Cardiorespiratory fitness, fatness and incident diabetes

Andreas Holtermann*, Finn Gyntelberg, Adrian Bauman, Magnus Thorsten Jensen

*Corresponding author for this work

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Abstract

Aims Increases in prevalence have led to a diabetes pandemic. Obesity and low cardiorespiratory fitness (CRF) are considered to be central mechanisms. We investigated if the effect of CRF on diabetes risk was equivalent across levels of fatness among healthy men. Methods In total 4988 middle-aged Caucasian employed men free of cardiovascular disease, diabetes and cancer were included from the Copenhagen Male Study starting in 1970–71. CRF was assessed using a sub-maximal bicycle ergometer test and body mass index (BMI) was measured by height and weight. Their interaction and stratified associations with diabetes incidence were estimated in multivariable Cox-models including conventional risk factors and social class. Diabetes incidence was assessed through a national register. Results During 44 years of follow-up, 518 (10.4%) incident cases of diabetes occurred. In the multi-adjusted model, the obese had a significantly higher risk of diabetes compared to normal weight men (Hazard Ratio (HR):4.89; 95% CI: 3.62–6.61) and CRF was significantly inversely associated with diabetes (HR:0.86; 95% CI: 0.75–0.98 per 10-unit increase in ml/kg/min1 CRF). A significant multi-adjusted interaction between CRF, BMI and diabetes was found (p = 0.009). The stratified multi-adjusted analyses on BMI showed a significantly stronger reduced risk of diabetes per 10-unit increase in ml/kg/min1 of CRF among the obese (HR:0.58; CI: 0.38–0.89), but a weaker association among overweight (HR:0.86; CI: 0.71–1.03) and normal weight (HR:0.97; CI: 0.76–1.23). Conclusion High CRF has a stronger protective effect on diabetes among obese than among normal weight men, supporting the recommendation of fitness-enhancing physical activity for preventing diabetes among the obese.

Original languageEnglish
JournalDiabetes Research and Clinical Practice
Volume134
Pages (from-to)113-120
ISSN0168-8227
DOIs
Publication statusPublished - 2017

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Weights and Measures
Body Mass Index
Cardiorespiratory Fitness
Incidence
Proportional Hazards Models
Exercise
Neoplasms

Keywords

  • BMI
  • Fatness
  • Physical fitness

Cite this

Holtermann, Andreas ; Gyntelberg, Finn ; Bauman, Adrian ; Thorsten Jensen, Magnus. / Cardiorespiratory fitness, fatness and incident diabetes. In: Diabetes Research and Clinical Practice. 2017 ; Vol. 134. pp. 113-120.
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title = "Cardiorespiratory fitness, fatness and incident diabetes",
abstract = "Aims Increases in prevalence have led to a diabetes pandemic. Obesity and low cardiorespiratory fitness (CRF) are considered to be central mechanisms. We investigated if the effect of CRF on diabetes risk was equivalent across levels of fatness among healthy men. Methods In total 4988 middle-aged Caucasian employed men free of cardiovascular disease, diabetes and cancer were included from the Copenhagen Male Study starting in 1970–71. CRF was assessed using a sub-maximal bicycle ergometer test and body mass index (BMI) was measured by height and weight. Their interaction and stratified associations with diabetes incidence were estimated in multivariable Cox-models including conventional risk factors and social class. Diabetes incidence was assessed through a national register. Results During 44 years of follow-up, 518 (10.4{\%}) incident cases of diabetes occurred. In the multi-adjusted model, the obese had a significantly higher risk of diabetes compared to normal weight men (Hazard Ratio (HR):4.89; 95{\%} CI: 3.62–6.61) and CRF was significantly inversely associated with diabetes (HR:0.86; 95{\%} CI: 0.75–0.98 per 10-unit increase in ml/kg/min1 CRF). A significant multi-adjusted interaction between CRF, BMI and diabetes was found (p = 0.009). The stratified multi-adjusted analyses on BMI showed a significantly stronger reduced risk of diabetes per 10-unit increase in ml/kg/min1 of CRF among the obese (HR:0.58; CI: 0.38–0.89), but a weaker association among overweight (HR:0.86; CI: 0.71–1.03) and normal weight (HR:0.97; CI: 0.76–1.23). Conclusion High CRF has a stronger protective effect on diabetes among obese than among normal weight men, supporting the recommendation of fitness-enhancing physical activity for preventing diabetes among the obese.",
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Holtermann, A, Gyntelberg, F, Bauman, A & Thorsten Jensen, M 2017, 'Cardiorespiratory fitness, fatness and incident diabetes', Diabetes Research and Clinical Practice, vol. 134, pp. 113-120. https://doi.org/10.1016/j.diabres.2017.10.001

Cardiorespiratory fitness, fatness and incident diabetes. / Holtermann, Andreas; Gyntelberg, Finn; Bauman, Adrian; Thorsten Jensen, Magnus.

