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：

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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事件的关联：OPACH 研究

目的 主要目的是评估每天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的强度和/或节奏是否与糖尿病发病率相关。研究设 395 人患上了糖尿病。臀部佩戴的 ActiGraph GT3X+ 加速度计佩戴 1 周后，可以测量每天的总步数、轻强度和中等到高强度（MV 强度）的步数。使用 Cox 比例风险分析，我们模拟了与每天总、光强度和 MV 强度步骤相关的糖尿病发病风险率的调整变化。我们进一步估计了由 BMI 介导的步数-糖尿病关联的比例。结果平均而言，参与者每天走 3,729 (SD 2,114) 步，其中 1,875 (791) 步是轻强度步，1,854 ± 1,762 步是 MV 强度。每天更多的步数与较低的糖尿病风险率相关。以 2,000 步/天为增量的混杂因素调整模型产生的风险比 (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 没有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) 与糖尿病发病率之间的关系比每天轻强度步数 (HR 0.97 [95% CI 0.73–1.29]; P = 0.84）。结论 这些发现表明，对于老年人，每天更多的步数与较低的糖尿病发病率相关，而 MV 强度步数与较低的糖尿病风险最密切相关。这一证据支持定期踏步是老年人预防 2 型糖尿病的重要风险因素。