Free-Living Physical Activity Energy Expenditure Is Strongly Related to Glucose Intolerance in Cameroonian Adults Independently of Obesity

Diabetes Care, Feb 2009

OBJECTIVE—We examined the cross-sectional association between objectively measured free-living physical activity energy expenditure (PAEE) and glucose tolerance in adult Cameroonians without known diabetes. RESEARCH DESIGN AND METHODS—PAEE was measured in 34 volunteers using the doubly labeled water method and indirect calorimetry (resting). Fasting blood glucose and 2-h postload blood glucose were measured during a standard 75-g oral glucose tolerance test. RESULTS—There was a significant negative correlation between PAEE and 2-h glucose (r = −0.43; P = 0.01) but not fasting glucose (r = 0.1; P = 0.57). The inverse association between PAEE and 2-h glucose remained after adjustment for age, sex, smoking, alcohol consumption, and BMI (β = −0.017 [95% CI −0.033 to −0.002]) and was unchanged after further adjustment for waist circumference, body fat percentage, or aerobic fitness. CONCLUSIONS—PAEE is inversely associated with 2-h glucose independently of adiposity or fitness. Interventions aimed at increasing PAEE could play an important role in diabetes prevention in developing countries.

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

https://care.diabetesjournals.org/content/32/2/367.full.pdf

Free-Living Physical Activity Energy Expenditure Is Strongly Related to Glucose Intolerance in Cameroonian Adults Independently of Obesity

FELIX K. ASSAH ULF EKELUND PHD SOREN BRAGE PHD JEAN CLAUDE MBANYA PHD NICHOLAS J. WAREHAM PHD C a r d i o v a s c u l a r a n d OBJECTIVE - We examined the cross-sectional association between objectively measured free-living physical activity energy expenditure (PAEE) and glucose tolerance in adult Cameroonians without known diabetes. RESEARCH DESIGN AND METHODS - PAEE was measured in 34 volunteers using the doubly labeled water method and indirect calorimetry (resting). Fasting blood glucose and 2-h postload blood glucose were measured during a standard 75-g oral glucose tolerance test. RESULTS - There was a significant negative correlation between PAEE and 2-h glucose (r 0.43; P 0.01) but not fasting glucose (r 0.1; P 0.57). The inverse association between PAEE and 2-h glucose remained after adjustment for age, sex, smoking, alcohol consumption, and BMI ( 0.017 [95% CI 0.033 to 0.002]) and was unchanged after further adjustment for waist circumference, body fat percentage, or aerobic fitness. CONCLUSIONS - PAEE is inversely associated with 2-h glucose independently of adiposity or fitness. Interventions aimed at increasing PAEE could play an important role in diabetes prevention in developing countries. - D a rapid epidemiologic transition eveloping countries are undergoing characterized by rising prevalence of obesity, diabetes, and cardiovascular diseases (CVDs). Recent changes in diet and physical activity patterns have been suggested as possible risk factors (1). It is important to understand the association between modifiable exposure variables and risk factors for chronic diseases in order to design appropriate intervention strategies. We examined the crosssectional association between physical activity energy expenditure (PAEE) and glucose tolerance in nondiabetic adult Cameroonians. RESEARCH DESIGN AND METHODS A cross-sectional study of 17 men and 17 women recruited from an urban and a rural residential area of Cameroon was conducted. Ethical approval for the study was obtained from the Cameroon National Ethics Committee, and all participants provided signed informed consent. Height and waist circumference were measured using standard clinical procedures. Body weight was measured using an electronic scale (Tanita TBF-531; Tanita U.K., Middlesex, U.K.). Total body water (TBW) was measured by deuterium dilution. Fat-free mass was calculated from TBW, assuming a hydration factor of 73%, and fat mass derived as the difference between body weight and fat-free mass. Resting energy expenditure (REE) was measured using the MedGem handheld indirect calorimeter (HealtheTech Inc., Golden, CO). Total energy expenditure (TEE) was measured by the doubly labeled water (DLW) method. Two baseline urine samples were collected on separate days before the administration of a standard dose of DLW (174 mg/kg body wt of oxygen-18 and 70 mg/kg body wt of deuterium). Postdose urine samples were collected daily for the next 6 days. TEE was calculated using Schoellers estimation of CO2 production, assuming a respiratory quotient of 0.85. PAEE (kJ day1 kg 1) was calculated as 0.9 TEE REE, taking the thermogenic effect of food into account. Aerobic fitness was estimated by linear extrapolation of the individually observed heart-rate response to a standardized step test up to the agepredicted maximum heart rate. Capillary blood glucose was measured after an overnight fast (fasting blood glucose [FBG]) and then 2 h after ingestion of 75 g glucose dissolved in 250 300 ml water (2-h postload blood glucose [2-h BG]). This was done using a HemoCue B-Glucose Analyzer (HemoCue, A ngelholm, Sweden). Statistical analyses were done using STATA (version 10 special edition; StataCorp, College Station, TX). Students t test was used to assess differences in the descriptive variables. Independent associations of PAEE with FBG and 2-h BG were assessed by multiple linear regression analyses. RESULTS The mean SD age of the study participants was 34.5 7.5 years. Body fat was significantly lower in men than in women (18.5 9.3 vs. 34.6 7.2%; P 0.001); however, the difference in BMI was of borderline significance (25.4 3.6 vs. 28.4 5.1 kg/m2; P 0.05). TEE (191.4 55.9 vs. 143 22.6 kJ kg1 day1 ; P 0.002) and PAEE (73.9 49.7 vs. 45.4 17.4 kJ kg1 day 1; P 0.03) were significantly higher in men than in women. There was no difference in mean FBG (4.3 0.7 vs. 4.6 0.6 mmol/l; P 0.21) or 2-h BG (5.9 1.8 vs. 6.3 1.1 mmol/l; P 0.43) between men and women. BMI, waist circumference, and body fat were not significantly correlated with FBG or 2-h BG. PAEE was not significantly correlated with FBG (r 0.11; P 0.53) but inversely correlated with 2-h BG (r 0.43; P 0.011). In unadjusted linear regression analyses (Table 1), PAEE was significantly negatively associated with 2-h BG ( 0.016 [95% CI 0.028 to 0.004]). This association remained largely unchanged when adjusted for age, sex, smoking, and alcohol c (...truncated)


This is a preview of a remote PDF: https://care.diabetesjournals.org/content/32/2/367.full.pdf

Felix K. Assah, Ulf Ekelund, Soren Brage, Jean Claude Mbanya, Nicholas J. Wareham. Free-Living Physical Activity Energy Expenditure Is Strongly Related to Glucose Intolerance in Cameroonian Adults Independently of Obesity, Diabetes Care, 2009, pp. 367-369, 32/2, DOI: 10.2337/dc08-1538