Non-Vigorous Physical Activity Associated with Reduced Hospitalization Risk with or without Diabetes or Peripheral Artery Disease: Study of Latinos.

Abstract

This study assessed whether greater physical activity (PA) and lesser sedentary behavior (SB) reduce hospitalization risk equally among those with and without prediabetes, diabetes, or peripheral artery disease (PAD). We studied PA, SB and hospitalizations in 12,734 adults from the Hispanic Community Health Study/Study of Latinos, who were 52.2% female with mean (standard deviation) age 41.1 (14.9) yr at baseline. Participants reported 10,025 nonpregnancy-related hospitalizations (excluding emergency room only) over 13 yr. We modeled the association between accelerometer-measured activity (SB; light intensity physical activity [LPA]; moderate physical activity [MPA]; vigorous physical activity [VPA]) and hospitalization, using Andersen-Gill proportional intensity models, adjusted for demographic, lifestyle, and clinical factors. We tested whether the association differed by baseline diabetes and PAD status: normoglycemia (without diabetes or prediabetes) and no PAD, n = 4589; normoglycemia and PAD, n = 505; prediabetes and no PAD, n = 3987; prediabetes and PAD, n = 947; diabetes and no PAD, n = 1829; diabetes and PAD, n = 877. Greater SB and lesser LPA were significantly associated with hospitalization risk in the overall population, with intensity ratios (generalization of hazard ratio) of 1.03 (95% confidence interval 1.00, 1.05)·per h/d SB, and 0.97 (0.95, 1.00)·per h/d LPA. MPA was inversely associated with hospitalization only when comparing the second tertile to the first; intensity ratio (95% confidence interval) 0.88 (0.79, 0.98). Categorical VPA results suggest benefit in those with normoglycemia (regardless of PAD) or prediabetes with no PAD. Among those with diabetes, we observed a direct association between VPA and hospitalization in those without PAD and no association in those with PAD. Lower risk of hospitalization was associated with lesser SB and greater LPA, while MPA was associated with fewer hospitalizations only when performed for a duration of >8-≤22 min·d -1 .