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Physical Activity, Obesity Status, and Glycemic Control: The ATTICA Study

Physical Activity, Obesity Status, and Glycemic Control: The ATTICA Study

Conclusion: Our data show that physical activity is a significant factor on insulin sensitivity, whereas increased physical activity may ameliorate the well-known effects of obesity on insulin sensitivity

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The basic metabolic abnormality of both diabetes and obesity is resistance of peripheral tissues to the action of insulin. In populations with genetic susceptibility to diabetes, insulin resistance has been characterized as a precursor of diabetes mellitus.[12] Obesity has been considered a major risk factor for the development of non-insulin-dependent diabetes mellitus. In a cohort of nearly 7000 men with no history of diabetes, the risk after a mean follow-up of 12 yr for those with BMI levels of 25.0-27.9 kg·m-2 was more than double that for those with BMI < 25.0 kg·m-2, and it increased further with increasing BMI.[23] In the same study, weight gain during the follow-up period was associated with a substantial increase in the risk of diabetes, whereas weight loss had the opposite effect. Even though obesity-related insulin resistance may never develop to the typical form of diabetes, the condition itself has been recognized as an independent morbidity risk factor, especially for cardiovascular diseases.[18,20]

Epidemiologic evidence suggests that regular physical activity is a key factor in the prevention or treatment of metabolic diseases. Prospective cohort studies have revealed that relatively high physical activity levels are associated with substantial reductions in the risk of developing non-insulin-dependent diabetes mellitus,[9] latent autoimmune diabetes,[2] and coronary heart disease.[21] In addition, extended clinical trials that incorporated a feasible goal of increased physical activity in individuals with impaired glucose tolerance have reported decreases in the risk of developing diabetes by 46-58% after follow-up evaluations of 3-6 yr.[6,11,15,22]

To the best of our knowledge, few data on the relationship between estimates of insulin resistance and physical activity levels have been presented. One study of 5159 middle-aged men has shown an inverse relationship between physical activity and fasting insulin levels, with those individuals performing vigorous activities having the lowest insulin levels, despite no differences in blood glucose levels among category groups of physical activity.[24] The purpose of the present study was to evaluate the relationship between physical activity status, obesity or overweight, and indices of glycemic control and insulin resistance.
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