title: Exercise capacity and body composition as predictors of mortality among men with diabetes.
abstract: OBJECTIVE
  To quantify the relation of fitness to mortality among men with diabetes, adjusted for BMI and within levels of BMI.
  
  
  METHODS
  In this observational cohort study, we calculated all-cause death rates in men with diabetes across quartiles of fitness and BMI categories. Study participants were 2,196 men with diabetes (average age 49.3 years, SD 9.5) who underwent a medical examination, including a maximal exercise test, during 1970 to 1995, with mortality follow-up to 31 December 1996.
  
  
  RESULTS
  We identified 275 deaths during 32,161 person-years of observation. Risk of all-cause mortality was inversely related to fitness. For example, in the fully adjusted model, the risk of mortality was 4.5 (2.6-7.6), 2.8 (1.6-4.7), and 1.6 (0.93-2.76) for the first, second, and third fitness quartiles, respectively, with the fourth quartile (highest fitness level) as the referent (P for trend <0.0001). There was no significant trend across BMI categories for mortality after adjustment for fitness. Similar results were found when the fitness-mortality relation was examined within levels of body composition. In normal-weight men with diabetes, the relative risks of mortality were 6.6 (2.8-15.0), 3.2 (1.4-7.0), and 2.2 (1.1-4.6) for the first, second, and third quartiles of fitness, respectively, as compared with the fourth quartile (P for trend <0.0001). We found similar results in the overweight and obese weight categories.
  
  
  CONCLUSIONS
  There was a steep inverse gradient between fitness and mortality in this cohort of men with documented diabetes, and this association was independent of BMI.
authors.affiliation: The Cooper Institute, Dallas, Texas. Cooper Clinic, Dallas, Texas 75230, USA. tchurch@cooperinst.org
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.forename: Yiling J
authors.initials: YJ
authors.lastname: Cheng
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Earnest
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Barlow
authors.forename: Larry W
authors.initials: LW
authors.lastname: Gibbons
authors.forename: Elisa L
authors.initials: EL
authors.lastname: Priest
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D001794:Blood Pressure; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000401:mortality / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D013997:Time Factors
chemical_list: D002784:Cholesterol