Isotemporal Substitution Modeling on Sedentary Behaviors and Physical Activity With Mortality Among People With Different Diabetes Statuses: A Prospective Cohort Study From the National Health and Nutrition Examination Survey Analysis 2007–2018

医学 危险系数 全国健康与营养检查调查 比例危险模型 置信区间 队列研究 糖尿病前期 前瞻性队列研究 人口学 糖尿病 队列 代谢当量 2型糖尿病 老年学 内科学 物理疗法 体力活动 人口 环境卫生 内分泌学 社会学
作者
Zhaojun Chen,Lishan Cai,Qiming Qin,Xiang Li,Shaoyou Lu,Litao Sun,Yang Zhang,Lu Qi,Tao Zhou
出处
期刊:Journal of Physical Activity and Health [Human Kinetics]
卷期号:: 1-9 被引量:1
标识
DOI:10.1123/jpah.2023-0576
摘要

Background : To assess the associations of replacing sedentary behavior with different types of physical activity with mortality among the US adults of varying diabetes statuses. Methods : This prospective cohort study included 21,637 participants (mean age, 48.5 y) from the National Health and Nutrition Examination Survey 2007–2018. Physical activity including leisure-time moderate-vigorous-intensity activity (MVPA), walking/bicycling, worktime MVPA, and sedentary behavior. We conducted an isotemporal substitution analysis using Cox regression to estimate the associations between replacements and mortality risks. Results : We found significant protective associations between replacing 30 minutes per day sedentary behavior with 3 types of physical activity and all-cause, cardiovascular disease (CVD) mortality risk (except worktime MVPA for CVD mortality) among total participants, with hazard ratio (HR; 95% confidence interval [CI]) ranging from 0.86 (0.77–0.95) to 0.96 (0.94–0.98). Among participants with diagnosed diabetes, replacing sedentary behavior with leisure-time MVPA was associated with a lower all-cause mortality risk (HR 0.81, 95% CI, 0.70–0.94), which was also observed in other subgroups, with HRs (95% CI) ranging from 0.87 (0.80–0.94) to 0.89 (0.81–0.99). Among those with prediabetes/undiagnosed diabetes, replacing sedentary behavior with walking/bicycling was associated with lower CVD mortality risk, and replacement to work-time MVPA was associated with lower all-cause and CVD mortality risk, with HRs (95% CI) ranging from 0.72 (0.63–0.83) to 0.96 (0.92–0.99). Conclusions : Replacing sedentary behaviors with 30 minutes per day leisure-time MVPA was associated with lower all-cause mortality, regardless of diabetes statuses. Among people with prediabetes/undiagnosed diabetes, walking/bicycling was additionally associated with lower CVD mortality, and worktime MVPA was associated with lower all-cause and CVD mortality.
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