Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes
Background: Physical activity (PA) is considered beneficial for lowering cardiovascular risks following type 2 diabetes mellitus (T2DM) and prediabetes, but existing evidence relies mainly on self-reported measurements. We aimed to describe the intensity-specific dose–response associations of PA and...
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2025-12-01
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| Series: | Journal of Sport and Health Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095254624001297 |
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| author | Yannis Yan Liang Yu He Piao Huang Hongliang Feng Haiteng Li Sizhi Ai Jing Du Huachen Xue Yaping Liu Jun Zhang Lu Qi Jihui Zhang |
| author_facet | Yannis Yan Liang Yu He Piao Huang Hongliang Feng Haiteng Li Sizhi Ai Jing Du Huachen Xue Yaping Liu Jun Zhang Lu Qi Jihui Zhang |
| author_sort | Yannis Yan Liang |
| collection | DOAJ |
| description | Background: Physical activity (PA) is considered beneficial for lowering cardiovascular risks following type 2 diabetes mellitus (T2DM) and prediabetes, but existing evidence relies mainly on self-reported measurements. We aimed to describe the intensity-specific dose–response associations of PA and sedentary behavior (SB) with macrovascular and microvascular events among individuals with T2DM and prediabetes. Methods: This study included 11,474 individuals with T2DM and prediabetes from the UK Biobank. PA, including total PA, moderate-to-vigorous intensity PA (MVPA), light-intensity PA (LPA), and SB, were measured by accelerometers over 7 days. MVPA was categorized according to the American Diabetes Association guideline-recommended level (at least 150 min/week), and total PA, LPA, and SB were grouped by tertiles. The outcomes were incidences of macrovascular events, microvascular events, heart failure (HF), and their combination (composite events). The events were ascertained using the International Classification of Diseases-10 (ICD-10) codes on the hospital or death records. Results: During a median follow-up of 6.8 years, 1680 cases were documented, including 969 macrovascular events, 839 microvascular events, and 284 incidents of HF. Accelerometer-measured PA, irrespective of intensity, was inversely associated with the risk of composite events and each outcome in the dose–response patterns. Regarding categorized PA, engagement in total PA (high vs. low) was associated with decreased risk of macrovascular events (hazard ratio (HR) = 0.80; 95% confidence interval (95%CI): 0.67–0.95), microvascular events (HR = 0.76; 95%CI: 0.63–0.93), and HF (HR = 0.46; 95%CI: 0.32–0.66). Adherence to MVPA, but not LPA, above the guideline-recommended level (at least 150 min/week) was associated with reduced risk of macrovascular events (HR = 0.80; 95%CI: 0.68–0.95), microvascular events (HR = 0.76; 95%CI: 0.63–0.92), and HF (HR = 0.65; 95%CI: 0.46–0.92). The minimum dose of MVPA for lowering the risk of composite events was approximately 59.0 min/week. More time spent in SB was associated with an increased risk of composite events (high vs. low, HR = 1.17; 95%CI: 1.02–1.35) and HF (high vs. low, HR = 1.54; 95%CI: 1.09–2.20). Replacement of 30 min of SB (HR = 0.73; 95%CI: 0.65–0.81) and LPA (HR = 0.74; 95%CI: 0.66–0.83) with MVPA dramatically reduced the risk of composite events. Conclusion: Adherence to a higher amount of accelerometer-measured PA, especially MVPA at least 59 min/week, is associated with reduced risks of macrovascular and microvascular events among individuals with T2DM and prediabetes. Replacement of SB and LPA with MVPA helped lower the risk of diabetic vascular events. |
| format | Article |
| id | doaj-art-5eac6c62497e437ca34b899b62b8124a |
| institution | Kabale University |
| issn | 2095-2546 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Sport and Health Science |
