title: Physical activity as a determinant of fasting and 2-h post-challenge glucose: a prospective cohort analysis of the NAVIGATOR trial.
abstract: OBJECTIVE
  To investigate whether previous physical activity levels are associated with blood glucose levels in individuals with impaired glucose tolerance in the context of an international pharmaceutical trial.
  
  
  METHODS
  Data were analysed from the NAVIGATOR trial, which involved 9306 individuals with impaired glucose tolerance and high cardiovascular risk from 40 different countries, recruited in the period 2002-2004. Fasting glucose, 2-h post-challenge glucose and physical activity (pedometer) were assessed annually. A longitudinal regression analysis was used to determine whether physical activity levels 2 years (t-2 ) and 1 year (t-1 ) previously were associated with levels of glucose, after adjusting for previous glucose levels and other patient characteristics. Those participants with four consecutive annual measures of glucose and two consecutive measures of physical activity were included in the analysis.
  
  
  RESULTS
  The analysis included 3964 individuals. Change in physical activity from t-2 to t-1 and activity levels at t-2 were both associated with 2-h glucose levels after adjustment for previous glucose levels and baseline characteristics; however, the associations were weak: a 100% increase in physical activity was associated with a 0.9% reduction in 2-h glucose levels. In addition, previous physical activity only explained an additional 0.05% of the variance in 2-h glucose over the variance explained by the history of 2-h glucose alone (R(2)  = 0.3473 vs. 0.3468). There was no association with fasting glucose.
  
  
  CONCLUSIONS
  In the context of a large international clinical trial, previous physical activity levels did not meaningfully influence glucose levels in those with a high risk of chronic disease, after taking into account participants' previous trajectory of glucose control.
authors.affiliation: NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK.|Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK.
authors.forename: T
authors.initials: T
authors.lastname: Yates
authors.affiliation: NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK.|Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: Department of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Haffner
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Schulte
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Huffman
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.|Durham VA Medical Center, Durham, NC, USA.
authors.forename: C W
authors.initials: CW
authors.lastname: Bales
authors.affiliation: British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: D
authors.initials: D
authors.lastname: Preiss
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Califf
authors.affiliation: Diabetes Trials Unit, University of Oxford, Oxford, UK.
authors.forename: R R
authors.initials: RR
authors.lastname: Holman
authors.affiliation: British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: J J V
authors.initials: JJ
authors.lastname: McMurray
authors.affiliation: Diabetes Trials Unit, University of Oxford, Oxford, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Bethel
authors.affiliation: Centre for Vascular Prevention, Danube University Krems, Krems, Austria.|South Ostrobothnia Central Hospital, Seinajoki, Finland.|King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
authors.forename: W E
authors.initials: WE
authors.lastname: Kraus
mesh_terms: D061725:Accelerometry; D056044:Actigraphy; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases; D015331:Cohort Studies; D003510:Cyclohexanes / Q000627:therapeutic use; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D000077715:Nateglinide; D010649:Phenylalanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D040242:Risk Reduction Behavior; D000068756:Valsartan / Q000627:therapeutic use
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001786:Blood Glucose; D003510:Cyclohexanes; D007004:Hypoglycemic Agents; D000077715:Nateglinide; D010649:Phenylalanine; D000068756:Valsartan