Baker Heart and Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
Int J Behav Nutr Phys Act. 2021 Dec 4;18(1):155. doi: 10.1186/s12966-021-01209-5.
Recent evidence suggests that prolonged sitting and its adverse impact on glycaemic indicators appear to be proportional to the degree of insulin resistance. To investigate this finding in a free-living context, we aimed to examine associations of device-measured 24-h time-use compositions of sitting, standing, stepping, and sleeping with fasting glucose (FPG) and 2 h post-load glucose (2hPLG) levels, and to examine separately the associations with time-use compositions among those at lower and at higher risk of developing type 2 diabetes.
Cross-sectional analyses examined thigh-worn inclinometer data (activPAL, 7 day, 24 h/day protocol) from 648 participants (aged 36-80 years) at either lower (< 39 mmol/mol; < 5.7% HbA1c) or higher (≥39 mmol/mol; ≥5.7% HbA1c) diabetes risk from the 2011-2012 Australian Diabetes, Obesity and Lifestyle study. Multiple linear regression models were used to examine associations of differing compositions with FPG and 2hPLG, with time spent in each behaviour allowed to vary up to 60 min.
In general, the associations with the FPG within the time-use compositions were small, with statistically significant associations observed for sitting and sleeping (in the lower diabetes risk group) and standing (in higher diabetes risk group) only. For 2hPLG, statistically significant associations were observed for stepping only, with findings similar between lower (β = - 0.12 95%CI:-0.22, - 0.02) and higher (β = - 0.13 95%CI:-0.26, - 0.01) risk groups. Varying the composition had minimal impact on FPG; however 1 h less sitting time and equivalent increase in standing time was associated with attenuated FPG levels in higher risk only (Δ FPG% = - 1.5 95%CI: - 2.4, - 0.5). Large differences in 2hPLG were observed for both groups when varying the composition. One hour less sitting with equivalent increase in stepping was associated with attenuated 2hPLG, with estimations similar in lower (Δ 2hPLG% = - 3.8 95%CI: - 7.3, - 0.2) and higher (Δ 2hPLG% = - 5.0 95%CI: - 9.7, - 0.0) risk for diabetes.
In middle-aged and older adults, glycaemic control could be improved by reducing daily sitting time and replacing it with stepping. Standing could also be beneficial for those at higher risk of developing type 2 diabetes.
最近的证据表明，长时间坐着以及由此导致的血糖指标恶化似乎与胰岛素抵抗程度成正比。为了在更接近日常生活的环境中验证这一发现，我们旨在研究设备测量的 24 小时坐姿、站姿、步数和睡眠时间与空腹血糖（FPG）和 2 小时餐后血糖（2hPLG）水平之间的关联，并分别研究在糖尿病风险较低和较高的人群中，与时间使用构成相关的关联。
横断面分析使用了来自澳大利亚糖尿病、肥胖和生活方式研究 2011-2012 年的 648 名参与者（年龄 36-80 岁）的大腿佩戴倾斜计数据（activPAL，7 天，24 小时/天方案），这些参与者的糖尿病风险较低（<39mmol/mol；<5.7%HbA1c）或较高（≥39mmol/mol；≥5.7%HbA1c）。使用多元线性回归模型来研究不同构成与 FPG 和 2hPLG 的关联，允许每种行为的时间分配最多变化 60 分钟。
一般来说，与时间使用构成相关的 FPG 关联较小，仅在糖尿病风险较低的组中观察到与坐姿和睡眠（在较低的糖尿病风险组）以及站立（在较高的糖尿病风险组）相关的统计学显著关联。对于 2hPLG，仅观察到与步数相关的统计学显著关联，在糖尿病风险较低（β=-0.12 95%CI：-0.22，-0.02）和较高（β=-0.13 95%CI：-0.26，-0.01）的组中发现的结果相似。改变构成对 FPG 的影响很小；然而，较高风险组中，减少 1 小时坐姿时间并相应增加站立时间与 FPG 水平降低有关（ΔFPG%=-1.5 95%CI：-2.4，-0.5）。对于两个组，改变构成时 2hPLG 的差异很大。减少 1 小时坐姿时间并相应增加步数与 2hPLG 降低有关，在糖尿病风险较低（Δ2hPLG%=-3.8 95%CI：-7.3，-0.2）和较高（Δ2hPLG%=-5.0 95%CI：-9.7，-0.0）的组中，估计值相似。
在中年和老年人中，通过减少日常坐姿时间并用步数代替，可以改善血糖控制。对于有较高患 2 型糖尿病风险的人群，站立也可能有益。
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