Dose–response relationship between physical activity and mortality in adults with noncommunicable diseases: A systematic review and meta-analysis of cohort studies

Geidl, Wolfgang; Schlesinger, Sabrina; Mino, Eriselda; Miranda, Lorena S.; Pfeifer, Klaus

doi:10.1101/2019.12.18.19014340

Cited by 3 publications

(3 citation statements)

References 65 publications

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“…It is clear that the overall goal of exercise in diabetes management is to decrease physical inactivity, exercise and the afore mentioned interventions all decrease physical inactivity. Higher levels of physical activity are associated with lower mortality rates in T2D (Geidl et al, 2020). Finally, we have not addressed adherence and barriers to exercise or the aforementioned interventions.…”

Section: Limitationsmentioning

confidence: 99%

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

et al. 2021

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Diabetes has reached worldwide epidemic proportions, and threatens to be a significant economic burden to both patients and healthcare systems, and an important driver of cardiovascular mortality and morbidity. Improvement in lifestyle interventions (which includes increase in physical activity via exercise) can reduce diabetes and cardiovascular disease mortality and morbidity. Encouraging a population to increase physical activity and exercise is not a simple feat particularly in individuals with co-morbidities (obesity, heart disease, stroke, peripheral vascular disease, and those with cognitive and physical limitations). Translation of the physiological benefits of exercise within that vulnerable population would be an important step for improving physical activity goals and a stopgap measure to exercise. In large part many of the beneficial effects of exercise are due to the introduction of pulsatile shear stress (PSS) to the vascular endothelium. PSS is a well-known stimulus for endothelial homeostasis, and induction of a myriad of pathways which include vasoreactivity, paracrine/endocrine function, fibrinolysis, inflammation, barrier function, and vessel growth and formation. The endothelial cell mediates the balance between vasoconstriction and relaxation via the major vasodilator endothelial derived nitric oxide (eNO). eNO is critical for vasorelaxation, increasing blood flow, and an important signaling molecule that downregulates the inflammatory cascade. A salient feature of diabetes, is endothelial dysfunction which is characterized by a reduction of the bioavailability of vasodilators, particularly nitric oxide (NO). Cellular derangements in diabetes are also related to dysregulation in Ca2+ handling with increased intracellular Ca2+overload, and oxidative stress. PSS increases eNO bioavailability, reduces inflammatory phenotype, decreases intracellular Ca2+ overload, and increases antioxidant capacity. This narrative review and perspective will outline four methods to non-invasively increase PSS; Exercise (the prototype for increasing PSS), Enhanced External Counterpulsation (EECP), Whole Body Vibration (WBV), Passive Simulated Jogging and its predicate device Whole Body Periodic Acceleration, and will discuss current knowledge on their use in diabetes.

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Section: Limitationsmentioning

confidence: 99%

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

et al. 2021

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“…7 Individual and regular physical education reduce mortality in both healthy adults and adults with chronic pulmonary and other diseases. 8 As COPD is not reversible and lung function will not improve, HRQoL is a key, modifiable patient-centered factor for health outcomes. 9 Also, for many VTE patients, impaired HRQoL is an important marker for clinically relevant outcomes such as overall mortality.…”

