Increased sedentary time and decreased physical activity increases lipoprotein associated phospholipase A2 in obese individuals

Background and aimsLipoprotein-associated Phospholipase A₂ (Lp-PLA₂) is a protein produced by inflammatory cells in circulation and is associated with cardiovascular disease (CVD) risk. Physical activity (PA) is known to reduce inflammation and risk for CVD. However, Lp-PLA₂ has yet to be examined in relation to PA and sedentary time. The purpose of this study was to determine if PA and sedentary time impacts Lp-PLA₂ mass. A total of 25 subjects with an average BMI of 30.6 ± 5.7 were included in the data analysis.Methods and resultsData collected included anthropometric data, Lp-PLA₂ mass, peak oxygen uptake (VO₂peak), resting heart rate and blood pressure, obstructive sleep apnea (OSA) risk, and assessment of PA using an accelerometer. Sedentary minutes per day was positively associated with Lp-PLA₂ (r = 0.41, P < 0.05). Light intensity PA was negatively associated (r = ?0.51. P = 0.01) with Lp-PLA₂. When subjects were divided into 2-quantiles by Lp-PLA₂, the group with the higher Lp-PLA₂ mass accumulated more sedentary time per day (P < 0.001) and less light intensity PA per day (P = 0.001). OSA risk and Lp-PLA₂ showed no relationship. Sedentary behavior was higher, and light intensity PA was lower in subjects with hiLp-PLA₂ mass. No difference was seen in moderate-to-vigorous intensity PA or steps per day.ConclusionsThis suggests that, total PA habits, including time spent sedentary and lower intensity PA, impacts the levels of Lp-PLA₂, an important inflammatory marker and marker of CVD risk.     

Association between objectively assessed sedentary time and physical activity with metabolic risk factors among people with recently diagnosed type 2 diabetes

Aims/hypothesis

The aim of our study was to examine the associations between sedentary time (SED-time), time spent in moderate-to-vigorous-intensity physical activity (MVPA), total physical activity energy expenditure (PAEE) and cardiorespiratory fitness with metabolic risk among individuals with recently diagnosed type 2 diabetes.

Methods

Individuals participating in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION)-Plus trial underwent measurement of SED-time, MVPA and PAEE using a combined activity and movement sensor (n?=?394), and evaluation of cardiorespiratory fitness (n?=?291) and anthropometric and metabolic status. Clustered metabolic risk was calculated by summing standardised values for waist circumference, triacylglycerol, HbA_1c, systolic blood pressure and the inverse of HDL-cholesterol. Multivariate linear regression analyses were used to quantify the associations between SED-time, MVPA, PAEE and cardiorespiratory fitness with individual metabolic risk factors and clustered metabolic risk.

Results

Each additional 1 h of SED-time was positively associated with clustered metabolic risk, independently of sleep duration and MVPA (β?=?0.16 [95% CI 0.03, 0.29]). After accounting for SED-time, MVPA was associated with systolic blood pressure (β?=??2.07 [?4.03, ?0.11]) but not with clustered metabolic risk (β?=?0.01 [?0.28, 0.30]). PAEE and cardiorespiratory fitness were significantly and independently inversely associated with clustered metabolic risk (β?=??0.03 [?0.05, ?0.02] and β?=??0.06 [?0.10, ?0.03], respectively). Associations between SED-time and metabolic risk were generally stronger in the low compared with the high fitness group.

Conclusions/interpretation

PAEE was inversely associated with metabolic risk, whereas SED-time was positively associated with metabolic risk. MVPA was not associated with clustered metabolic risk after accounting for SED-time. Encouraging this high-risk group to decrease SED-time, particularly those with low cardiorespiratory fitness, and increase their overall physical activity may have beneficial effects on disease progression and reduction of cardiovascular risk. Trial registration: ISRCTN99175498     

2型糖尿病患者一级亲属中血尿酸与代谢综合征的关系研究

目的　探讨 2型糖尿病一级亲属中血尿酸 (UA)与代谢综合征 (MS)的相关性。方法　 2型糖尿病患者一级亲属 43 0例 ,按美国国家胆固醇教育计划 (NECP ATPIII ,2 0 0 1)提出的MS诊断标准 ,参考中国肥胖问题工作组建议 ,分为各指标均正常组 (NC组 )、MS单项异常组 (MS1组 )、不完全MS组 (MS2组 )和完全MS组 (MS3组 )。以上各组均按性别进行分层分析。将血UA与相关指标进行多元回归分析。结果　本组人群中完全MS的患病率为 2 4.9% ,高尿酸患病率占2 4.4%。男女人群MS3组伴有高UA者均明显高于其他组 ;MS3组UA均高于NC组 (P <0 .0 5 )。MS的各项指标与UA密切相关 ,多元逐步回归分析显示 ,在男女人群中腰围、甘油三酯、高血压和完全MS是影响MS中高UA独立的危险因素。结论　 2型糖尿病一级亲属中血UA是MS的关联因素。     

Effectiveness of physical activity and sedentary behaviour interventions in altering sedentary behaviour among older adults: a systematic review

Background

Long and frequent bouts of sedentary behaviour pose a major risk to health and increase the incidence of hypokinetic diseases and mortality, independent of the risks caused by physical inactivity alone. The aim of this systematic review was to determine the effectiveness of interventions used by researchers in altering sedentary behaviour among adults aged 60 years or older.

