Sex Differences in Step Count-Blood Pressure Association A Preliminary Study in Type 2 Diabetes 英文参考文献.docVIP

SexDifferencesinStepCount-BloodPressure Association:APreliminaryStudyinType2Diabetes PriyaManjoo1,2,LawrenceJoseph1,LouisePilote1,KaberiDasgupta1* 1Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Canada, 2Department of Medicine, Vancouver Island Health Authority,Victoria,Canada Abstract Background: Walking and cardiovascular mortality are inversely associated in type 2 diabetes, but few studies have objectivelymeasuredassociationsofwalkingwithindividualcardiovascularriskfactors.Suchinformationwouldbeuseful for ‘‘dosing’’ daily steps in clinical practice. This study aimed to quantify decrements in blood pressure and glycated hemoglobin(A1C)per1,000dailystepincrements. Methodology/Principal Findings: Two hundred and one subjects with type 2 diabetes underwent assessments of step counts(pedometer-measured),bloodpressure,A1Candanthropometricparameters.Duetomissingdata,thefinalanalysis wasconductedon83womenand102men,withameanageof60years.Associationsofdailystepswithbloodpressure and A1C were evaluated using sex-specific multivariate linear regression models (adjusted for age, ethnicity, and BMI). Potentialsexdifferenceswereconfirmedinacombinedmodel(womenandmen)withinteractionterms.Meanvaluesfor dailysteps,bloodpressure,A1CandBMIwere5,357steps/day;137/80mmHg;7.7%and30.4kg/m2respectively.A1,000 dailystepincrementamongwomenwasassociatedwitha22.6(95%CI:24.1to21.1)mmHgchangeinsystolicanda 21.4(95%CI:22.2to20.6)mmHgchangeindiastolicbloodpressure.Amongmen,correspondingchangeswere20.7 (95% CI: 22.1 to 0.7) and 20.6 (95% CI: 21.4 to0.3) mm Hg, respectively. Sexdifferences were confirmed in combined models.StepcountsandA1Cdidnotdemonstrateclinicallyimportantassociations. Conclusions/Significance: A 1,000 steps/day increment is associated with important blood pressure decrements among womenwithtype2diabetesbutthedatawereinconclusiveamongmen.Targeted‘‘doseincrements’’of1,000steps/dayin women may lead to measurable blood pressur