Chen Yijia, Yang Jie, Su Jian, Qin Yu, Shen Chong, Li Ying, Lu Shurong, Pan Enchun, Gao Yan, Miao Dandan, Zhang Ning, Zhou Jinyi, Wu Ming
Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.
Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China.
BMJ Open. 2019 Aug 22;9(8):e027906. doi: 10.1136/bmjopen-2018-027906.
Investigating the association between total physical activity, physical activity in different domains and sedentary time with clustered metabolic risk in patients with type 2 diabetes from Jiangsu province, China.
Interview-based cross-sectional study conducted between December 2013 and January 2014.
44 selected townships across two cities, Changshu and Huai'an, in Jiangsu province.
20 340 participants selected using stratified cluster-randomised sampling and an interviewer-managed questionnaire.
We constructed clustered metabolic risk by summing sex-specific standardised values of waist circumference, fasting triacylglycerol, fasting plasma glucose, systolic blood pressure and the inverse of blood high-density lipoprotein cholesterol (HDL-cholesterol). Self-reported total physical activity included occupation, commuting and leisure-time physical activity. The un-standardised regression coefficient [B] and its 95% CI were calculated using multivariate linear regression analyses.
This study included 17 750 type 2 diabetes patients (aged 21-94 years, 60.3% female). The total (B=-0.080; 95% CI: -0.114 to -0.046), occupational (B=-0.066; 95% CI: -0.101 to- 0.031) and leisure-time physical activity (B=-0.041; 95% CI: -0.075 to -0.007), and sedentary time (B=0.117; 95% CI: 0.083 to 0.151) were associated with clustered metabolic risk. Total physical activity, occupational physical activity and sedentary time were associated with waist circumference, triacylglycerol and HDL-cholesterol, but not with systolic blood pressure. Commuting physical activity and sedentary time were significantly associated with triacylglycerol (B=-0.012; 95% CI: -0.019 to -0.005) and fasting plasma glucose (B=0.008; 95% CI: 0.003 to 0.01), respectively. Leisure-time physical activity was only significantly associated with systolic blood pressure (B=-0.239; 95% CI: -0.542 to- 0.045).
Total, occupational and leisure-time physical activity were inversely associated with clustered metabolic risk, whereas sedentary time increased metabolic risk. Commuting physical activity was inversely associated with triacylglycerol. These findings suggest that increased physical activity in different domains and decreased sedentary time may have protective effects against metabolic risk in type 2 diabetes patients.
研究中国江苏省2型糖尿病患者的总体身体活动、不同领域的身体活动以及久坐时间与代谢综合征风险之间的关联。
2013年12月至2014年1月期间进行的基于访谈的横断面研究。
江苏省常熟和淮安两个城市的44个选定乡镇。
采用分层整群随机抽样和访谈员管理的问卷选取20340名参与者。
我们通过将腰围、空腹三酰甘油、空腹血糖、收缩压以及血液高密度脂蛋白胆固醇（HDL-胆固醇）倒数的性别特异性标准化值相加来构建代谢综合征风险。自我报告的总体身体活动包括职业、通勤和休闲时间的身体活动。使用多元线性回归分析计算未标准化回归系数[B]及其95%置信区间。
本研究纳入了17750例2型糖尿病患者（年龄21 - 94岁，女性占60.3%）。总体身体活动（B = -0.080；95%置信区间：-0.114至-0.046）、职业身体活动（B = -0.066；95%置信区间：-0.101至-0.031）和休闲时间身体活动（B = -0.041；95%置信区间：-0.075至-0.007）以及久坐时间（B = 0.117；95%置信区间：0.083至0.151）均与代谢综合征风险相关。总体身体活动、职业身体活动和久坐时间与腰围、三酰甘油和HDL-胆固醇相关，但与收缩压无关。通勤身体活动和久坐时间分别与三酰甘油（B = -0.012；95%置信区间：-0.019至-0.005）和空腹血糖（B = 0.008；95%置信区间：0.003至0.01）显著相关。休闲时间身体活动仅与收缩压显著相关（B = -0.239；95%置信区间：-0.542至-0.045）。
总体、职业和休闲时间的身体活动与代谢综合征风险呈负相关，而久坐时间会增加代谢风险。通勤身体活动与三酰甘油呈负相关。这些发现表明，增加不同领域的身体活动和减少久坐时间可能对2型糖尿病患者的代谢风险具有保护作用。
