title: Leisure-time physical activity and development and progression of diabetic nephropathy in type 1 diabetes: the FinnDiane Study.
abstract: OBJECTIVE
  The aim of this study was to assess how physical activity predicts the development and progression of diabetic nephropathy in patients with type 1 diabetes.
  
  
  METHODS
  This prospective study (follow-up time 6.4 ± 3.1 years) included 1,390 patients (48.5% men, mean age 37.0 ± 12.4 years, duration of diabetes 20.4 ± 12.3 years) participating in the nationwide multicentre Finnish Diabetic Nephropathy (FinnDiane) Study. Leisure-time physical activity (LTPA) was assessed using a validated self-report questionnaire. Renal status was defined according to standard clinical cut-off values for urinary AER.
  
  
  RESULTS
  The total amount of LTPA was not associated with progression in renal status. For the intensity of LTPA, however, the 10 year cumulative progression rate was 24.0% (95% CI 18.8, 28.8), 13.5% (95% CI 10.3, 16.6) or 13.1% (95% CI 10.3%, 16.6%; p = 0.01) of the patients with low, moderate or high intensity LTPA. This pattern was similar to that for the development of de novo microalbuminuria. Corresponding progression rates for LTPA frequency of <1, 1-2 or >2 sessions/week was 24.7% (95% CI 18.3, 30.7), 14.7% (95% CI 10.2, 19.0) or 12.6% (95% CI 9.4, 15.7), respectively (p = 0.003).
  
  
  CONCLUSIONS
  This study demonstrates for the first time in a prospective setting the relationship between physical activity and the risk of diabetic nephropathy in patients with type 1 diabetes. The data suggest that physical activity, and in particular its intensity, may have an impact on the initiation and progression of diabetic nephropathy in type 1 diabetes.
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Centre, Helsinki, Finland.
authors: Johan
authors: J
authors: Wadén
authors: Heidi K
authors: HK
authors: Tikkanen
authors: Carol
authors: C
authors: Forsblom
authors: Valma
authors: V
authors: Harjutsalo
authors: Lena M
authors: LM
authors: Thorn
authors: Markku
authors: M
authors: Saraheimo
authors: Nina
authors: N
authors: Tolonen
authors: Milla
authors: M
authors: Rosengård-Bärlund
authors: Daniel
authors: D
authors: Gordin
authors: Heikki O
authors: HO
authors: Tikkanen
authors: Per-Henrik
authors: PH
authors: Groop
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000209:etiology* / Q000503:physiopathology; D018450:Disease Progression; D015444:Exercise / Q000502:physiology*; D005260:Female; D005387:Finland; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
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