Influence of Sedentary Behavior on Insulin Sensitivity and Cardiometabolic Risk in Adults With Prediabetes
DOI:
https://doi.org/10.61336/jdme.0501.03Keywords:
Prediabetes, sedentary behavior, insulin sensitivity, insulin resistanceAbstract
Sedentary behavior is increasingly recognized as an independent component of cardiometabolic risk, even among individuals who achieve recommended levels of moderate-to-vigorous physical activity. This study evaluated the relationship between objectively measured sedentary behavior, insulin sensitivity, and cardiometabolic risk in adults with prediabetes. A prospective observational study was conducted among 178 adults aged 35–70 years with impaired fasting glucose, impaired glucose tolerance, or HbA1c within the prediabetes range. Sedentary time and daily movement patterns were assessed using a thigh-worn accelerometer over seven consecutive days, while fasting glucose, fasting insulin, HbA1c, lipid profile, blood pressure, waist circumference, and high-sensitivity C-reactive protein were measured at baseline. Insulin sensitivity was estimated using HOMA-IR and QUICKI. Participants were classified according to daily sedentary time and the frequency of prolonged uninterrupted sedentary bouts. Higher sedentary time was associated with greater HOMA-IR, higher triglycerides, increased waist circumference, elevated systolic blood pressure, and higher hs-CRP. Participants spending more than 9 hours per day sedentary had significantly lower estimated insulin sensitivity than those spending less than 7 hours per day sedentary. Frequent prolonged sedentary bouts were also associated with an unfavorable cardiometabolic profile independently of total sedentary duration. After adjustment for age, sex, BMI, sleep duration, moderate-to-vigorous physical activity, and dietary quality, each additional hour of sedentary behavior was independently associated with higher HOMA-IR. Participants with high sedentary exposure had approximately 2.6-fold greater odds of having a high cardiometabolic risk profile. These findings suggest that both the amount and pattern of sedentary behavior may be relevant determinants of insulin sensitivity and cardiometabolic health in adults with prediabetes.
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