Section: Vte Copd Physical Activity and Quality Of Lifementioning

confidence: 99%

Apixaban Interacts with Haemoglobin: Effects on Its Plasma Levels

et al. 2018

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The direct oral anticoagulant apixaban (APX), a strong factor Xa inhibitor, binds also to plasma proteins, especially albumin, and minimally to α1-acid glycoprotein. Although APX can cross the red cell membrane, due to its chemical structure, and could bind to haemoglobin (Hb), no investigation was performed on this possible phenomenon that could affect the APX plasma concentration and thus its pharmacokinetics and pharmacodynamics. We addressed this issue by (1) measuring the levels of APX and haematological/biochemical parameters in 90 patients on APX therapy; (2) assessing the effect of APX on oxygen saturation curves of Hb; (3) testing the direct APX binding to Hb by fluorescence spectroscopy and a zinc-induced precipitation of Hb coupled to a reversed-phase high-performance liquid chromatography (HPLC)-based method; and (4) simulating in silico by molecular docking the APX interaction with human Hb. In a multivariable analysis, Hb was the only independent variable significantly and inversely associated in 90 patients with APX peak plasma level, at variance with patients treated with rivaroxaban (n = 86) and dabigatran (n = 34) therapy. APX causes a progressive left-shift of the oxygen dissociation curve of purified Hb solution, with a Kd ≅300 µM. Fluorescence- and HPLC-based assays concordantly showed that APX binds to Hb with a Kd ≅350 µM. Finally, docking simulations showed that APX can fit into in the central cavity of Hb. These findings support the hypothesis that APX does bind to Hb, which, due to its millimolar concentration in blood, can act as ‘buffer’ for the drug and consequently affect its free plasma level.

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“…Studies have demonstrated that a decrease in moderate to vigorous physical activity (MVPA) over a 30-year period is associated with increased odds of developing diabetes (9). Moreover, it has been found that mortality rates in patients with diabetes decrease by approximately 4% for every 10 METs per hour/week increase in physical activity (10). Thus, physical activity in diabetic individuals is a nonpharmacological treatment protecting from major diabetes-related complications (5).…”

Section: Introductionmentioning

confidence: 99%

Exploring the Interplay Between Physical Activity, Dietary Patterns, Diabetes, and All-Cause Mortality in the U.S. Population: A Distributional Data Analysis Perspective.

Carreira-Casais,

Matabuena,

Ghosal

et al. 2023

Preprint

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Purpose A proper physical activity level and a wholesome dietary are pivotal for averting diabetes onset and its clinical complications. There is a scarcity of works comprehensively evaluating the influence of objectively measured physical activity, on the prevalence of diabetes and the incidence of adverse events among persons with diabetes. Aims First, to precisely quantify the association between accelerometer-measured physical activity and diabetes susceptibility within an adult U.S. population. Second, to verify the interplay between physical activity levels, glucose values, and survival among older adults who present the highest mortality risk as consequence of diabetes. Methods This study encompassed a comprehensive cohort of 5011 adults drawn from the 2011–2014 National Health and Nutrition Examination Survey (NHANES). Physical activity (total activity counts) was transformed into distributional representations, and subsequently submitted to cluster analyses. The association of clusters with diabetes and all-cause mortality was analyzed using logistic regression and Cox models, respectively, also accounting for the survey weights and the covariates sex, age, and ethnicity. Results The phenotype with the lower prevalence of diabetes (phenotype 1) spent 5% of the time in moderous to vigourous physical activity, while the other phenotypes had a prevalence of diabetes (phenotype 2) and spent approximately 1–3% in moderous to vigorous physical activity. The susceptibility to diabetes exhibits considerable variability, contingent upon distinct physical activity phenotypes (1 to 4) and pertinent clinical attributes such as age and ethnicity. Between phenotype 1 and phenotype 3, the risk of diabetes mellitus showcases a fluctuation exceeding 114%. In this scenario, these variations are more attributable to the ethnic composition of phenotypes rather than mere disparities in overall physical activity levels. In the context of phenotypes 2 and 3, the dissimilarities are primarily linked to specific profiles of physical activity. In survival analysis, a interplay emerges between patterns of physical activity and the glucose levels of patients, exerting a significant influence on time-to-event analysis. The most sedentary phenotypes contribute to escalated hazard ratios of 14% and 16% in the interaction with the glucose values, thus underscoring their pronounced impact on patient outcomes. Conclusions Using a novel representation of physical activity data and an unbiased data-driven analysis, we identified 4 clusters of physical activity that clearly stratify diabetes and mortality risk.

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Dose–response relationship between physical activity and mortality in adults with noncommunicable diseases: A systematic review and meta-analysis of cohort studies

Cited by 3 publications

References 65 publications

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

Apixaban Interacts with Haemoglobin: Effects on Its Plasma Levels

Exploring the Interplay Between Physical Activity, Dietary Patterns, Diabetes, and All-Cause Mortality in the U.S. Population: A Distributional Data Analysis Perspective.

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