title: Leisure-time physical activity and type 2 diabetes during a 28 year follow-up in twins.
abstract: OBJECTIVE
  The study aimed to investigate whether baseline physical activity protects against the occurrence of type 2 diabetes during a 28 year follow-up, after controlling for childhood environment and genetic predisposition.
  
  
  METHODS
  At baseline in 1975 same-sex twin pairs born in Finland before 1958 were sent a questionnaire including questions on physical activity. The participants (20,487 individuals, including 8,182 complete twin pairs) were divided into quintiles by leisure-time physical activity metabolic equivalent (MET) index (MET h/day). Type 2 diabetes was determined from nationwide registers for the follow-up period (1 January 1976-31 December 2004). Individual and pairwise Cox proportional hazard models were used.
  
  
  RESULTS
  During follow-up, 1,082 type 2 diabetes cases were observed. Among all individuals, participants in MET quintiles (Q) III-V had significantly decreased risk for type 2 diabetes compared with sedentary individuals (QI). The pairwise analysis on pairs discordant for physical activity showed that participants in MET QII to V had significantly lower hazard ratios (0.61, 0.59, 0.61, 0.61) compared with sedentary participants. These findings from the pairwise analysis persisted after adjusting for BMI. In the pairwise analysis, the BMI-adjusted hazard ratio for type 2 diabetes was lower for physically active members of twin pairs (combined QII-V) than for inactive co-twins (HR 0.54; 95% CI 0.37-0.78). Similar results were obtained for both dizygotic and monozygotic pairs, as well as for the subgroup of twin pairs defined as free of co-morbidities in 1981 (HR 0.36; 95% CI 0.17-0.76).
  
  
  CONCLUSIONS
  Leisure-time physical activity protects from type 2 diabetes after taking familial and genetic effects into account.
authors: Department of Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyväskylä, Finland. katja.waller@jyu.fi
authors: K
authors: K
authors: Waller
authors: J
authors: J
authors: Kaprio
authors: M
authors: M
authors: Lehtovirta
authors: K
authors: K
authors: Silventoinen
authors: M
authors: M
authors: Koskenvuo
authors: U M
authors: UM
authors: Kujala
mesh_terms: D000328:Adult; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D057185:Sedentary Behavior; D013997:Time Factors; D014427:Twins; D055815:Young Adult