title: Changes in physical activity are associated with changes in metabolic cardiovascular risk factors.
abstract: OBJECTIVE
  To investigate the effect of changes in physical activity on changes in metabolic cardiovascular risk factors and to investigate what factors affect the association between physical activity and cardiovascular mortality.
  
  
  METHODS
  Of the 1860 men who were 50 years of age and who were without pre-existing cardiovascular disease participating in a population-based study, 898 were re-examined 20 years later. Altogether 231 died from cardiovascular diseases during the follow-up (mean = 22.6 years). The examinations which the men underwent at 50 and 70 years of age included assessment of physical activity (self-reported at four alternative levels), anthropometry, measurements of fasting concentrations of glucose, specific insulin, proinsulin, split proinsulin and lipids.
  
  
  RESULTS
  During the 20 years, 31 % increased their amount of physical activity while 51 % continued the same amount of exercise. Increased physical activity was associated with significant changes in several important metabolic variables, including fasting glucose, proinsulin and HDL cholesterol, independent of body weight changes. The risk of cardiovascular disease for men performing moderate, regular and athletic physical activity was 25 % (p = 0.127), 34 % (p = 0.022) and 71 % (p = 0.009) lower, respectively, compared with sedentary men. The association was attenuated by adjustment for baseline measurements of insulin, proinsulin and split proinsulin. Additional adjustment for other cardiovascular risk factors did not further attenuate the association.
  
  
  CONCLUSIONS
  Increased leisure time physical activity between the ages of 50 and 70 years, in the absence of active intervention, is associated with improved glucose, insulin and lipid metabolism in men. The concentrations of insulin, proinsulin and split proinsulin could mediate much of the association between a sedentary lifestyle and increased risk of cardiovascular mortality.
authors.affiliation: Section of Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 609, SE-75125 Uppsala, Sweden. liisa.byberg@pubcare.uu.se
authors.forename: L
authors.initials: L
authors.lastname: Byberg
authors.forename: B
authors.initials: B
authors.lastname: Zethelius
authors.forename: P M
authors.initials: PM
authors.lastname: McKeigue
authors.forename: H O
authors.initials: HO
authors.lastname: Lithell
mesh_terms: D000368:Aged; D000886:Anthropometry; D001769:Blood / Q000378:metabolism*; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D015444:Exercise / Q000502:physiology*; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D011384:Proinsulin / Q000097:blood; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D008055:Lipids; D011384:Proinsulin