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Inactive adults with diabetes at increased risk for MI
Inactive adults with diabetes face more than twice the risk for a first acute myocardial infarction compared with those without diabetes, according to recent findings.
This increase was nullified in people with diabetes who reported a high activity level, and normal body weight also was associated with a lower risk for first acute MI, according to the researchers.
In the prospective study, researchers evaluated 55,534 participants from the HUNT study, a large, population-based health survey conducted in Nord-Trøndelag County in Norway. For the second wave of the study (HUNT2), which took place between 1995 and 1997, researchers invited all inhabitants of this county aged at least 20 years to participate; 70% agreed, completed questionnaires and underwent clinical examinations. From the date of enrollment in HUNT2, participants were followed until they were diagnosed with a first acute MI or until the end of follow-up on Dec. 31, 2008.
For each patient, data on a variety of lifestyle and health-related factors were collected, including medical history, physical activity, smoking status, alcohol consumption and education level achieve. Participants were categorized as normal weight (BMI <25 kg/m2), overweight (BMI 26-29.9 kg/m2) or obese (BMI ≥30 kg/m2). Blood pressure was measured and blood samples were taken and tested for glucose and total cholesterol levels.
The researchers used Cox proportional hazard model to estimate adjusted HRs of first acute MI related to diabetes. A separate analysis evaluated the combined association of physical activity and diabetes and BMI and diabetes, with the risk of acute MI.
Overall, 1,887 acute MIs were identified during the 12.3-year follow-up. Compared with inactive participants without diabetes, inactive participants with diabetes had an HR of 2.37 (95% CI, 1.58-3.57), whereas the highly active group had an HR of 1.04 (95% CI, 0.62-1.74).
Participants with diabetes classified as normal weight had an HR of 1.6 (95% CI, 1.05-2.44) while participants with obesity had an HR of 2.55 (95% CI, 1.97-3.29).
These findings indicated a relative excess risk due to interaction for diabetes and inactivity of 1.43 (95% CI, 0.08-2.78). The excess risk due to interaction for obesity and diabetes was smaller at 0.67 (95% CI, –0.24 to 1.58).
“In conclusion, the results from this prospective cohort study showed that inactive people with diabetes had a more than twofold increased risk of a first [acute] MI when compared with inactive people without diabetes,” the researchers wrote. “This excess risk was canceled out in people with diabetes who reported a high physical activity level. Moreover, a normal body weight was also associated with a moderate or high level of physical activity. The data suggest that leisure-time physical activity and weight maintenance may be effective means for the primary prevention of [acute] MI in people with diabetes.”
Disclosure: The researchers report no relevant financial disclosures.