Low Cardiorespiratory Fitness And Body Composition As Predictors Of CVD Mortality Among Men With Diabetes

Abstract

We previously reported that higher levels of cardiorespiratory fitness (CRF) are associated with substantially reduced risk of all-cause mortality within normal weight, overweight, and obese men with diabetes. However, the limited number of deaths prevented cause-specific analyses. PURPOSE Examine the joint association of CRF and body mass index (BMI) with cardiovascular disease (CVD) mortality in men with diabetes. METHODS Participants were 2,513 men (age 50±10 years; BMI 27.8±4.8, range = 18.5–59.5 kg/m2) who received a medical examination during 1970 to 1997. Diabetes was either self-reported physician diagnosis or a fasting plasma glucose >126 mg/dL at baseline. CRF quantified as tertiles of maximal METs estimated from the final speed and grade of a symptom-limited graded treadmill exercise test. BMI categories were defined by NIH clinical guidelines. Mortality surveillance was completed through December 31, 1998. RESULTS A total of 200 CVD deaths occurred during 38,753 man-years of observation with an average follow-up of 15.4 ± 7.7 years. Normal weight men with high CRF were the referent. After adjusting for age & examination year, significantly higher risk of CVD mortality was observed in men with low CRF in each BMI category. Additionally, obese men (BMI ≥ 30 kg/m2) with moderate/high CRF had a significantly lower risk of CVD mortality compared with normal weight (BMI <25 kg/m2) men with lower fitness. CONCLUSION Low CRF is a significant independent predictor of CVD mortality in men with diabetes, irrespective of BMI de fined weight classification. Supported by NIH grants AG06945 and HL6250–04Figure