Physical activity, sedentary time and their associations with clustered metabolic risk among people with type 2 diabetes in Jiangsu province: a cross-sectional study

Abstract

Objective: Investigating the association between total physical activity, physical activity in different domains and sedentary time with clustered metabolic risk in patients with type 2 diabetes from Jiangsu province, China.

Design: Interview-based cross-sectional study conducted between December 2013 and January 2014.

Setting: 44 selected townships across two cities, Changshu and Huai'an, in Jiangsu province.

Participants: 20 340 participants selected using stratified cluster-randomised sampling and an interviewer-managed questionnaire.

Methods: We constructed clustered metabolic risk by summing sex-specific standardised values of waist circumference, fasting triacylglycerol, fasting plasma glucose, systolic blood pressure and the inverse of blood high-density lipoprotein cholesterol (HDL-cholesterol). Self-reported total physical activity included occupation, commuting and leisure-time physical activity. The un-standardised regression coefficient [B] and its 95% CI were calculated using multivariate linear regression analyses.

Results: This study included 17 750 type 2 diabetes patients (aged 21-94 years, 60.3% female). The total (B=-0.080; 95% CI: -0.114 to -0.046), occupational (B=-0.066; 95% CI: -0.101 to- 0.031) and leisure-time physical activity (B=-0.041; 95% CI: -0.075 to -0.007), and sedentary time (B=0.117; 95% CI: 0.083 to 0.151) were associated with clustered metabolic risk. Total physical activity, occupational physical activity and sedentary time were associated with waist circumference, triacylglycerol and HDL-cholesterol, but not with systolic blood pressure. Commuting physical activity and sedentary time were significantly associated with triacylglycerol (B=-0.012; 95% CI: -0.019 to -0.005) and fasting plasma glucose (B=0.008; 95% CI: 0.003 to 0.01), respectively. Leisure-time physical activity was only significantly associated with systolic blood pressure (B=-0.239; 95% CI: -0.542 to- 0.045).

Conclusions: Total, occupational and leisure-time physical activity were inversely associated with clustered metabolic risk, whereas sedentary time increased metabolic risk. Commuting physical activity was inversely associated with triacylglycerol. These findings suggest that increased physical activity in different domains and decreased sedentary time may have protective effects against metabolic risk in type 2 diabetes patients.

Keywords: cross-sectional study; metabolic risk; physical activity; sedentary time; type 2 diabetes.

Figure 1

Means of clustered metabolic risk scores by sedentary time and physical activity among 17 750 patients with diabetes. The adjusted mean was calculated using general linear regression models after adjustment for age. For physical activity, in men, the cut-off values for defining low, moderate and high tertile groups were 4.00 and 11.14 MET hours/day, while they were 4.57 and 12.00 MET hours/day for women. For sedentary time, the four groups by quartiles of sedentary time were ＜2.2, 2.3–3.3, 3.4–4.9 and ≥5.0 hours/day for men and ＜2.2, 2.3–3.3, 3.4–4.4 and ≥4.5 hours/day for women.