Non-Vigorous Physical Activity Associated with Reduced Hospitalization Risk with or without Diabetes or Peripheral Artery Disease: Study of Latinos
Sarah K. Alver, Carmen C. Cuthbertson, Kelly R. Evenson, Jennifer A. Schrack, Daniela Sotres-Alvarez, Natasha Z. Anita, Yasmin Mossavar-Rahmani, Linda C. Gallo, Jordan A. Carlson, Matthew Allison, Martha L. Daviglus, Olga Garcia-Bedoya, Christina Cordero, Xiaonan Xue, Jianwen Cai, Kunihiro Matsushita, Robert C. KaplanPurpose:
This study assessed whether greater physical activity (PA) and lesser sedentary behavior (SB) reduce hospitalization risk equally among those with and without prediabetes, diabetes, or peripheral artery disease (PAD).
Methods:
We studied PA, SB and hospitalizations in 12,734 adults from the Hispanic Community Health Study/Study of Latinos, who were 52.2% female with mean (SD) age 41.1 (14.9) years at baseline. Participants reported 10,025 non-pregnancy-related hospitalizations (excluding emergency room only) over 13 years. We modeled the association between accelerometer-measured activity (SB; light/LPA; moderate/MPA; vigorous/VPA) and hospitalization, using Andersen-Gill proportional intensity models, adjusted for demographic, lifestyle, and clinical factors. We tested whether the association differed by baseline diabetes and PAD status: normoglycemia (without diabetes or prediabetes) and no PAD, n=4589; normoglycemia and PAD, n=505; prediabetes and no PAD, n=3987; prediabetes and PAD, n=947; diabetes and no PAD, n=1829; diabetes and PAD, n=877.
Results:
Greater SB and lesser LPA were significantly associated with hospitalization risk in the overall population, with intensity ratios (IR, generalization of hazard ratio) of 1.03 (95% CI 1.00, 1.05) per hour/day SB, and 0.97 (0.95, 1.00) per hour/day LPA. MPA was inversely associated with hospitalization only when comparing the second tertile to the first; IR (95% CI) 0.88 (0.79, 0.98). Categorical VPA results suggest benefit in those with normoglycemia (regardless of PAD) or prediabetes with no PAD. Among those with diabetes, we observed a direct association between VPA and hospitalization in those without PAD and no association in those with PAD.
Conclusions:
Lower risk of hospitalization was associated with lesser SB and greater LPA, while MPA was associated with fewer hospitalizations only when performed for a duration of >8 to ≤22 minutes/day.