Impact of leisure-time physical activity on glycemic control and cardiovascular risk factors in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry.

Shinako Kaizu,Hiro Kishimoto,Takanari Kitazono,Yohei Kikuchi,Hitoshi Ide,Yasuhiro Idewaki,Toshiaki Ohkuma,Masanori Iwase,Tamaki Jodai,Hiroki Fujii,Udai Nakamura,Yoichiro Hirakawa

doi:10.1371/journal.pone.0098768

Shinako Kaizu, Hiro Kishimoto + Show 10 more

Open Access

https://doi.org/10.1371/journal.pone.0098768

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Journal: PloS one	Publication Date: Jun 4, 2014
Citations: 60	License type: CC BY 4.0

Affiliation: Kyushu University, Uji Hospital, Kyushu Dental University

Abstract

Aims/hypothesisThe effects of leisure-time physical activity (LTPA) on glycemia and cardiovascular risk factors are not fully understood in Asian type 2 diabetic patients, who are typically non-obese. We studied associations between LTPA and glycemia and cardiovascular risk factors in Japanese type 2 diabetic patients.MethodsA total of 4,870 Japanese type 2 diabetic patients aged ≥20 years were divided into eight groups according to their LTPA. We investigated associations between the amount and intensity levels of physical activity (PA) and glycemic control, insulin sensitivity, cardiovascular risk factors, and low-grade systemic inflammation in a cross-sectional study.ResultsLTPA was dose-dependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, high density lipoprotein cholesterol, high sensitivity C-reactive protein, and prevalence of metabolic syndrome, but not with blood pressure, low density lipoprotein cholesterol or adiponectin. The amount of PA required to lower HbA1c was greater than that required to improve cardiovascular risk factors. LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustments for age, sex, duration of diabetes, current smoking, current drinking, energy intake, cardiovascular diseases, depressive symptoms, and treatment of diabetes. Higher-intensity LTPA, not lower-intensity LTPA was associated with HbA1c after multivariate adjustments with further adjustment including BMI.Conclusions/interpretationLTPA was dose-dependently associated with better glycemic control and amelioration of some cardiovascular risk factors in Japanese type 2 diabetic patients. In addition, increased higher-intensity LTPA may be appropriate for glycemic control.

Highlights

The present study demonstrated that: (1) total leisure-time physical activity (T-leisure-time physical activity (LTPA)) was dosedependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, HOMA2-IR, triglyceride, high density lipoprotein (HDL) cholester
Ol, high sensitivity Creactive protein (HS-CRP), and prevalence of metabolic syndrome; (2) T-LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustment; (3) higherintensity LTPA ($3.6 metabolic equivalents (METs)) was associated with HbA1c and HOMA2-IR, whereas lower-intensity LTPA was not
The amounts of T-LTPA from which clinical variables significantly improved as compared with O1 were O3 for BMI, waist circumference, and HS-CRP, O4 for HOMA2-IR, HDL cholesterol, and prevalence of metabolic syndrome, and O5 for triglyceride and O6 for HbA1c, respectively

Summary

Introduction

Because large clinical trials examining exercise therapy are usually difficult to maintain because of poor adherence, a number of smaller studies have been performed and preferentially used for recent meta-analyses [3,4,5,6,7,8]. The beneficial effects of PA on glycemic control, cardiovascular risk factors, body composition, and mental health have been reported [6,7,8,12]. These effects have not been confirmed in Asian diabetic patients who are typically non-obese

Methods

Results

Conclusion