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J Diabetes Investig:久坐增加糖尿病风险:受胰岛素抵抗影响?

2018-12-14 国际糖尿病编辑部 国际糖尿病

根据J Diabetes Investigation上发表的日本一项研究结果,久坐可增加成人患糖尿病的风险,且糖尿病风险与久坐之间的相关性可能受胰岛素抵抗的影响。

根据J Diabetes Investigation上发表的日本一项研究结果,久坐可增加成人患糖尿病的风险,且糖尿病风险与久坐之间的相关性可能受胰岛素抵抗的影响。

关于久坐时间与糖尿病之间联系的现有证据大多是基于自我报告的久坐时间,但自我报告的久坐时间可能存在测量误差,从而导致错误的推断。日本九州大学医学研究生院流行病学与公共卫生系教授Toshiharu Ninomiya及其同事研究了一项基于人群的血管疾病队列研究的数据,数据来自2012年日本福冈市1758例受试者(59%为女性,平均年龄61岁),受试者连续7天在清醒时配戴加速计装置,通过加速计客观评估其活动的数据。用估计的活动强度的代谢当量确定久坐时间和体力活动,代谢当量≤1.5被定义为久坐,≥3则被分类为中等至强烈的体力活动。根据受试者每天的久坐时间分为四类:<6小时、6~8小时、8~10小时以及≥10小时。

结果显示,共有279例受试者患有糖尿病。与≤6小时组相比,≥10小时组的患病率更高(18.8% vs. 12.5%,P=0.01)。校正年龄、性别、加速计配戴时间、糖尿病家族史、高血压、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、吸烟习惯、酒精摄入和体力活动等因素后,≥10小时组的患病率也显著高于≤6小时组(比值比[OR]=2.02,95%CI:1.18~3.43)。

随着久坐时间的增加,糖尿病患病率也增加。每久坐2小时,发生糖尿病的OR为1.21(95%CI:1.02~1.42)。研究人员注意到,当校正整体肥胖(OR=1.19)、中心性肥胖(OR=1.18)和膳食能量摄入(OR=1.17)后,二者的关联仍然显著存在。但将稳态模型评估的胰岛素抵抗指数(HOMA-IR)包括在内时,则关联性为零(OR=1.15,95%CI:0.97~1.37)。此外,研究发现,久坐时间越长,胰岛素抵抗水平越高(P<0.01)。

研究表明,肥胖对久坐时间与糖尿病之间关系的影响很小,相反,HOMA-IR则减弱二者之间的关联,这表明,二者之间的关联主要归因于胰岛素抵抗。久坐行为与胰岛素抵抗之间联系的机制仍有待阐明,一个可能的解释是长期不用肌肉可导致肌肉萎缩和肌纤维类型改变,进而导致肌肉的胰岛素抵抗。

原始出处:
Takanori Honda, Hiro Kishimoto, Naoko Mukai, et al. Objectively measured sedentary time and diabetes mellitus in a general Japanese population: The Hisayama Study. Journal of Diabetes Investigation. Dec 2018.

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    2019-02-20 baoya
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    2019-07-29 hb2008ye
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    2018-12-15 misszhang

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