Timing of physical activity and cardiovascular and mortality risk in patients with type 2 diabetes: a UK biobank cohort study

Le résumé fourni par la source

Aim: The study aims to explore the relationship between objectively measured physical activity (PA) timing and the cardiovascular disease (CVD) incidence, cardiovascular-specific mortality, and all-cause mortality (ACM) in type 2 diabetes mellitus (T2DM) patients. Methods: Data were obtained from the UK Biobank, a population-based prospective cohort study. From February 2013 to December 2015, the PA of the participants was objectively measured by continuously wearing an accelerometer for 7 days. CVD was defined through the International Classification of Diseases (10th Revision) codes by linking to national hospitalization data. Death data was obtained through the National Health Service Information Center. K-means cluster analysis was used to cluster patients with similar temporal activity patterns. Results: Among 3,143 adults with T2DM (mean age 65.9 years; 62.0% men), followed for a median of 7.82 years, 13.91% developed CVD, 13.53% died from cardiovascular causes, and 9.61% died from any cause. A Cox proportional hazards regression model showed that higher hourly PA was associated with lower CVD and cardiovascular mortality risk, particularly for activity accumulated between 8 am and 4 pm. Lower ACM risk was observed for activity performed throughout the day and evening, whereas elevated early-morning activity, most notably around 3 am, was linked to higher CVD and mortality risk. Cluster analysis identified three PAtiming profiles. Compared with participants exhibiting evenly distributed daytime activity (Cluster 1), those with morning activity peaks at 8-9 am (Cluster 2) or 11-12 am (Cluster 3) had substantially reduced CVD incidence {hazard ratio (HR) 0.449 [95% confidence interval (CI), 0.318-0.634] and 0.493 (95%CI: 0.363-0.670), respectively}. The ACM risk was similarly lower in clusters 2 [HR 0.625 (95%CI: 0.448-0.873)] and 3 [HR 0.548 (95%CI: 0.403-0.746)]. These associations were independent of overall PA intensity. Conclusion: Engaging in PA in the late morning or at noon is associated with a lower risk of CVD and ACM in patients with T2DM. Time-dependent PA interventions may constitute an additional benefit for managing cardiovascular and mortality risks in these patients.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.