We used Cox proportional hazards models to estimate the hazard ratios (HRs) of the incidence of type 2 diabetes. We first compared baseline characteristics of participants according to quartiles of the fitness trend using one-way ANOVA for continuous variables and a χ 2 test for categorical variables as appropriate. This study was thus designed to investigate the relationship between long-term trends in fitness and the incidence of type 2 diabetes using a cohort study design among nondiabetic Japanese men. No data are available from individuals at usual risk. Several randomized controlled trials of lifestyle, including physical activity, healthful diet, and weight reduction, in relation to type 2 diabetes over a period of years, have shown that such lifestyle changes decrease the incidence of developing type 2 diabetes among individuals with impaired glucose tolerance ( 8, – 10). There are no data on long-term trends in activity or fitness as they relate to the risk of developing type 2 diabetes. However, these studies considered only once or twice measures of fitness level at baseline as the exposure. Previous cohort studies also have shown a strong inverse relationship between cardiorespiratory fitness and the incidence of type 2 diabetes ( 4,, – 7). It is well known that physical inactivity is one of the primary causes of type 2 diabetes ( 2, 3). Institutional Subscriptions and Site Licenses.Special Edition Series: Disrupting Therapeutic Inertia in Diabetes Management.Special Edition: SGLT2 Inhibitors and Diabetic Kidney Disease.
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