Objectively Measured Sedentary Time and Cardiovascular Risk Factor Control in US Hispanics/Latinos With Diabetes Mellitus: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

Background: Cardiovascular disease (CVD) risk factor control is a cornerstone of diabetes mellitus management. Little is known about relationships of objectively measured sedentary time and physical activity with major CVD risk factor control in individuals with diabetes mellitus. We examined associations of objectively measured sedentary time and moderate-to-vigorous physical activity with reaching major CVD risk factor control goals among US Hispanic/Latino adults with diabetes mellitus.

Methods and results: This cross-sectional analysis included 1699 participants with diabetes mellitus from the Hispanic Community Health Study/Study of Latinos (2008-2011). Logistic regression models were used to estimate the odds ratios (ORs) of meeting the following 5 major CVD risk factor control goals: hemoglobin A_1c <7.0%; systolic/diastolic blood pressure <140/80 mm Hg; triglycerides <150 mg/dL; low-density lipoprotein cholesterol <100 mg/dL; and high-density lipoprotein cholesterol >40/50 mg/dL for men/women. After adjustment for covariates including moderate-to-vigorous physical activity, less sedentary time was associated with increased odds of reaching hemoglobin A_1c (OR=1.76 [95% CI: 1.10, 2.82]) and triglyceride control goals (OR=2.16 [1.36, 3.46]), and reaching ≥3 CVD risk factor control goals (OR=2.08 [1.34, 3.23]) (all ORs for comparisons of extreme tertiles of sedentary time). Moderate-to-vigorous physical activity was not associated with reaching any CVD risk factor control goals. Substituting 60-min/day of sedentary time with light-intensity physical activity was associated with increased odds of reaching hemoglobin A_1c (OR=1.18 [1.04, 1.35]), high-density lipoprotein cholesterol (OR=1.17 [1.04, 1.32]), and triglyceride (OR=1.20 [1.05, 1.36]) control goals.

Conclusions: Among US Hispanic/Latino adults with diabetes mellitus, less sedentary time, but not moderate-to-vigorous physical activity, was associated with improved CVD risk factor control, specifically in reaching hemoglobin A_1c and triglyceride control goals.

Keywords: Hispanic/Latino; cardiovascular disease risk factors; diabetes mellitus; moderate‐to‐vigorous physical activity; sedentary behaviors.

Figure 1

Association between sedentary time and number of reaching major cardiovascular disease (CVD) risk factor control goals among Hispanics/Latinos with diagnosed diabetes mellitus (n=1699). A, Values are means (95% SE), adjusted for age, sex, annual household income, education, employment status, Hispanic/Latino background, field center, smoking, alcohol consumption, duration of diabetes mellitus, health insurance status, alternative healthy eating index (continuous), self‐reported physical health score (continuous), and use of antidiabetic, antihypertensive, and lipid‐lowering medications, and moderate‐to‐vigorous physical activity (MVPA). B, Values are odds ratios (ORs) (95% CI) for reaching 3+ vs 0 to 2 (reference) control goals, adjusted for age, sex, annual household income, education, employment status, Hispanic/Latino background, field center, smoking, alcohol consumption, family history of diabetes mellitus, health insurance status, alternative healthy eating index‐2010 (continuous), self‐reported physical health score (continuous), use of antidiabetic, antihypertensive, and lipid‐lowering medications, and MVPA. Major CVD risk factor control was defined based on the following cut‐offs recommended by the American Diabetes Association: glycemic control, hemoglobin A_1c <7.0% (<53 mmol/mol); blood pressure control, systolic blood pressure <140 mm Hg and diastolic blood pressure <80 mm Hg; low‐density lipoprotein cholesterol (LDL‐c) control, LDL‐c <100 mg/dL; triglyceride control, triglycerides <150 mg/dL; and high‐density lipoprotein cholesterol (HDL‐c) control, HDL‐c >40 mg/dL for men or >50 mg/dL for women.