| spelling | doaj-art-5eac6c62497e437ca34b899b62b8124a2025-01-11T06:41:10ZengElsevierJournal of Sport and Health Science2095-25462025-12-0114100973Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetesYannis Yan Liang0Yu He1Piao Huang2Hongliang Feng3Haiteng Li4Sizhi Ai5Jing Du6Huachen Xue7Yaping Liu8Jun Zhang9Lu Qi10Jihui Zhang11Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China; Institute of Psycho-neuroscience, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, ChinaCenter for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Division of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, ChinaGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Southern Medical University, Guangzhou 510080, ChinaCenter for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, ChinaDivision of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, ChinaCenter for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, ChinaCenter for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, ChinaCenter for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, ChinaCenter for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, ChinaDivision of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, ChinaDepartment of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Corresponding authors.Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China; Corresponding authors.Background: Physical activity (PA) is considered beneficial for lowering cardiovascular risks following type 2 diabetes mellitus (T2DM) and prediabetes, but existing evidence relies mainly on self-reported measurements. We aimed to describe the intensity-specific dose–response associations of PA and sedentary behavior (SB) with macrovascular and microvascular events among individuals with T2DM and prediabetes. Methods: This study included 11,474 individuals with T2DM and prediabetes from the UK Biobank. PA, including total PA, moderate-to-vigorous intensity PA (MVPA), light-intensity PA (LPA), and SB, were measured by accelerometers over 7 days. MVPA was categorized according to the American Diabetes Association guideline-recommended level (at least 150 min/week), and total PA, LPA, and SB were grouped by tertiles. The outcomes were incidences of macrovascular events, microvascular events, heart failure (HF), and their combination (composite events). The events were ascertained using the International Classification of Diseases-10 (ICD-10) codes on the hospital or death records. Results: During a median follow-up of 6.8 years, 1680 cases were documented, including 969 macrovascular events, 839 microvascular events, and 284 incidents of HF. Accelerometer-measured PA, irrespective of intensity, was inversely associated with the risk of composite events and each outcome in the dose–response patterns. Regarding categorized PA, engagement in total PA (high vs. low) was associated with decreased risk of macrovascular events (hazard ratio (HR) = 0.80; 95% confidence interval (95%CI): 0.67–0.95), microvascular events (HR = 0.76; 95%CI: 0.63–0.93), and HF (HR = 0.46; 95%CI: 0.32–0.66). Adherence to MVPA, but not LPA, above the guideline-recommended level (at least 150 min/week) was associated with reduced risk of macrovascular events (HR = 0.80; 95%CI: 0.68–0.95), microvascular events (HR = 0.76; 95%CI: 0.63–0.92), and HF (HR = 0.65; 95%CI: 0.46–0.92). The minimum dose of MVPA for lowering the risk of composite events was approximately 59.0 min/week. More time spent in SB was associated with an increased risk of composite events (high vs. low, HR = 1.17; 95%CI: 1.02–1.35) and HF (high vs. low, HR = 1.54; 95%CI: 1.09–2.20). Replacement of 30 min of SB (HR = 0.73; 95%CI: 0.65–0.81) and LPA (HR = 0.74; 95%CI: 0.66–0.83) with MVPA dramatically reduced the risk of composite events. Conclusion: Adherence to a higher amount of accelerometer-measured PA, especially MVPA at least 59 min/week, is associated with reduced risks of macrovascular and microvascular events among individuals with T2DM and prediabetes. Replacement of SB and LPA with MVPA helped lower the risk of diabetic vascular events.http://www.sciencedirect.com/science/article/pii/S2095254624001297Physical activitySedentary behaviorVascular riskType 2 diabetes mellitus |
| spellingShingle | Yannis Yan Liang Yu He Piao Huang Hongliang Feng Haiteng Li Sizhi Ai Jing Du Huachen Xue Yaping Liu Jun Zhang Lu Qi Jihui Zhang Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes Journal of Sport and Health Science Physical activity Sedentary behavior Vascular risk Type 2 diabetes mellitus |
| title | Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes |
| title_full | Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes |
| title_fullStr | Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes |
| title_full_unstemmed | Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes |
| title_short | Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes |
| title_sort | accelerometer measured physical activity sedentary behavior and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes |
| topic | Physical activity Sedentary behavior Vascular risk Type 2 diabetes mellitus |
| url | http://www.sciencedirect.com/science/article/pii/S2095254624001297 |
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