Li Xiang, Zhou Tao, Ma Hao, Liang Zhaoxia, Fonseca Vivian A, Qi Lu
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, LA.
Department of Epidemiology and Biostatistics, School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, Guangdong, China.
Diabetes Care. 2021 Jun 28;44(10):2403-10. doi: 10.2337/dc21-0455.
To prospectively analyze the association of sedentary behavior time with type 2 diabetes (T2D) risk and perform the isotemporal substitution analyses to estimate the effect of substitution of sedentary behaviors by equal time of different types of daily-life physical activities and structured exercise. We also examined modifications by the genetic predisposition to T2D.
We included 475,502 participants free of T2D in the UK Biobank. Sedentary time was quantified by summing up the time spent on television watching, computer use, and driving.
During a median follow-up of 11 years, we documented 18,169 incident T2D cases. In comparison of the extreme categories (≥6 vs. <2 h/day), the hazard ratio for T2D was 1.58 (95% CI 1.47, 1.71) after adjustment for age, race, sex, lifestyle factors, and other covariates. Replacing 30 min of sedentary behavior per day with an equal amount of time of different types of daily-life activities and structured exercise was significantly associated with a 6-31% risk reduction of T2D, with strenuous sports showing the strongest (31%, 95% CI 24, 37) benefit. Moreover, we found a significant interaction between sedentary behavior and genetic predisposition for the risk of T2D ( = 0.0008). The association was more profound among participants with a lower genetic risk of T2D.
Our study indicates that sedentary behavior time is associated with an increased risk of T2D; replacing sedentary behavior with a short duration (30 min/day) of daily-life physical activities or structured exercise is related to a significant reduction in T2D risk. Furthermore, such association was stronger among those with a lower genetic risk of T2D.
前瞻性分析久坐行为时间与2型糖尿病（T2D）风险之间的关联，并进行等时替代分析，以估计用相同时间的不同类型的日常身体活动和结构化锻炼替代久坐行为的效果。我们还研究了T2D遗传易感性对这种关联的影响。
我们纳入了英国生物银行中475,502名无T2D的参与者。通过汇总看电视、使用电脑和开车所花费的时间来量化久坐时间。
在中位随访11年期间，我们记录了18,169例T2D新发病例。在比较极端类别（≥6小时/天与<2小时/天）时，在调整年龄、种族、性别、生活方式因素和其他协变量后，T2D的风险比为1.58（95%置信区间1.47, 1.71）。每天用相同时间的不同类型的日常活动和结构化锻炼替代30分钟的久坐行为与T2D风险降低6 - 31%显著相关，剧烈运动显示出最强的益处（31%，95%置信区间24, 37）。此外，我们发现久坐行为与T2D风险的遗传易感性之间存在显著交互作用（P = 0.0008）。这种关联在T2D遗传风险较低的参与者中更为显著。
我们的研究表明，久坐行为时间与T2D风险增加相关；用短时间（30分钟/天）的日常身体活动或结构化锻炼替代久坐行为与T2D风险显著降低有关。此外，这种关联在T2D遗传风险较低的人群中更强。
