Association of cardiorespiratory fitness, muscle strength with the risk of type 2 diabetes

Takeaway

• Higher cardiorespiratory fitness and muscle strength were associated with a decreased risk for type 2 diabetes (T2D).
• Reduction in risk was linear throughout low-to-high cardiorespiratory fitness levels.

Why this matters

• Clinicians and public health authorities should encourage physical activities enhancing maximal aerobic capacity and/or muscular strength as preventive strategies for T2D.

Study design

• 26 studies evaluating the association between cardiorespiratory fitness (n=15), muscular strength (n=11) and risk for incident T2D met eligibility criteria after a search across electronic databases.
• Funding: None.

Key results

• In adiposity-controlled models including 40,286 incident cases of T2D in 1,601,490 participants, each 1 metabolic equivalent increase in cardiorespiratory fitness was associated with a decreased risk for T2D (relative risk [RR], 0.92; 95% CI, 0.90-0.94; I², 83.1%).
• This association was linear throughout the observed spectrum of cardiorespiratory fitness.
• In adiposity-controlled models including 39,233 cases and 1,713,468 participants, each 1 standard deviation increase in muscular strength was associated with a lower risk for T2D (RR, 0.87; 95% CI, 0.81-0.94; I², 80.5%).
• The hypothetical effect of successful changes in the population distribution of cardiorespiratory fitness among men and women aged 45-64 years varied from 4-21% of new annual cases of T2D that could be prevented.

Limitations

• Heterogeneity among studies.
• Accuracy of applied assumptions may differ across studies.