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Multicenter Study
. 2008 Oct;57(10):2613-8.
doi: 10.2337/db07-1605. Epub 2008 Jun 30.

Physical activity and insulin sensitivity: the RISC study

Beverley Balkau  1 , Leila Mhamdi, Jean-Michel Oppert, John Nolan, Alain Golay, Francesca Porcellati, Markku Laakso, Ele Ferrannini; EGIR-RISC Study Group
Affiliations
Multicenter Study

Physical activity and insulin sensitivity: the RISC study

Beverley Balkau et al. Diabetes. 2008 Oct.

Abstract

Objective: Physical activity is a modifiable risk factor for type 2 diabetes, partly through its action on insulin sensitivity. We report the relation between insulin sensitivity and physical activity measured by accelerometry.

Research design and methods: This is a cross-sectional study of 346 men and 455 women, aged 30-60 years, without cardiovascular disease and not treated by drugs for diabetes, hypertension, dyslipidemia, or obesity. Participants were recruited in 18 clinical centers from 13 European countries. Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamp. Physical activity was recorded by accelerometry for a median of 6 days. We studied the relationship of insulin sensitivity with total activity (in counts per minute), percent of time spent sedentary, percent of time in light activity, and activity intensity (whether the participant recorded some vigorous or some moderate activity).

Results: In both men and women, total activity was associated with insulin sensitivity (P < 0.0001). Time spent sedentary, in light activity, and activity intensity was also associated with insulin sensitivity (P < 0.0004/0.01, 0.002/0.03, and 0.02/0.004, respectively, for men/women) but lost significance once adjusted for total activity. Adjustment for confounders such as adiposity attenuated the relationship with total activity; there were no interactions with confounders. Even in the 25% most sedentary individuals, total activity was significantly associated with better insulin sensitivity (P < 0.0001).

Conclusions: Accumulated daily physical activity is a major determinant of insulin sensitivity. Time spent sedentary, time spent in light-activity, and bouts of moderate or vigorous activity did not impact insulin sensitivity independently of total activity.

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Figures

FIG. 1.
FIG. 1.
Mean insulin sensitivity (95% CI) adjusted for age and clinical recruitment center, and characteristics of physical activity measured by accelerometer in men and women according to: mean number of counts/min that the accelerometer was worn (A), by percent sedentary time (B), and by groups according to some moderate and some vigorous intensity activity (C). The RISC study.
FIG. 2.
FIG. 2.
Mean insulin sensitivity (age, sex, and recruitment center adjusted) and physical activity measured by accelerometer (in men and women combined) by quartiles of average number of counts/min worn and quartiles of percent time sedentary. Table gives the distribution of participants according to total activity and time sedentary quartiles. The RISC study.
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