Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults. Issue 1 (18th December 2019)

• Record Type: Journal Article
• Authors: Bennett, Derrick A; Du, Huaidong; Bragg, Fiona; Guo, Yu; Wright, Neil; Yang, Ling; Bian, Zheng; Chen, Yiping; YU, Canqing; Wang, Sisi; Meng, Fanwen; Lv, Jun; Chen, Junshi; Li, Liming; Clarke, Robert; Chen, Zhengming
• Other Names: author non-byline.; Chen Junshi author non-byline.; Chen Zhengming author non-byline.; Clarke Robert author non-byline.; Collins Rory author non-byline.; Guo Yu author non-byline.; Li Liming author non-byline.; Lv Jun author non-byline.; Peto Richard author non-byline.; Walters Robin author non-byline.; Avery Daniel author non-byline.; Bennett Derrick author non-byline.; Boxall Ruth author non-byline.; Bragg Fiona author non-byline.; Chang Yumei author non-byline.; Chen Yiping author non-byline.; Chen Zhengming author non-byline.; Clarke Robert author non-byline.; Du Huaidong author non-byline.; Gilbert Simon author non-byline.; Hacker Alex author non-byline.; Holmes Michael author non-byline.; Kartsonaki Christiana author non-byline.; Kerosi Rene author non-byline.; Lancaster Garry author non-byline.; Lin Kuang author non-byline.; McDonnell John author non-byline.; Millwood Iona author non-byline.; Nie Qunhua author non-byline.; Yao Pang author non-byline.; Ryder Paul author non-byline.; Sansome Sam author non-byline.; Schmidt Dan author non-byline.; Sohoni Rajani author non-byline.; Turnbull Iain author non-byline.; Walters Robin author non-byline.; Wang Lin author non-byline.; Wright Neil author non-byline.; Yang Ling author non-byline.; Yang Xiaoming author non-byline.; Bian Zheng author non-byline.; Guo Yu author non-byline.; Han Xiao author non-byline.; Hou Can author non-byline.; Jing Biao author non-byline.; Liu Chao author non-byline.; Lv Jun author non-byline.; Pei Pei author non-byline.; Tan Yunlong author non-byline.; Yu Canqing author non-byline.; Tang enzhu author non-byline.; Chen Naying author non-byline.; Huang Ying author non-byline.;
• Is Part Of: BMJ open diabetes research and care. Volume 7:Issue 1(2019)
• Publication Date: 2019-12-18
• Subjects: physical activity -- sedentary leisure-time -- adiposity -- type 2 diabetes; Diabetes -- Periodicals; 616.462005
• DOI: 10.1136/bmjdrc-2019-000835
• Languages: English
• ISSNs: 2052-4897

Abstract

Abstract : Objective: Aim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated by adiposity. Research design and methods: The prospective China Kadoorie Biobank recruited ~512 000 adults from 10 diverse areas across China. Self-reported PA was estimated based on type, frequency and duration of specific types of PA, covering four domains (occupation, leisure, household and commuting). SLT was defined as hours per day spent watching television, reading or playing card games. Stratified Cox proportional hazards models were used to estimate adjusted HRs (aHRs) for PA and SLT associated with incident diabetes. Analyses were stratified by age-at-risk (5-year intervals), sex and region and adjusted for household income, education, alcohol consumption, smoking, fresh fruit intake, self-reported general health status, family history of diabetes and body mass index (BMI) status. Analyses of total PA, occupational and non-occupational PA and SLT were mutually adjusted for each other, as appropriate. Results: After ~9 years of follow-up, there were 14 940 incident diabetes cases among 460 736 participants without prior diabetes or cardiovascular diseases at baseline. The mean (SD) age at baseline was 51 (10.6) years, 59% were women and 43% resided in urban areas. Overall, the mean BMI was 23.5 (3.3) kg/m 2, which differed by ~0.5 kg/m 2 among individuals in the highest compared with the lowest PA and SLT groups. PA was inversely associated the risk of diabetes 16% (aHR: 0.84, 95% CI 0.81 to 0.88) lower in top than bottom fifth. After further adjustment for BMI this was attenuated to 0.99 (95% CI 0.98 to 1.00). SLT was positively associated with diabetes and each 1 hour per day higher usual level was associated with aHR of 1.13 (95% CI 1.09 to 1.17) for diabetes, attenuated to 1.05 (95% CI 1.01 to 1.09) after further adjustment for BMI. Conclusions: Among Chinese adults, higher levels of PA and lower levels of SLT were associated with lower risks of diabetes with no evidence of effect modification by each other. These associations appeared to arise mainly through adiposity.