Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands.
TiFN, Wageningen, the Netherlands.
Acta Physiol (Oxf). 2023 Apr;237(4):e13945. doi: 10.1111/apha.13945. Epub 2023 Feb 28.
The aim of this study is to investigate associations between the physical activity (PA) spectrum (sedentary behavior to exercise) and tissue-specific insulin resistance (IR).
We included 219 participants for analysis (median [IQR]: 61 [55; 67] years, BMI 29.6 [26.9; 32.0] kg/m ; 60% female) with predominant muscle or liver IR, as determined using a 7-point oral glucose tolerance test (OGTT). PA and sedentary behavior were measured objectively (ActivPAL) across 7 days. Context-specific PA was assessed with the Baecke questionnaire. Multiple linear regression models (adjustments include age, sex, BMI, site, season, retirement, and dietary intake) were used to determine associations between the PA spectrum and hepatic insulin resistance index (HIRI), muscle insulin sensitivity index (MISI) and whole-body IR (HOMA-IR, Matsuda index).
In fully adjusted models, objectively measured total PA (standardized regression coefficient β = 0.17, p = 0.020), light-intensity PA (β = 0.15, p = 0.045) and moderate-to-vigorous intensity PA (β = 0.13, p = 0.048) were independently associated with Matsuda index, but not HOMA-IR (p > 0.05). A higher questionnaire-derived sport index and leisure index were associated with significantly lower whole-body IR (Matsuda, HOMA-IR) in men but not in women. Results varied across tissues: more time spent sedentary (β = -0.24, p = 0.045) and a higher leisure index (β = 0.14, p = 0.034) were respectively negatively and positively associated with MISI, but not HIRI. A higher sport index was associated with lower HIRI (β = -0.30, p = 0.007, in men only).
While we confirm a beneficial association between PA and whole-body IR, our findings indicate that associations between the PA spectrum and IR seem distinct depending on the primary site of insulin resistance (muscle or liver).
本研究旨在探讨体力活动（PA）谱（久坐行为至运动）与组织特异性胰岛素抵抗（IR）之间的关联。
我们纳入了 219 名参与者进行分析（中位数[IQR]：61[55；67]岁，BMI 29.6[26.9；32.0]kg/m²；60%为女性），这些参与者的主要肌肉或肝脏 IR 通过 7 点口服葡萄糖耐量试验（OGTT）确定。PA 和久坐行为通过 ActivPAL 在 7 天内进行客观测量。特定于上下文的 PA 通过 Baecke 问卷进行评估。使用多元线性回归模型（调整因素包括年龄、性别、BMI、部位、季节、退休和饮食摄入）来确定 PA 谱与肝胰岛素抵抗指数（HIRI）、肌肉胰岛素敏感性指数（MISI）和全身 IR（HOMA-IR、Matsuda 指数）之间的关联。
在完全调整的模型中，客观测量的总 PA（标准化回归系数β=0.17，p=0.020）、低强度 PA（β=0.15，p=0.045）和中高强度 PA（β=0.13，p=0.048）与 Matsuda 指数独立相关，但与 HOMA-IR 无关（p>0.05）。较高的问卷衍生运动指数和休闲指数与男性的全身 IR（Matsuda、HOMA-IR）显著降低相关，但与女性无关。结果因组织而异：更多的久坐时间（β=-0.24，p=0.045）和较高的休闲指数（β=0.14，p=0.034）分别与 MISI 呈负相关和正相关，但与 HIRI 无关。较高的运动指数与较低的 HIRI 相关（β=-0.30，p=0.007，仅在男性中）。
虽然我们证实了 PA 与全身 IR 之间存在有益的关联，但我们的研究结果表明，PA 谱与 IR 之间的关联似乎因胰岛素抵抗的主要部位（肌肉或肝脏）而异。