The relationship between type 2 diabetes family history,body composition and blood basal glycemia in sedentary people

The aim of this study was to verify whether there is a positive correlation between family history to type 2 diabetes mellitus and body mass and composition, and alterations in blood basal glycaemia levels in sedentary male and female. Anthropometric variables, blood parameters, body composition and body surface area were evaluated on 183 male and 237 female sedentary individuals. Participants were classified into two groups: FH⁺ (family history positive) and FH^? (familiar history negative) according to their medical history. The FH⁺ group showed higher values of body mass and body surface area than FH^? group. These differences were statistically significant (p < 0.05) for the female subgroup. When compared to the FH^? group, FH⁺ female individuals showed a significantly greater fat mass (p < 0.01) and a significantly lower free fat mass-to-fat mass ratio (FFM/FM ratio) (p < 0.05). FH⁺ female individuals showed significant lower levels of basal glucose values for Kg of FFM (p < 0.05), FM (p < 0.01) and BSA (p < 0.01) than FH^? group. The results of this study indicate that body mass and composition correlate positively to family history to type 2 diabetes. The relationship between family history and body composition is particularly evident in young FH⁺ female. Thus, as family history might represent a risk factor for the development of type 2 diabetes, this could be considered as an important parameter able to predict the onset of the disease itself. This knowledge could be used to improve preventive interventions (i.e. increasing levels of physical activity) promoting healthy lifestyle.     

Self-monitoring of physical activity: effects on self-efficacy and behavior in people with type 2 diabetes

PURPOSE: The purpose of this study was to test the effect of keeping daily activity records on physical activity levels and self-efficacy for physical activity in adults with type 2 diabetes, and to examine the feasibility and acceptability of this intervention from the perspective of the participants. METHODS: This intervention study included 58 individuals with type 2 diabetes aged 40 to 65 years. Participants were randomly assigned: individuals in the intervention group kept daily activity records for 6 weeks, mailed to the researcher every 2 weeks. Data collection was completed at the beginning of the study and 6 weeks later, using the habitual physical activity index and the self-efficacy for exercise scale. Participants in the intervention group also completed the perceived feasibility checklist. RESULTS: The intervention resulted in enhanced self-efficacy. Physical activity improved in both the intervention and control groups. Activity recording was judged to be acceptable and feasible. CONCLUSIONS: Daily activity recording can be used as part of a program to increase physical activity self-efficacy levels. Focused interactions between health care providers and patients may be enough to motivate people to higher levels of physical activity. The relationship between self-efficacy and behavior is complex and should be the subject of further research.     

Short-term metabolic effects of the ACE-inhibitor benazepril in type 2 diabetes mellitus associated with arterial hypertension.

To assess the short-term metabolic effects a long-acting non-sulphydryl ACE-inhibitor benazepril on glycaemic control in Type 2 diabetes mellitus and arterial hypertension, 10 hypertensive diabetic patients treated with glibenclamide were studied in a double-blind, crossover fashion over two 10-day periods in which either benazepril (10 mg/day) or placebo was given. At the end of the 10 day treatment, both blood pressure and plasma glucose concentrations were lower after benazepril versus placebo (benazepril, blood pressure: 143 +/- 11/83 +/- 5 mmHg, plasma glucose: 7.1 +/- 1.2 mmol/l; placebo: blood pressure: 157 +/- 10/99 +/- 2 mmHg, plasma glucose: 8.2 +/- 1 mmol/l, p < 0.05). In response to an oral glucose tolerance test combined with 1 mg intravenous glibenclamide, plasma glucose levels were lower after benazepril versus placebo (0-460 min: 8.4 +/- 0.8 versus 10.5 +/- 0.9 mmol/l, p < 0.05), whereas plasma insulin, C-peptide and glibenclamide concentrations were not different. It is concluded that a short-term administration of benazepril in Type 2 diabetes mellitus reduces blood pressure and improves blood glucose control, most likely by decreasing insulin resistance.     

The effects of intensive glycaemic control on body composition in patients with type 2 diabetes

