Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Apr;32(4):623-8.
doi: 10.2337/dc08-1876. Epub 2009 Feb 5.

Exercise capacity and all-cause mortality in African American and Caucasian men with type 2 diabetes

Peter Kokkinos  1 , Jonathan Myers, Eric Nylen, Demosthenes B Panagiotakos, Athanasios Manolis, Andreas Pittaras, Marc R Blackman, Roshney Jacob-Issac, Charles Faselis, Joshua Abella, Steven Singh
Affiliations

Exercise capacity and all-cause mortality in African American and Caucasian men with type 2 diabetes

Peter Kokkinos et al. Diabetes Care. 2009 Apr.

Abstract

Objective: The purpose of this study was to assess the association between exercise capacity and mortality in African Americans and Caucasians with type 2 diabetes and to explore racial differences regarding this relationship.

Research design and methods: African American (n = 1,703; aged 60 +/- 10 years) and Caucasian (n = 1,445; aged 62 +/- 10 years) men with type 2 diabetes completed a maximal exercise test between 1986 and 2007 at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, California. Three fitness categories were established (low-, moderate-, and high-fit) based on peak METs achieved. Subjects were followed for all-cause mortality for 7.3 +/- 4.7 years.

Results: The adjusted mortality risk was 23% higher in African Americans than in Caucasians (hazard ratio 1.23 [95% CI 1.1-1.4]). A graded reduction in mortality risk was noted with increased exercise capacity for both races. There was a significant interaction between race and METs (P < 0.001) and among race and fitness categories (P < 0.001). The association was stronger for Caucasians. Each 1-MET increase in exercise capacity yielded a 19% lower risk for Caucasians and 14% for African Americans (P < 0.001). Similarly, the risk was 43% lower (0.57 [0.44-0.73]) for moderate-fit and 67% lower (0.33 [0.22-0.48]) for high-fit Caucasians. The comparable reductions in African Americans were 34% (0.66 [0.55-0.80]) and 46% (0.54 [0.39-0.73]), respectively.

Conclusions: Exercise capacity is a strong predictor of all-cause mortality in African American and Caucasian men with type 2 diabetes. The exercise capacity-related reduction in mortality appears to be stronger and more graded for Caucasians than for African Americans.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cumulative survival for the entire cohort according to fitness categories.
See this image and copyright information in PMC

References

    1. Kokkinos P, Myers J, Kokkinos JP, Pittaras A, Narayan P, Manolis A, Karasik P, Greenberg M, Papademetriou V, Singh S: Exercise capacity and mortality in black and white men. Circulation 117: 614– 622, 2008 - PubMed
    1. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE: Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 346: 793– 801, 2002 - PubMed
    1. Church TS, Cheng YJ, Earnest CP, Barlow CE, Gibbons LW, Priest EL, Blair SN: Exercise capacity and body composition as predictors of mortality among men with diabetes. Diabetes Care 27: 83– 88, 2004 - PubMed
    1. Church TS, LaMonte MJ, Barlow CE, Blair SN: Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes. Arch Intern Med 165: 2114– 2120, 2005 - PubMed
    1. Wei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN: Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med 132: 605– 611, 2000 - PubMed