Prognostic value of exercise capacity in incident diabetes: a country with high prevalence of diabetes

BMC Endocrine Disorders

Research

Husam I. Ardah¹  Mouaz H. Al-Mallah²  Amjad M. Ahmed³  Abdelrahman A. Jamiel³ 

[1] Department of Biostatistics and bioinformatics, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia;Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia;Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA;Houston Methodist Academic Institute, Houston, TX, USA;King Abdulaziz Cardiac Center - Adult Cardiology, King Abdulaziz Medical City for National Guard, 1413 P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia;King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia;King Saud bin Abdulaziz University for Health Specialties, Riyadh, Saudi Arabia;

关键词: Incident Diabetes;    Exercise Capacity;    Metabolic equivalent of tasks (METs);    Net reclassification index;    Predictive modeling;   

DOI  :  10.1186/s12902-022-01174-5

 received in 2021-12-15, accepted in 2022-08-30,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundDiabetes Mellitus (DM) is a fast-growing health problem that imposes an enormous economic burden. Several studies demonstrated the association between physical inactivity and predicting the incidence of diabetes. However, these prediction models have limited validation locally. Therefore, we aim to explore the predictive value of exercise capacity in the incidence of diabetes within a high diabetes prevalence population.MethodologyA retrospective cohort study including consecutive patients free of diabetes who underwent clinically indicated treadmill stress testing. Diabetic patients at baseline or patients younger than 18 years of age were excluded. Incident diabetes was defined as an established clinical diagnosis post-exercise testing date. The predictive value of exercise capacity was examined using Harrell’s c-index, net reclassification index (NRI), and integrated discrimination index (IDI).ResultsA total of 8,722 participants (mean age 46 ± 12 years, 66.3% were men) were free of diabetes at baseline. Over a median follow-up period of 5.24 (2.17–8.78) years, there were 2,280 (≈ 26%) new cases of diabetes. In a multivariate model adjusted for conventional risk factors, we found a 12% reduction in the risk of incident diabetes for each METs achieved (HR, 0.9; 95% CI, 0.88–0.92; P < 0.001). Using Cox regression, exercise capacity improved the prediction ability beyond the conventional risk factors (AUC = 0.62 to 0.66 and c-index = 0.62 to 0.68).ConclusionExercise capacity improved the overall predictability of diabetes. Patients with reduced exercise capacity are at high risk for developing incidence diabetes. Improvement of both physical activity and functional capacity represents a preventive measure for the general population.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 3

13690_2022_1011_Article_IEq2.gif

Fig. 1