SUMMARY
Aim   To examine the effects of improved glycaemic control over 20 weeks on the type and distribution of weight change in patients with type 2 diabetes who at baseline have poor glycaemic control.
Methods   Forty-three patients with type 2 diabetes and HbA_1c > 8.9% were randomised to either intensive glycaemic control (IC) n = 21 or usual glycaemic control (UC) n = 22 for 20 weeks. Dual energy X-ray absorptiometry was used to assess the type and distribution of weight change during the study.
Results   After 20 weeks HbA_1c was significantly lower in patients randomised to IC than UC (HbA_1c IC 8.02 ± 0.25% vs. UC 10.23 ± 0.23%, p < 0.0001). In the IC group weight increased by 3.2 ± 0.8 kg after 20 weeks (fat-free mass increased by 1.8 ± 0.3 kg) compared to 0.02 ± 0.70 kg in UC (p = 0.003). The gain in total body fat mass comprised trunk fat mass (IC 0.94 ± 0.5 kg vs. UC 0.04 ± 0.4 kg, p = 0.18) and peripheral fat mass (total body fat – trunk fat) (IC 0.71 ± 0.32 kg vs. UC −0.21 ± 0.28 kg, p = 0.04). Blood pressure and serum lipid concentrations did not change over time in either group.
Conclusions   Intensive glycaemic control was associated with weight gain which was distributed in similar proportions between the central and peripheral regions and consisted of similar proportions of fat and fat-free mass. Blood pressure and serum lipid concentrations were not adversely affected.     

Self-reported physical functioning and mortality among individuals with type 2 diabetes: insights from TRIAD

AimsTo examine the association between physical functioning and mortality in people with type 2 diabetes, and determine if this association differs by race/ethnicity in managed care.MethodsWe studied 7894 type 2 diabetic patients in Translating Research Into Action for Diabetes (TRIAD), a prospective observational study of diabetes care in managed care. Physical functioning was assessed with the Short Form Health Survey. The National Death Index was searched for deaths over 10 years of follow-up (2000–2009).ResultsAt baseline, mean age was 61.7 years, 50% were non-Hispanic White, 22% were Black, and 16% of participants reported good physical functioning. Over 10 years, 28% of participants died; 39% due to cardiovascular disease. Relative to those reporting good functioning, those reporting poor physical functioning had a 39% higher all-cause death rate after adjusting for age, sex, race/ethnicity, education, income, body mass index, smoking, and comorbidities (Hazard Ratio = 1.39; 95% Confidence Interval: 1.16, 1.67). Although Blacks were less likely than Whites to report good functioning (p < 0.01), the association between functioning and mortality did not differ by race/ethnicity.ConclusionsIn this managed care population, self-reported physical functioning was a robust independent predictor of mortality and may be a useful benchmark for tailoring clinical care.     

Development of a theory-based daily activity intervention for individuals with type 2 diabetes

PURPOSE: This article describes a theory-driven approach to developing a physical activity intervention for sedentary individuals with type 2 diabetes. METHODS: Development of the intervention was based on 6 essential elements of program theory: problem definition, critical inputs, mediating processes, expected outcomes, extraneous factors, and implementation issues. Each element was formulated based on available literature and in collaboration with both intended service deliverers (diabetes educators) and recipients (sedentary persons with type 2 diabetes). RESULTS: Diabetes education requires a simple physical activity intervention template that is feasible, acceptable, and effective in a variety of settings. Successful programs are individualized, specific, flexible, and based on walking. Pedometers have potential as self-monitoring and feedback tools. The primary expected outcome is an increase in physical activity, specifically walking. Behavior modification and social support are critical to adoption and adherence. CONCLUSIONS: Theory-driven interventions specify what works for whom and under what conditions of delivery. The underlying theory guides the evaluation, refinement, and clinical replication of an intervention. Recruitment, delivery, and follow-up are real-world implementation issues.     

Obesity and risk factors for cardiovascular disease and type 2 diabetes: Investigating the role of physical activity and sedentary behaviour in mid-life in the 1958 British cohort

Objective

A key public health priority is to minimise obesity-related health consequences. We aim to establish whether physical activity (PA) or less sedentary behaviour ameliorate associations of obesity with biomarkers for cardiovascular disease (CVD) and type 2 diabetes.

Methods

Data on obesity (33 y), PA (42 y), TV-viewing and health biomarkers (45 y) are from the 1958 British birth cohort (N = 9377).

Results

Obesity was associated with an adverse biomarker profile for CVD and type 2 diabetes. For PA, men active ≥1/week had 1.09% (0.28, 1.90) lower diastolic blood pressure (DBP) than less active men; triglycerides were 2.08% (0.52, 3.64) lower per unit higher PA (on 4-point scale). TV-viewing was independently associated with several biomarkers, e.g. per unit higher TV-viewing (on 4-point scale) DBP was raised by 0.50% (0.09, 0.90) and triglycerides by 3.61% (1.58, 5.64). For both TV-viewing and PA, associations with HbA1c were greatest for the obese (p_interaction ≤ 0.04): compared to a reference value of 5.20 HbA1c% in non-obese men viewing 0–1 h/day, HbA1c% differed little for those viewing >3 h/day; among obese men HbA1c% was 5.36 (5.22, 5.51) and 5.65 (5.53, 5.76), for 0–1 and >3 h/day respectively. For PA in non-obese men, the reduction associated with activity ≥1/week was negligible compared to a reference value of 5.20 HbA1c% for those less active; but there was a reduction among obese men, HbA1c% was 5.50 (5.40, 5.59) vs 5.66 (5.55, 5.77) respectively.

Conclusion

Reduced TV-viewing and prevention of infrequent activity have greatest beneficial associations for glucose metabolism among the obese, with benefits for other biomarkers across obese and non-obese groups.