title: Cardiorespiratory fitness and incident diabetes: the FIT (Henry Ford ExercIse Testing) project.
abstract: OBJECTIVE
  Prior evidence has linked higher cardiorespiratory fitness with a lower risk of diabetes in ambulatory populations. Using a demographically diverse study sample, we examined the association of fitness with incident diabetes in 46,979 patients from The Henry Ford ExercIse Testing (FIT) Project without diabetes at baseline.
  
  
  METHODS
  Fitness was measured during a clinician-referred treadmill stress test performed between 1991 and 2009. Incident diabetes was defined as a new diagnosis of diabetes on three separate consecutive encounters derived from electronic medical records or administrative claims files. Analyses were performed with Cox proportional hazards models and were adjusted for diabetes risk factors.
  
  
  RESULTS
  The mean age was 53 years with 48% women and 27% black patients. Mean metabolic equivalents (METs) achieved was 9.5 (SD 3.0). During a median follow-up period of 5.2 years (interquartile range 2.6-8.3 years), there were 6,851 new diabetes cases (14.6%). After adjustment, patients achieving ≥12 METs had a 54% lower risk of incident diabetes compared with patients achieving <6 METs (hazard ratio 0.46 [95% CI 0.41, 0.51]; P-trend < 0.001). This relationship was preserved across strata of age, sex, race, obesity, hypertension, and hyperlipidemia.
  
  
  CONCLUSIONS
  These data demonstrate that higher fitness is associated with a lower risk of incident diabetes regardless of demographic characteristics and baseline risk factors. Future studies should examine the association between change in fitness over time and incident diabetes.
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Juraschek
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: Department of Medicine, Henry Ford Hospital, Detroit, MI.
authors.forename: Clinton
authors.initials: C
authors.lastname: Brawner
authors.affiliation: Department of Medicine, Henry Ford Hospital, Detroit, MI Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Waqas
authors.initials: W
authors.lastname: Qureshi
authors.affiliation: Department of Medicine, Henry Ford Hospital, Detroit, MI.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Keteyian
authors.affiliation: Department of Medicine, Henry Ford Hospital, Detroit, MI.
authors.forename: John
authors.initials: J
authors.lastname: Schairer
authors.affiliation: Department of Medicine, Henry Ford Hospital, Detroit, MI.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Ehrman
authors.affiliation: Department of Medicine, Henry Ford Hospital, Detroit, MI mouaz74@gmail.com.
authors.forename: Mouaz H
authors.initials: MH
authors.lastname: Al-Mallah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D010809:Physical Fitness / Q000502:physiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin