Diaz Keith M, Goldsmith Jeff, Greenlee Heather, Strizich Garrett, Qi Qibin, Mossavar-Rahmani Yasmin, Vidot Denise C, Buelna Christina, Brintz Carrie E, Elfassy Tali, Gallo Linda C, Daviglus Martha L, Sotres-Alvarez Daniela, Kaplan Robert C
From Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D.); Department of Biostatistics (J.G.) and Department of Epidemiology (H.G.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (G.S., Q.Q., Y.M.-R., R.C.K.); Department of Psychology, University of Miami, Coral Gables, FL (D.C.V., C.E.B.); South Bay Latino Research Center, Graduate School of Public Health (C.B.), and Department of Psychology (L.C.G.), San Diego State University, CA; Department of Epidemiology & Public Health, University of Miami, FL (T.E.); Institute for Minority Health Research, University of Illinois at Chicago (M.L.D.); and Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (D.S.-A.).
Circulation. 2017 Oct 10;136(15):1362-1373. doi: 10.1161/CIRCULATIONAHA.116.026858. Epub 2017 Aug 23.
Excessive sedentary time is ubiquitous in developed nations and is associated with deleterious health outcomes. Few studies have examined whether the manner in which sedentary time is accrued (in short or long bouts) carries any clinical relevance. The purpose of this study was to examine the association of prolonged, uninterrupted sedentary behavior with glycemic biomarkers in a cohort of US Hispanic/Latino adults.
We studied 12 083 participants from the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), a population-based study of Hispanic/Latino adults 18 to 74 years of age. Homeostatic model assessment of insulin resistance and glycosylated hemoglobin were measured from a fasting blood sample, and 2-hour glucose was measured after an oral glucose tolerance test. Sedentary time was objectively measured with a hip-mounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length.
After adjustment for potential confounders and moderate to vigorous physical activity, longer sedentary bout duration was dose-dependently associated with increased homeostatic model assessment of insulin resistance ( for trend<0.001) and 2-hour glucose levels ( for trend=0.015). These associations were not independent of total sedentary time; however, a significant interaction between sedentary bout duration and total sedentary time was observed. Evaluation of the joint association of total sedentary time and sedentary bout duration showed that participants in the upper quartile for both sedentary characteristics (ie, high total sedentary time and high sedentary bout duration) had the highest levels of homeostatic model assessment of insulin resistance (<0.001 versus low group for both sedentary characteristics) and 2-hour glucose (=0.002 versus low group for both sedentary characteristics). High total sedentary time or high sedentary bout duration alone were not associated with differences in any glycemic biomarkers.
Accruing sedentary time in prolonged, uninterrupted bouts may be deleteriously associated with biomarkers of glucose regulation.
久坐时间过长在发达国家普遍存在，且与有害健康的后果相关。很少有研究探讨久坐时间的累积方式（短时间或长时间）是否具有任何临床意义。本研究的目的是在一组美国西班牙裔/拉丁裔成年人中，研究长时间不间断的久坐行为与血糖生物标志物之间的关联。
我们对来自HCHS/SOL（西班牙裔社区健康研究/拉丁裔研究）的12083名参与者进行了研究，这是一项针对18至74岁西班牙裔/拉丁裔成年人的基于人群的研究。通过空腹血样测量胰岛素抵抗的稳态模型评估和糖化血红蛋白，并在口服葡萄糖耐量试验后测量2小时血糖。使用佩戴在髋部的加速度计客观测量久坐时间。长时间不间断的久坐以平均久坐时长表示。
在对潜在混杂因素和中度至剧烈身体活动进行调整后，久坐时长越长与胰岛素抵抗稳态模型评估增加（趋势<0.001）和2小时血糖水平增加（趋势=0.015）呈剂量依赖性相关。这些关联并非独立于总久坐时间；然而，观察到久坐时长与总久坐时间之间存在显著交互作用。对总久坐时间和久坐时长的联合关联进行评估表明，在久坐特征方面处于上四分位数的参与者（即高总久坐时间和高久坐时长）的胰岛素抵抗稳态模型评估水平最高（两种久坐特征的低分组相比，<0.001），2小时血糖水平也最高（两种久坐特征的低分组相比，=0.002）。单独的高总久坐时间或高久坐时长与任何血糖生物标志物的差异均无关联。
长时间不间断地累积久坐时间可能与葡萄糖调节生物标志物存在有害关联。
