Physical fitness among swedish military conscripts and long-term risk for type 2 diabetes mellitus a cohort study
(2016) In Annals of Internal Medicine 164(9). p.577-584- Abstract
Background: Early-life physical fitness has rarely been examined in relation to type 2 diabetes mellitus (DM) in adulthood because of the lengthy follow-up required. Elucidation of modifiable risk factors at young ages may help facilitate earlier and more effective interventions. Objective: To examine aerobic capacity and muscle strength at age 18 years in relation to risk for type 2 DM in adulthood. Design: National cohort study. Setting: Sweden. Participants: 1 534 425 military conscripts from 1969 to 1997 (97% to 98% of all men aged 18 years nationwide) without prior type 2 DM. Measurements: Aerobic capacity and muscle strength (measured in watts and newtons per kilogram of body weight, respectively) were examined in relation to type... (More)
Background: Early-life physical fitness has rarely been examined in relation to type 2 diabetes mellitus (DM) in adulthood because of the lengthy follow-up required. Elucidation of modifiable risk factors at young ages may help facilitate earlier and more effective interventions. Objective: To examine aerobic capacity and muscle strength at age 18 years in relation to risk for type 2 DM in adulthood. Design: National cohort study. Setting: Sweden. Participants: 1 534 425 military conscripts from 1969 to 1997 (97% to 98% of all men aged 18 years nationwide) without prior type 2 DM. Measurements: Aerobic capacity and muscle strength (measured in watts and newtons per kilogram of body weight, respectively) were examined in relation to type 2 DM identified from outpatient and inpatient diagnoses from 1987 to 2012 (maximum age, 62 years). Results: 34 008 men were diagnosed with type 2 DM in 39.4 million person-years of follow-up. Low aerobic capacity and muscle strength were independently associated with increased risk for type 2 DM. The absolute difference in cumulative incidence of type 2 DM between the lowest and highest tertiles of both aerobic capacity and strength was 0.22% at 20 years of follow-up (95% CI, 0.20% to 0.25%), 0.76% at 30 years (CI, 0.71% to 0.81%), and 3.97% at 40 years (CI, 3.87% to 4.06%). Overall, the combination of low aerobic capacity and muscle strength was associated with a 3-fold risk for type 2 DM(adjusted hazard ratio, 3.07 [CI, 2.88 to 3.27]; P <0.001), with a positive additive interaction (P <0.001). These associations were seen even among men with normal body mass index. Limitation: This cohort did not include women and did not measure physical fitness at older ages. Conclusion: In this large cohort of Swedish male military conscripts, low aerobic capacity and muscle strength at age 18 years were associated with increased long-term risk for type 2 DM, even among those with normal body mass index. Primary Funding Source: National Institutes of Health.
(Less)
- author
- Crump, Casey LU ; Sundquist, Jan LU ; Winkleby, Marilyn A. LU ; Sieh, Weiva and Sundquist, Kristina LU
- organization
- publishing date
- 2016-05-03
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Internal Medicine
- volume
- 164
- issue
- 9
- pages
- 8 pages
- publisher
- American College of Physicians
- external identifiers
-
- pmid:26954518
- wos:000375744000015
- scopus:84982145824
- ISSN
- 0003-4819
- DOI
- 10.7326/M15-2002
- language
- English
- LU publication?
- yes
- id
- 96eb81f1-5848-4f54-b389-2303f0c6943c
- date added to LUP
- 2016-09-02 15:27:01
- date last changed
- 2024-04-19 08:59:51
@article{96eb81f1-5848-4f54-b389-2303f0c6943c,
abstract = {{<p>Background: Early-life physical fitness has rarely been examined in relation to type 2 diabetes mellitus (DM) in adulthood because of the lengthy follow-up required. Elucidation of modifiable risk factors at young ages may help facilitate earlier and more effective interventions. Objective: To examine aerobic capacity and muscle strength at age 18 years in relation to risk for type 2 DM in adulthood. Design: National cohort study. Setting: Sweden. Participants: 1 534 425 military conscripts from 1969 to 1997 (97% to 98% of all men aged 18 years nationwide) without prior type 2 DM. Measurements: Aerobic capacity and muscle strength (measured in watts and newtons per kilogram of body weight, respectively) were examined in relation to type 2 DM identified from outpatient and inpatient diagnoses from 1987 to 2012 (maximum age, 62 years). Results: 34 008 men were diagnosed with type 2 DM in 39.4 million person-years of follow-up. Low aerobic capacity and muscle strength were independently associated with increased risk for type 2 DM. The absolute difference in cumulative incidence of type 2 DM between the lowest and highest tertiles of both aerobic capacity and strength was 0.22% at 20 years of follow-up (95% CI, 0.20% to 0.25%), 0.76% at 30 years (CI, 0.71% to 0.81%), and 3.97% at 40 years (CI, 3.87% to 4.06%). Overall, the combination of low aerobic capacity and muscle strength was associated with a 3-fold risk for type 2 DM(adjusted hazard ratio, 3.07 [CI, 2.88 to 3.27]; P <0.001), with a positive additive interaction (P <0.001). These associations were seen even among men with normal body mass index. Limitation: This cohort did not include women and did not measure physical fitness at older ages. Conclusion: In this large cohort of Swedish male military conscripts, low aerobic capacity and muscle strength at age 18 years were associated with increased long-term risk for type 2 DM, even among those with normal body mass index. Primary Funding Source: National Institutes of Health.</p>}},
author = {{Crump, Casey and Sundquist, Jan and Winkleby, Marilyn A. and Sieh, Weiva and Sundquist, Kristina}},
issn = {{0003-4819}},
language = {{eng}},
month = {{05}},
number = {{9}},
pages = {{577--584}},
publisher = {{American College of Physicians}},
series = {{Annals of Internal Medicine}},
title = {{Physical fitness among swedish military conscripts and long-term risk for type 2 diabetes mellitus a cohort study}},
url = {{http://dx.doi.org/10.7326/M15-2002}},
doi = {{10.7326/M15-2002}},
volume = {{164}},
year = {{2016}},
}