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Diabetologia
Published in: Diabetologia 12/2018

Open Access 01-12-2018 | Article

Which is more important for cardiometabolic health: sedentary time, higher intensity physical activity or cardiorespiratory fitness? The Maastricht Study

Authors: Jeroen H. P. M. van der Velde, Nicolaas C. Schaper, Coen D. A. Stehouwer, Carla J. H. van der Kallen, Simone J. S. Sep, Miranda T. Schram, Ronald M. A. Henry, Pieter C. Dagnelie, Simone J. P. M. Eussen, Martien C. J. M. van Dongen, Hans H. C. M. Savelberg, Annemarie Koster

Published in: Diabetologia | Issue 12/2018

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Abstract

Aims/hypotheses

Our aim was to examine the independent and combined (cross-sectional) associations of sedentary time (ST), higher intensity physical activity (HPA) and cardiorespiratory fitness (CRF) with metabolic syndrome and diabetes status.

Methods

In 1933 adults (aged 40–75 years) ST and HPA (surrogate measure for moderate to vigorous physical activity) were measured with the activPAL3. CRF was assessed by submaximal cycle–ergometer testing. Metabolic syndrome was defined according to the Adult Treatment Panel (ATP) III guidelines. Diabetes status (normal, prediabetes [i.e. impaired glucose tolerance and/or impaired fasting glucose] or type 2 diabetes) was determined from OGTT. (Multinomial) logistic regression analyses were used to calculate likelihood for the metabolic syndrome, prediabetes and type 2 diabetes according to ST, HPA and CRF separately and combinations of ST–CRF and HPA–CRF.

Results

Higher ST, lower HPA and lower CRF were associated with greater odds for the metabolic syndrome and type 2 diabetes independently of each other. Compared with individuals with high CRF and high HPA (CRFhigh–HPAhigh), odds for the metabolic syndrome and type 2 diabetes were higher in groups with a lower CRF regardless of HPA. Individuals with low CRF and low HPA (CRFlow–HPAlow) had a particularly high odds for the metabolic syndrome (OR 5.73 [95% CI 3.84, 8.56]) and type 2 diabetes (OR 6.42 [95% CI 3.95, 10.45]). Similarly, compared with those with high CRF and low ST (CRFhigh–STlow), those with medium or low CRF had higher odds for the metabolic syndrome, prediabetes and type 2 diabetes, irrespective of ST. In those with high CRF, high ST was associated with significantly high odds for the metabolic syndrome (OR 2.93 [95% CI 1.72, 4.99]) and type 2 diabetes (OR 2.21 [95% CI 1.17, 4.17]). The highest odds for the metabolic syndrome and type 2 diabetes were observed in individuals with low CRF and high ST (CRFlow–SThigh) (OR [95% CI]: the metabolic syndrome, 9.22 [5.74, 14.80]; type 2 diabetes, 8.38 [4.83, 14.55]).

Conclusions/interpretation

These data suggest that ST, HPA and CRF should all be targeted in order to optimally reduce the risk for the metabolic syndrome and type 2 diabetes.
Appendix
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Metadata
Title
Which is more important for cardiometabolic health: sedentary time, higher intensity physical activity or cardiorespiratory fitness? The Maastricht Study
Authors
Jeroen H. P. M. van der Velde
Nicolaas C. Schaper
Coen D. A. Stehouwer
Carla J. H. van der Kallen
Simone J. S. Sep
Miranda T. Schram
Ronald M. A. Henry
Pieter C. Dagnelie
Simone J. P. M. Eussen
Martien C. J. M. van Dongen
Hans H. C. M. Savelberg
Annemarie Koster
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 12/2018
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-018-4719-7

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