In: Diabetes Research and Clinical Practice, Vol. 134, 2017, p. 113-120.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Cardiorespiratory fitness, fatness and incident diabetes

AU - Holtermann, Andreas

AU - Gyntelberg, Finn

AU - Bauman, Adrian

AU - Thorsten Jensen, Magnus

PY - 2017

Y1 - 2017

N2 - Aims Increases in prevalence have led to a diabetes pandemic. Obesity and low cardiorespiratory fitness (CRF) are considered to be central mechanisms. We investigated if the effect of CRF on diabetes risk was equivalent across levels of fatness among healthy men. Methods In total 4988 middle-aged Caucasian employed men free of cardiovascular disease, diabetes and cancer were included from the Copenhagen Male Study starting in 1970–71. CRF was assessed using a sub-maximal bicycle ergometer test and body mass index (BMI) was measured by height and weight. Their interaction and stratified associations with diabetes incidence were estimated in multivariable Cox-models including conventional risk factors and social class. Diabetes incidence was assessed through a national register. Results During 44 years of follow-up, 518 (10.4%) incident cases of diabetes occurred. In the multi-adjusted model, the obese had a significantly higher risk of diabetes compared to normal weight men (Hazard Ratio (HR):4.89; 95% CI: 3.62–6.61) and CRF was significantly inversely associated with diabetes (HR:0.86; 95% CI: 0.75–0.98 per 10-unit increase in ml/kg/min1 CRF). A significant multi-adjusted interaction between CRF, BMI and diabetes was found (p = 0.009). The stratified multi-adjusted analyses on BMI showed a significantly stronger reduced risk of diabetes per 10-unit increase in ml/kg/min1 of CRF among the obese (HR:0.58; CI: 0.38–0.89), but a weaker association among overweight (HR:0.86; CI: 0.71–1.03) and normal weight (HR:0.97; CI: 0.76–1.23). Conclusion High CRF has a stronger protective effect on diabetes among obese than among normal weight men, supporting the recommendation of fitness-enhancing physical activity for preventing diabetes among the obese.

AB - Aims Increases in prevalence have led to a diabetes pandemic. Obesity and low cardiorespiratory fitness (CRF) are considered to be central mechanisms. We investigated if the effect of CRF on diabetes risk was equivalent across levels of fatness among healthy men. Methods In total 4988 middle-aged Caucasian employed men free of cardiovascular disease, diabetes and cancer were included from the Copenhagen Male Study starting in 1970–71. CRF was assessed using a sub-maximal bicycle ergometer test and body mass index (BMI) was measured by height and weight. Their interaction and stratified associations with diabetes incidence were estimated in multivariable Cox-models including conventional risk factors and social class. Diabetes incidence was assessed through a national register. Results During 44 years of follow-up, 518 (10.4%) incident cases of diabetes occurred. In the multi-adjusted model, the obese had a significantly higher risk of diabetes compared to normal weight men (Hazard Ratio (HR):4.89; 95% CI: 3.62–6.61) and CRF was significantly inversely associated with diabetes (HR:0.86; 95% CI: 0.75–0.98 per 10-unit increase in ml/kg/min1 CRF). A significant multi-adjusted interaction between CRF, BMI and diabetes was found (p = 0.009). The stratified multi-adjusted analyses on BMI showed a significantly stronger reduced risk of diabetes per 10-unit increase in ml/kg/min1 of CRF among the obese (HR:0.58; CI: 0.38–0.89), but a weaker association among overweight (HR:0.86; CI: 0.71–1.03) and normal weight (HR:0.97; CI: 0.76–1.23). Conclusion High CRF has a stronger protective effect on diabetes among obese than among normal weight men, supporting the recommendation of fitness-enhancing physical activity for preventing diabetes among the obese.

KW - BMI

KW - Fatness

KW - Physical fitness

U2 - 10.1016/j.diabres.2017.10.001

DO - 10.1016/j.diabres.2017.10.001

M3 - Journal article

C2 - 28993157

AN - SCOPUS:85034109941

VL - 134

SP - 113

EP - 120

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

SN - 0168-8227

ER -