OBJECTIVE The primary aim was to assess associations between total steps per day and incident diabetes, whereas the secondary aim was to assess whether the intensity and/or cadence of steps is associated with incident diabetes. RESEARCH DESIGN AND METHODS Women without physician-diagnosed diabetes (n = 4,838; mean [SD] age 78.9 [6.7] years) were followed up to 6.9 years; 395 developed diabetes. Hip-worn ActiGraph GT3X+ accelerometers worn for 1 week enabled measures of total, light-intensity, and moderate- to vigorous-intensity (MV-intensity) steps per day. Using Cox proportional hazards analysis we modeled adjusted change in the hazard rate for incident diabetes associated with total, light-intensity, and MV-intensity steps per day. We further estimated the proportion of the steps-diabetes association mediated by BMI. RESULTS On average, participants took 3,729 (SD 2,114) steps/day, of which 1,875 (791) were light-intensity steps and 1,854 ± 1,762 were MV-intensity. More steps per day were associated with a lower hazard rate for incident diabetes. Confounder-adjusted models for a 2,000 steps/day increment yielded hazard ratio (HR) 0.88 (95% CI 0.78–1.00; P = 0.046). After further adjustment for BMI, HR was 0.90 (95% CI 0.80–1.02; P = 0.11). BMI did not significantly mediate the steps-diabetes association (proportion mediated = 17.7% [95% CI −55.0 to 142.0]; P = 0.09]). The relationship between MV-intensity steps per day (HR 0.86 [95% CI 0.74–1.00]; P = 0.04) and incident diabetes was stronger than for light-intensity steps per day (HR 0.97 [95% CI 0.73–1.29]; P = 0.84). CONCLUSIONS These findings suggest that for older adults, more steps per day are associated with lower incident diabetes and MV-intensity steps are most strongly associated with a lower hazard of diabetes. This evidence supports that regular stepping is an important risk factor for type 2 diabetes prevention in older adults.

中文翻译：

---

老年女性前瞻性队列研究中每日步数和步数强度与糖尿病发病率的关联：OPACH 研究


目的 主要目的是评估每日总步数与糖尿病发病率之间的关联，而次要目的是评估步数强度和/或步频是否与糖尿病发病率相关。研究设计和方法 对没有医生诊断为糖尿病的女性（n = 4,838；平均 [SD] 年龄 78.9 [6.7] 岁）进行了长达 6.9 年的随访； 395 人患有糖尿病。佩戴在臀部的 ActiGraph GT3X+ 加速度计佩戴 1 周后，可以测量每天的总步数、轻度强度和中强度到剧烈强度（MV 强度）步数。使用 Cox 比例风险分析，我们模拟了与每天总步数、光强度和 MV 强度相关的糖尿病发病风险率的调整变化。我们进一步估计了 BMI 介导的步数与糖尿病关联的比例。结果 参与者平均每天走 3,729 (SD 2,114) 步，其中 1,875 (791) 步为轻强度步，1,854 ± 1,762 步为中强度步。每天走的步数越多，患糖尿病的风险率就越低。每天增加 2,000 步的混杂因素调整模型得出的风险比 (HR) 为 0.88（95% CI 0.78–1.00；P = 0.046）。进一步调整 BMI 后，HR 为 0.90（95% CI 0.80-1.02；P = 0.11）。 BMI 并未显着介导步数与糖尿病的关联（介导的比例 = 17.7% [95% CI -55.0 至 142.0]；P = 0.09]）。每天 MV 强度步数（HR 0.86 [95% CI 0.74–1.00]；P = 0.04）与糖尿病发病之间的关系强于每天光强度步数（HR 0.97 [95% CI 0.73–1.29]；P = 0.04）。 P = 0.84）。 结论 这些研究结果表明，对于老年人来说，每天走更多的步数与降低糖尿病发病率相关，并且 MV 强度的步数与降低糖尿病风险密切相关。该证据表明，定期行走是预防老年人 2 型糖尿病的重要危险因素。