Association between physical activity level and cardiovascular risk factors in adolescents living with type 1 diabetes mellitus: a cross-sectional study

Abstract

Background Type 1 diabetes mellitus (T1DM) is associated with an increased risk for cardiovascular disease (CVD) related morbidity and premature mortality. Regular physical activity plays an important role in the primary and secondary prevention of CVD, improving overall health and wellbeing. Previous observational studies have examined the associations between self-reported physical activity and CVD risk factors in largely adult Caucasian populations. However, limited work has evaluated the relationship between objectively measured physical activity and CVD risk factors in other ethnicities, particularly Chinese youth living with T1DM. Methods This cross-sectional study assessed CVD risk factors, physical activity, and aerobic fitness (and their associations) in Chinese youth living with T1DM (n = 48) and peers (n = 19) without T1DM. Primary outcomes included blood pressure, lipid profiles, and physical activity (accelerometry). Statistical differences between groups were determined with chi-square, independent-samples t-tests, or analysis of covariance. The associations between aerobic fitness, daily physical activity variables, and CVD risk factors were assessed with univariate and multivariate linear regression analyses. Results Results were summarized using means and standard deviation (SD) for normally distributed variables and medians and 25–75th quartile for non-normally distributed variables. In comparison to peers without diabetes, youth living with T1DM showed higher levels of total cholesterol (3.14 ± 0.67 vs. 4.03 ± 0.81 mmol·L-1, p = 0.001), low-density lipoprotein cholesterol (1.74 ± 0.38 vs. 2.31 ± 0.72 mmol·L-1, p = 0.005), and triglycerides (0.60 ± 0.40 vs. 0.89 ± 0.31 mmol·L-1p = 0.012), and lower maximal oxygen power (44.43 ± 8.29 vs. 35.48 ± 8.72 mL·kg-1·min-1, p = 0.003), total physical activity counts (451.01 ± 133.52 vs. 346.87 ± 101.97 counts·min-1, p = 0.004), metabolic equivalents (METs) (2.41 ± 0.60 vs. 2.09 ± 0.41 METs, p = 0.033), moderate-to-vigorous intensity physical activity [MVPA: 89.57 (61.00–124.14) vs (53.19 (35.68–63.16) min, p = 0.001], and the percentage of time spent in MVPA [11.91 (7.74–16.22) vs 8.56 (6.18–10.12) %, p = 0.038]. The level of high-density lipoprotein cholesterol was positively associated with METs (β = 0.29, p = 0.030, model R2 = 0.168), and the level of triglycerides was negatively associated with physical activity counts (β = − 0.001, p = 0.018, model R2 = 0.205) and METs (β = − 0.359, p = 0.015, model R2 = 0.208), and positively associated with time spent in sedentary behaviour (β = 0.002, p = 0.041, model R2 = 0.156) in persons living with T1DM. Conclusions Chinese youth with T1DM, despite their young age and short duration of diabetes, present early signs of CVD risk, as well as low physical activity levels and cardiorespiratory fitness compared to apparently healthy peers without diabetes. Regular physical activity is associated with a beneficial cardiovascular profile in T1DM, including improvements in lipid profile. Thus, physical activity participation should be widely promoted in youth living with T1DM.

Nine-fold higher risk of acute myocardial infarction in subjects with type 1 diabetes compared to controls in Norway 1973–2017

“…In our study, we have followed the participants from diabetes onset, with a longer maximum follow-up and with increased focus on preventative measures focused on CHD and AMI in the last decades, it is notable that there was no observable reduction in CHD or AMI risk the last ten tears. Our findings are in keeping with a recent cross-sectional Chinese study of 48 subjects with type 1 diabetes (age 12–17 years, mean diabetes duration < 4 years) and 19 controls without diabetes [ 28 ]. This study reported higher CVD risk factors (i.e., negative lipid profile and lower physical activity) among subjects with childhood-onset type 1 diabetes compared to their peers without diabetes [ 28 ].…”

“…Our findings are in keeping with a recent cross-sectional Chinese study of 48 subjects with type 1 diabetes (age 12–17 years, mean diabetes duration < 4 years) and 19 controls without diabetes [ 28 ]. This study reported higher CVD risk factors (i.e., negative lipid profile and lower physical activity) among subjects with childhood-onset type 1 diabetes compared to their peers without diabetes [ 28 ]. Higher levels of CVD risk factors, including inflammatory markers, have also been shown in young Norwegian subjects with childhood-onset type 1 diabetes compared to controls [ 29 ].…”

Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes

“…Most of the results are related to sedentary behaviors, such as going to school by car, which likely reflects a generally reduced physical activity that could be underreported. Our results strengthen the importance of empowerment to improve physical activity in youths with T1D to reduce cardiovascular risk [5,83].…”

Higher Body Fat in Children and Adolescents With Type 1 Diabetes–A Systematic Review and Meta-Analysis

“…Two out of the six reports were identified from screening reference lists (citation search) (28,29). The other four reports presented body composition measures as background information (30)(31)(32)(33). They were identified during a literature search related to children with T1D (Figure 1).…”