Barone Gibbs Bethany, Pettee Gabriel Kelley, Reis Jared P, Jakicic John M, Carnethon Mercedes R, Sternfeld Barbara
Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health Austin Regional Campus, Austin, TX.
Diabetes Care. 2015 Oct;38(10):1835-43. doi: 10.2337/dc15-0226. Epub 2015 Jul 8.
Prolonged sedentary time (ST) might be contributing to the diabetes epidemic, but most studies have been cross-sectional and few have objectively measured ST. The purpose of this study was to evaluate cross-sectional and 5-year longitudinal relationships between ST and metabolic parameters and outcomes.
This was an analysis of 2,027 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (aged 38-50 years, 57% female, and mean BMI of 29.0 ± 7.0 kg/m(2)) with accelerometry data (≥4 days with ≥10 h/day) measured at the year 20 follow-up exam (2005-2006). Metabolic variables (fasting glucose, fasting insulin, 2-h postchallenge glucose, HOMA of insulin resistance [HOMA-IR], and HbA1c) and outcomes (impaired fasting glucose [IFG], impaired glucose tolerance [IGT], prediabetes by HbA1c, and diabetes) were assessed concurrently and 5 years later.
Average ST was 8.1 ± 1.7 h/day or 55 ± 10% of wear time. Each additional hour per day of ST was cross-sectionally associated with a 3% higher fasting insulin and HOMA-IR (both P < 0.01) but not 5-year changes in metabolic parameters. Having ≥10 h/day vs. <6 h/day of ST was associated with an odds ratio (OR) = 2.74 (95% CI 1.13, 6.62) for IGT and an OR = 3.80 (95% CI 1.39, 10.35) for diabetes. ST was not associated with prevalent IFG, prevalent prediabetes by HbA1c, or 5-year incidence of any metabolic outcomes (all P > 0.05).
ST was independently related to insulin, HOMA-IR, and prevalent diabetes and IGT but did not predict 5-year changes in metabolic parameters or incidence of metabolic outcomes. These results suggest that higher ST may not be a risk factor for future metabolic outcomes, but more research with repeated ST measurement and longer follow-up is needed.
久坐时间延长可能是导致糖尿病流行的原因之一,但大多数研究都是横断面研究,很少有研究客观地测量久坐时间。本研究的目的是评估久坐时间与代谢参数及结局之间的横断面关系和5年纵向关系。
这是一项对2027名青年成人冠状动脉风险发展研究(CARDIA)参与者(年龄38 - 50岁,57%为女性,平均BMI为29.0±7.0kg/m²)的分析,这些参与者在第20次随访检查(2005 - 2006年)时有加速度计数据(≥4天,每天≥10小时)。同时评估代谢变量(空腹血糖、空腹胰岛素、餐后2小时血糖、胰岛素抵抗的稳态模型评估[HOMA - IR]和糖化血红蛋白)和结局(空腹血糖受损[IFG]、糖耐量受损[IGT]、糖化血红蛋白定义的糖尿病前期和糖尿病),并在5年后再次评估。
平均久坐时间为8.1±1.7小时/天,占佩戴时间的55±10%。每天久坐时间每增加1小时,横断面分析显示空腹胰岛素和HOMA - IR分别升高3%(均P<0.01),但与代谢参数的5年变化无关。与每天久坐时间<6小时相比,每天久坐时间≥10小时与IGT的比值比(OR) = 2.74(95%CI 1.13,6.62)以及糖尿病的OR = 3.80(95%CI 1.39,10.35)相关。久坐时间与现患IFG、糖化血红蛋白定义的现患糖尿病前期或任何代谢结局的5年发病率均无关(所有P>0.05)。
久坐时间与胰岛素、HOMA - IR以及现患糖尿病和IGT独立相关,但不能预测代谢参数的5年变化或代谢结局的发病率。这些结果表明,较长的久坐时间可能不是未来代谢结局的危险因素,但需要更多重复测量久坐时间和更长随访时间的研究。