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Diabetes associated with objectively measured sedentary time in Japanese adults
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Longer periods of sedentary time increase the risk for diabetes in Japanese adults, with the link likely influenced by insulin resistance, according to findings published in the Journal of Diabetes Investigation.
“Prolonged sedentary time might ... contribute to the epidemic of diabetes mellitus,” Toshiharu Ninomiya, PhD, professor in the department of epidemiology and public health in the graduate school of medical sciences at Kyushu University in Japan, and colleagues wrote. “However, the existing evidence investigating the link between sedentary time and diabetes mellitus is mostly based on self-reported measurement of sedentary time, which is known to have the potential for measurement error and consequently can result in incorrect inferences.”
Ninomiya and colleagues examined data from a population-based cohort study of cardiovascular diseases in which participants had activity objectively measured by accelerometer. Data from 1,758 participants (59% women; mean age, 61 years) from the Fukuoka metropolitan area of Japan in 2012 were used in the analysis. Participants wore an accelerometer device while awake for 7 straight days.
Metabolic equivalents of estimated activity intensity were used to determine sedentary time and physical activity. Readings of 1.5 metabolic equivalents or fewer were defined as sedentary time. Measurements of 3 or more metabolic equivalents were classified as moderate to vigorous physical activity. Participants were divided into four categories based on sedentary time: less than 6 hours, 6 to less than 8 hours, 8 to less than 10 hours and at least 10 hours.
A total of 279 participants had diabetes, and prevalence was higher for those who spent an average of 10 or more hours in sedentary time per day vs. those who spend fewer than 6 hours in sedentary time per day (18.8% vs. 12.5%; P = .01). The odds of diabetes development after adjustments for age, sex, accelerometer wear time, family history of diabetes, hypertension, total cholesterol, HDL cholesterol, triglycerides, smoking habits, alcohol and physical activity were also significantly higher in the 10 or more hours group (OR = 2.02; 95% CI, 1.18-3.43) vs. the 6 hours or fewer group, which was used as reference.
Diabetes prevalence increased as sedentary time increased. For each 2-hour period of sedentary time, the OR for diabetes was 1.21 (95% CI, 1.02-1.42). The researchers noted that association remained significant when adjusting for overall obesity (OR = 1.19; 95% CI, 1.004-1.4), central obesity (OR = 1.18; 95% CI, 1.002-1.4) and dietary energy intake (OR = 1.17; 95% CI, 0.99-1.38), but “null” when including homeostatic model assessment of insulin resistance (OR = 1.15; 95% CI, 0.97-1.37). In addition, the researchers found that participants with more sedentary time have higher levels of insulin resistance (P < .01).
“Our findings suggested that adiposity had only minor effects on the association between sedentary time and diabetes mellitus. ... In contrast, HOMA-IR attenuated the association ... suggesting that the association might be largely attributable to insulin resistance,” the researchers wrote.
“The mechanisms underlying the link between sedentary behavior and insulin resistance remain to be fully elucidated,” the researchers wrote. “One possible explanation is that prolonged muscle disuse leads to muscle atrophy and a shift in muscle fiber type, which in turn contributes to muscle insulin resistance.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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