Balducci Stefano, D'Errico Valeria, Haxhi Jonida, Sacchetti Massimo, Orlando Giorgio, Cardelli Patrizia, Di Biase Nicolina, Bollanti Lucilla, Conti Francesco, Zanuso Silvano, Nicolucci Antonio, Pugliese Giuseppe
Department of Clinical and Molecular Medicine, ''La Sapienza" University, Rome, Italy.
Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
PLoS One. 2017 Mar 14;12(3):e0173337. doi: 10.1371/journal.pone.0173337. eCollection 2017.
Patients with type 2 diabetes usually show reduced physical activity (PA) and increased sedentary (SED)-time, though to a varying extent, especially for low-intensity PA (LPA), a major determinant of daily energy expenditure that is not accurately captured by questionnaires. This study assessed the level and correlates of PA and SED-time in patients from the Italian Diabetes and Exercise Study_2 (IDES_2).
Three-hundred physically inactive and sedentary patients with type 2 diabetes were enrolled in the IDES_2 to be randomized to an intervention group, receiving theoretical and practical exercise counseling, and a control group, receiving standard care. At baseline, LPA, moderate-to-vigorous-intensity PA (MVPA), and SED-time were measured by accelerometer. Physical fitness and cardiovascular risk factors and scores were also assessed.
LPA was 3.93±1.35 hours∙day-1, MVPA was 12.4±4.6 min∙day-1, and SED-time was 11.6±1.2 hours∙day-1, with a large range of values (0.89-7.11 hours∙day-1, 0.6-21.0 min∙day-1, and 9.14-15.28 hours∙day-1, respectively). At bivariate analysis, LPA and MVPA correlated with better cardiovascular risk profile and fitness parameters, whereas the opposite was observed for SED-time. Likewise, values of LPA, MVPA, and SED-time falling in the best tertile were associated with optimal or acceptable levels of cardiovascular risk factors and scores. At multivariate analysis, age, female gender, HbA1c, BMI or waist circumference, and high-sensitivity C reactive protein (for LPA and SED-time only) were negatively associated with LPA and MPA and positively associated with SED-time in an independent manner.
Physically inactive and sedentary patients with type 2 diabetes from the IDES_2 show a low level of PA, though values of LPA, MVPA, and SED-time vary largely. Furthermore, there is a strong correlation of these measures with glycemic control, adiposity and inflammation, thus suggesting that even small improvements in LPA, MVPA, and SED-time might be associated with significant improvement in cardiovascular risk profile.
ClinicalTrials.gov NCT01600937.
2型糖尿病患者通常体力活动（PA）减少，久坐（SED）时间增加，不过程度各异，尤其是低强度PA（LPA），这是日常能量消耗的主要决定因素，问卷调查无法准确获取。本研究评估了意大利糖尿病与运动研究_2（IDES_2）中患者的PA水平及其相关因素和SED时间。
300名缺乏体力活动且久坐的2型糖尿病患者纳入IDES_2，随机分为干预组（接受理论和实践运动咨询）和对照组（接受标准护理）。在基线时，通过加速度计测量LPA、中度至剧烈强度PA（MVPA）和SED时间。还评估了身体素质、心血管危险因素及评分。
LPA为3.93±1.35小时·天⁻¹，MVPA为12.4±4.6分钟·天⁻¹，SED时间为11.6±1.2小时·天⁻¹，数值范围很大（分别为0.89 - 7.11小时·天⁻¹、0.6 - 21.0分钟·天⁻¹和9.14 - 15.28小时·天⁻¹）。在双变量分析中，LPA和MVPA与更好的心血管风险状况及身体素质参数相关，而SED时间则相反。同样，LPA、MVPA和SED时间处于最佳三分位数的值与心血管危险因素及评分的最佳或可接受水平相关。在多变量分析中，年龄、女性性别、糖化血红蛋白、体重指数或腰围以及高敏C反应蛋白（仅针对LPA和SED时间）以独立方式与LPA和MPA呈负相关，与SED时间呈正相关。
IDES_2中缺乏体力活动且久坐的2型糖尿病患者PA水平较低，不过LPA、MVPA和SED时间的值差异很大。此外，这些指标与血糖控制、肥胖和炎症密切相关，因此表明即使LPA、MVPA和SED时间有小的改善也可能与心血管风险状况的显著改善相关。
ClinicalTrials.gov NCT01600937。
