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19 January 1999 | Volume 130 Issue 2 | Pages 89-96
Background: Several studies show an inverse association between self-reported physical activity and type 2 diabetes. It is not known whether physical activity or cardiorespiratory fitness is associated with the onset of objectively determined impaired fasting glucose and type 2 diabetes.
Objective: To determine whether cardiorespiratory fitness, an objective marker of physical activity, is associated with risk for impaired fasting glucose and type 2 diabetes.
Design: Population-based prospective study.
Setting: Preventive medicine clinic.
Patients: 8633 nondiabetic men (of whom 7511 did not have impaired fasting glucose) who were examined at least twice.
Measurements: Cardiorespiratory fitness (determined by a maximal exercise test on a treadmill), fasting plasma glucose level, and other clinical and personal characteristics and incidence of impaired fasting glucose and type 2 diabetes.
Results: During an average follow-up of 6 years, 149 patients developed type 2 diabetes and 593 patients developed impaired fasting glucose. After age, cigarette smoking, alcohol consumption, and parental diabetes were considered, men in the low-fitness group (the least fit 20% of the cohort) at baseline had a 1.9-fold risk (95% CI, 1.5- to 2.4-fold) for impaired fasting glucose and a 3.7-fold risk (CI, 2.4- to 5.8-fold) for diabetes compared with those in the high-fitness group (the most fit 40% of the cohort). The risk for impaired fasting glucose was elevated in older men and those with a higher body mass index. Age, body mass index, blood pressure, triglyceride level, and a history of parental diabetes were also directly related to risk for type 2 diabetes.
Conclusions: Low cardiorespiratory fitness was associated with increased risk for impaired fasting glucose and type 2 diabetes. A sedentary lifestyle may contribute to the progression from normal fasting glucose to impaired fasting glucose and diabetes. Risk for type 2 diabetes was elevated in older persons and those with higher body mass index, blood pressure, and triglyceride levels and a parental history of diabetes.
Author and Article Information
From the Cooper Institute for Aerobics Research and the Cooper Clinic, Dallas, Texas.
Acknowledgments: The authors thank the patients, physicians, and technicians at the Cooper Clinic for their participation, Dr. Kenneth H. Cooper for establishing the Aerobics Center Longitudinal Study, Carolyn E. Barlow for data management, and Melba Morrow for editorial assistance.
Grant Support: In part by a grant from the National Institutes of Health National Institute on Aging (AG06945) and by several private contributions.
Requests for Reprints: Ming Wei, MD, Cooper Institute for Aerobics Research, 12330 Preston Road, Dallas, TX 75230; e-mail, mwei{at}cooperinst.org.
Current Author Addresses: Drs. Wei, Kampert, Lee, and Blair: Cooper Institute for Aerobics Research, 12330 Preston Road, Dallas, TX 75230.
Drs. Gibbons and Mitchell: Cooper Clinic, 12200 Preston Road, Dallas, TX 75230. ARTICLE
The Association between Cardiorespiratory Fitness and Impaired Fasting Glucose and Type 2 Diabetes Mellitus in Men
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