo-graphic and health surveys? Econ Hum Biol 2014;14:109–27. https://doi.org/10.1016/j.ehb. 2013. 11.003
30. Burke V, Zhao Y, Lee AH, et al. Predictors of type 2 diabetes and diabetes-related hospitalisation in an Australian Aboriginal cohort. Diab Res Clin Pract 2007;78:360–8. https://doi.org/10.1016/j.dia-bres. 2007.04.007
31. Chien K-L, Chen M-F, Hsu H-C, et al. Sports activity and risk of type 2 diabetes in Chinese. Diab Res Clin Pract 2009;84:311–18. https://doi. org/10.1016/j.diabres.2009.03.006
32. Hainer V, Aldhoon-Hainerová I. Obesity paradox does exist. Diab Care 2013;36:S276–81. https://doi.org/10.2337/dcS13-2023
33. Weinstein AR, Sesso HD, Lee IM, et al. Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA 2004;292:1188–94. https://doi.org/10.1001/jama. 292.10.1188
34. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circum-ference and BMI for adult cardiometabolic risk factors: Systematic review and meta-analysis. Obes Rev 2012;13:275–86. https://doi.org/10.1111/
j. 1467-789X. 2011.00952.x
35. Kim YH, So W-Y. Anthropometrics and meta-bolic syndrome in healthy Korean adults: A 7-year longitudinal study. J Mens Health 2018;14:e1–10. https://doi.org/10.22374/1875-6822.214.171.124
36. Moreno-Gómez C, Romaguera-Bosch D, Tauler-Riera P, et al. Clustering of lifestyle factors in Spanish university students: The relationship between smoking, alcohol consumption, physical activity and diet quality. Public Health Nutr 2012;15:2131–9. https://doi.org/10.1017/S136898 00 12000080
37. Shubair MM, McCrory C, Reschny JA, et al. Elderly men and health service provision for type 2 diabetes management: Synthesis of knowledge gaps and identification of research needs. J Mens Health 2018;18(1):595. https://doi.org/10.22374/ 1875-68126.96.36.199
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