European journal of preventive cardiology · 2026
Association of muscle-strengthening and aerobic physical activity with all-cause, cardiovascular disease, and cancer mortality in US adults with diabetes.
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Dai Jin, Dai Wen, Li Wen-Qing
Аннотация
AIMS: The aim of this study was to evaluate associations of muscle-strengthening activity (MSA) with all-cause, cardiovascular disease (CVD), and cancer mortality in adults with diabetes, independent of and jointly with moderate-to-vigorous aerobic physical activity (MVPA).
METHODS AND RESULTS: This prospective cohort study included 29 609 adults with diabetes free of CVD and cancer from the US National Health Interview Survey 1997-2018 (baseline). Muscle-strengthening activity and MVPA were derived from standardized questionnaires. Mortality by 2019 was ascertained through linkage to the National Death Index. Cox models were utilized to estimate adjusted hazard ratios (aHRs). Over 270 178 person-years, 6716 all-cause, 1995 CVD, and 1202 cancer deaths were documented in the study population (mean age, 55.7 years, 51.6% female). There were U-shaped associations of MSA with all-cause mortality risk, with ≤ 3 times/week associated with mortality benefits. Compared with no MSA, aHRs of all-cause mortality were 0.72 (95% confidence interval, 0.47-1.10) for MSA < 1 time/week, 0.58 (0.44-0.77) for 1 time/week, 0.76 (0.61-0.96) for 2 times/week, 0.80 (0.67-0.96) for 3 times/week, 0.97 (0.65-1.47) for 4-6 times/week, and 0.99 (0.83-1.19) for ≥ 7 times/week. Non-linear associations with CVD and cancer mortality were also observed. These associations did not vary by age or sex. Jointly, compared with no MSA and MVPA < 150 min/week, adults performing MSA ≤ 2 times/week and MVPA ≥ 150 min/week had the lowest all-cause and CVD mortality risk.
CONCLUSION: For adults with diabetes, performing MSA ≤ 3 times/week may be associated with lower all-cause, CVD, and cancer mortality risk, independent of MVPA. Jointly performing MSA ≤ 2 times/week and MVPA ≥ 150 min/week may confer the lowest all-cause and CVD mortality risk.
METHODS AND RESULTS: This prospective cohort study included 29 609 adults with diabetes free of CVD and cancer from the US National Health Interview Survey 1997-2018 (baseline). Muscle-strengthening activity and MVPA were derived from standardized questionnaires. Mortality by 2019 was ascertained through linkage to the National Death Index. Cox models were utilized to estimate adjusted hazard ratios (aHRs). Over 270 178 person-years, 6716 all-cause, 1995 CVD, and 1202 cancer deaths were documented in the study population (mean age, 55.7 years, 51.6% female). There were U-shaped associations of MSA with all-cause mortality risk, with ≤ 3 times/week associated with mortality benefits. Compared with no MSA, aHRs of all-cause mortality were 0.72 (95% confidence interval, 0.47-1.10) for MSA < 1 time/week, 0.58 (0.44-0.77) for 1 time/week, 0.76 (0.61-0.96) for 2 times/week, 0.80 (0.67-0.96) for 3 times/week, 0.97 (0.65-1.47) for 4-6 times/week, and 0.99 (0.83-1.19) for ≥ 7 times/week. Non-linear associations with CVD and cancer mortality were also observed. These associations did not vary by age or sex. Jointly, compared with no MSA and MVPA < 150 min/week, adults performing MSA ≤ 2 times/week and MVPA ≥ 150 min/week had the lowest all-cause and CVD mortality risk.
CONCLUSION: For adults with diabetes, performing MSA ≤ 3 times/week may be associated with lower all-cause, CVD, and cancer mortality risk, independent of MVPA. Jointly performing MSA ≤ 2 times/week and MVPA ≥ 150 min/week may confer the lowest all-cause and CVD mortality risk.