title: Frequent and intensive physical activity reduces risk of cardiovascular events in type 1 diabetes.
abstract: Cardiovascular disease (CVD) is the most common cause of premature death and disability among patients with type 1 diabetes. Diabetic nephropathy accounts for the increased cardiovascular morbidity and mortality of these patients. We recently showed that the intensity of exercise predicts the incidence and progression of diabetic nephropathy in patients with type 1 diabetes. Little is known about the relationship between physical activity and CVD. Therefore, we studied how physical activity affects the risk of CVD events in patients with type 1 diabetes.
  
  
  
  A 10 year follow-up study including 2180 type 1 diabetes patients from the nationwide multicentre Finnish Diabetic Nephropathy Study (FinnDiane). Leisure time physical activity (LTPA) was assessed by a previously validated self-report questionnaire. A CVD event was defined as a verified myocardial infarction, coronary procedure or stroke. Patients were analysed separately for the risk of developing a first ever CVD event and for the risk of a recurrent CVD event following a baseline event.
  
  
  
  A total of 206 patients had an incident CVD event during follow-up. A higher total LTPA and higher intensity, frequency and duration of activity were associated with a lower risk of incident CVD events. The observed association between exercise frequency and incident CVD remained significant when adjusted for classic risk factors. Exercise intensity also had a borderline effect on the recurrence-free time in patients with a major CVD event at baseline.
  
  
  
  This study suggests that exercise, particularly high frequency and high intensity exercise, may reduce the risk of CVD events in patients with type 1 diabetes.
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Tikkanen-Dolenc
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Johan
authors.initials: J
authors.lastname: Wadén
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.|Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Valma
authors.initials: V
authors.lastname: Harjutsalo
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Thorn
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Saraheimo
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Nina
authors.initials: N
authors.lastname: Elonen
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Milla
authors.initials: M
authors.lastname: Rosengård-Bärlund
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gordin
authors.affiliation: Department of Sports and Exercise Medicine, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland.|Foundation for Sports and Exercise Medicine, Clinic for Sports and Exercise Medicine, Helsinki, Finland.|School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Heikki O
authors.initials: HO
authors.lastname: Tikkanen
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland. per-henrik.groop@helsinki.fi.|Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland. per-henrik.groop@helsinki.fi.|Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. per-henrik.groop@helsinki.fi.|Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. per-henrik.groop@helsinki.fi.
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000628:therapy*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Cardiovascular disease; Exercise; Leisure-time physical activity; Type 1 diabetes