The Association Between Cardiorespiratory Fitness and Risk of All-Cause Mortality Among Women With Impaired Fasting Glucose or Undiagnosed Diabetes Mellitus

Lyerly, G. William; Xuemei Sui; Lavie, Carl J.; Church, Timothy S.; Hand, Gregory A.; Blair, Steven N.
September 2009
Mayo Clinic Proceedings;Sep2009, Vol. 84 Issue 9, p780
Academic Journal
OBJECTIVE: To evaluate the Independent and Joint associations among cardiorespiratory fitness (CRF), body mass index, and risk of mortality from any cause among women with impaired fasting glucose (IFG) or undiagnosed diabetes mellitus (DM). PATIENTS AND METHODS: Female patients (N=3044; mean age, 47.4 years) with IFG or undiagnosed DM completed a maximal exercise treadmill test (between January 26, 1971, and March 21, 2001). The women had no history of a cardiovascular disease event or diagnosed DM at baseline. Cardiorespiratory fitness was defined categorically as low (bottom 20%), moderate (middle 40%), or high (upper 40%) according to previously published Aerobics Center Longitudinal Study guidelines. Body mass index was calculated as the weight in kilograms divided by the height in meters squared (kg/m²). RESULTS: During a 16-year follow-up period, 171 deaths occurred. There was an inverse association between CRF and all-cause mortality risk. Women with moderate or high CRF were at lower risk of mortality (moderate CRF, 35% lower; high CRF, 36% lower; Ptrend=°3) than those with low CRF. An exercise capacity lower than 7 metabolic equivalents was associated with a 1.5-fold higher risk of death than an exercise capacity of 9 metabolic equivalents or higher (Ptrend=-.05). The multivariate adjusted hazard ratios (HR8), including adjustments for CRF, were higher for heavier patients than for patients of normal weight (overweight patients: HR, 0.86; 95% confidence interval, 0.57-1.30; obese patients: HR, 1.19; 95% confidence interval, 0.70-2.03; Ptrend=84)- Combined analyses showed that women who were overweight or obese and unfit (low CRF) were at more than twice the risk of death than women who were of normal weight and fit (moderate or high CRF). CONCLUSION: Cardiorespiratory fitness, not body mass index, is a significant predictor of all-cause mortality among women with IFG or undiagnosed DM. Assessing CRF levels provides important prognostic information independent of traditional risk factors.


Related Articles

  • Associations of Cardiorespiratory Fitness and Obesity With Risks of impaired Fasting Glucose and Type 2 Diabetes in Men. Lee, Duck-Chul; Xuemei Sui; Church, Timothy S.; I.-Min Lee; Blair, Steven N. // Diabetes Care;Feb2009, Vol. 32 Issue 2, p257 

    OBJECTIVE -- The purpose of this study was to examine the associations of cardiorespiratory fitness (hereafter fitness) and various obesity measures with risks of incident impaired fasting glucose (IFG) and type 2 diabetes. RESEARCH DESIGN AND METHODS -- This was a prospective cohort study of...

  • Could Thinner be Worse for Newly Diagnosed Diabetics?  // Neurology Alert;Oct2012 Clinical Briefs in Primary Care, p20 

    The article discusses the results of a 2012 study which showed that newly diagnosed diabetics with low to normal body mass index (BMI) have a higher mortality risk than obese or overweight diabetics.

  • Insulin Administration and Rate of Glucose Appearance in People With Type 1 Diabetes. Pennant, Mary E.; Block, Leslie J. C.; Marcovecchio, M. Loredana; Salgin, Burak; Hovorka, Roman; Dunger, David B. // Diabetes Care;Nov2008, Vol. 31 Issue 11, p2183 

    OBJECTIVE -- To assess whether prandial insulin, in addition to basal insulin, has an effect on the rate of glucose appearance from a meal in people with type 1 diabetes. RESEARCH DESIGN AND METHODS -- The rate of glucose appearance from a mixed meal (Ra[sub meal]) was investigated in six adult...

  • Associations of the FTO rs9939609 and the MC4R rs17782313 polymorphisms with type 2 diabetes are modulated by diet, being higher when adherence to the Mediterranean diet pattern is low. Ortega-Azorín, Carolina; Sorlí, Jose V.; Asensio, Eva M.; Coltell, Oscar; Martínez-González, Miguel Ángel; Salas-Salvadó, Jordi; Covas, Maria-Isabel; Arós, Fernando; Lapetra, José; Serra-Majem, Lluís; Gómez-Gracia, Enrique; Fiol, Miquel; Sáez-Tormo, Guillermo; Pintó, Xavier; Muñoz, Miguel Angel; Ros, Emilio; Ordovás, Jose M.; Estruch, Ramon; Corella, Dolores // Cardiovascular Diabetology;2012, Vol. 11 Issue 1, p137 

    Background: Although the Fat Mass and Obesity (FTO) and Melanocortin-4 Receptor (MC4R) genes have been consistently associated with obesity risk, the association between the obesity-risk alleles with type 2 diabetes is still controversial. In some recent meta-analyses in which significant...

  • Could Thinner be Worse for Newly Diagnosed Diabetics? Kuritzky, Louis // Infectious Disease Alert;Oct2012 Clinical Briefs in Primary Care, p20 

    The article discusses research by M. R. Carnethon and colleagues, published in a 2012 issue of the "Journal of the American Medical Association" (JAMA) on the relationship between mortality and body mass index (BMI) for persons with newly diagnosed diabetes.

  • Awareness and attitude toward diabetes in the rural population of Arunachal Pradesh, Northeast India. Singh, Ashita; Milton, Pratibha E.; Nanaiah, Amrit; Samuel, Prasanna; Thomas, Nihal // Indian Journal of Endocrinology & Metabolism;Mar2012 Supplement, p83 

    Background: India has the largest number of patients with diabetes in the world, accounting for more than 50 million subjects. There are limited studies on diabetes awareness, attitude, and prevalence in rural communities, especially in the northeastern part of India. Materials and Methods: A...

  • A Prospective Study of Cardiorespiratory Fitness and Risk of Type 2 Diabetes in Women. Sui, Xuemei; Hooker, Steven P.; Lee, I-Min; Church, Timothy S.; Colabianchi, Natalie; Lee, Chong-Do; Blair, Steven N. // Diabetes Care;Mar2008, Vol. 31 Issue 3, p550 

    OBJECTIVE -- The purpose of this study was to determine the independent and joint associations of cardiorespiratory fitness (CRF) and BMI with the incidence of type 2 diabetes in women. RESEARCH DESIGN AND METHODS -- An observational cohort of 6,249 women aged 20-79 years was free of baseline...

  • BMI and cardiorespiratory fitness predicted mortality in older adults. Sui, X. // Evidence Based Medicine;Jun2008, Vol. 13 Issue 3, p90 

    STUDY QUESTION In older adults, do measures of adiposity and cardiorespiratory fitness predict mortality? STUDY DESIGN Design: prospective cohort study with mean follow-up of 12 years. Setting: healthcare clinic in Dallas, Texas, USA. Patients: 2603 people ⩾60 years of age (mean 64 y, 80%...

  • Exercise - easiest option does trick. Targett, Steve // New Zealand Doctor;2/29/2012, p23 

    The article discusses the health benefits of exercise, with evidence from the Internet video "23 and a Half Hours: What Is the Single Best Thing We Can Do for Our Health?" and a study on the impact of changes in fitness levels and body mass index (BMI). The video suggested doing exercises for 30...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics