RESUMO
OBJECTIVE: Prolonged sedentary time (ST) might be contributing to the diabetes epidemic, but most studies have been cross-sectional and few have objectively measured ST. The purpose of this study was to evaluate cross-sectional and 5-year longitudinal relationships between ST and metabolic parameters and outcomes. RESEARCH DESIGN AND METHODS: This was an analysis of 2,027 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (aged 38-50 years, 57% female, and mean BMI of 29.0 ± 7.0 kg/m(2)) with accelerometry data (≥4 days with ≥10 h/day) measured at the year 20 follow-up exam (2005-2006). Metabolic variables (fasting glucose, fasting insulin, 2-h postchallenge glucose, HOMA of insulin resistance [HOMA-IR], and HbA1c) and outcomes (impaired fasting glucose [IFG], impaired glucose tolerance [IGT], prediabetes by HbA1c, and diabetes) were assessed concurrently and 5 years later. RESULTS: Average ST was 8.1 ± 1.7 h/day or 55 ± 10% of wear time. Each additional hour per day of ST was cross-sectionally associated with a 3% higher fasting insulin and HOMA-IR (both P < 0.01) but not 5-year changes in metabolic parameters. Having ≥10 h/day vs. <6 h/day of ST was associated with an odds ratio (OR) = 2.74 (95% CI 1.13, 6.62) for IGT and an OR = 3.80 (95% CI 1.39, 10.35) for diabetes. ST was not associated with prevalent IFG, prevalent prediabetes by HbA1c, or 5-year incidence of any metabolic outcomes (all P > 0.05). CONCLUSIONS: ST was independently related to insulin, HOMA-IR, and prevalent diabetes and IGT but did not predict 5-year changes in metabolic parameters or incidence of metabolic outcomes. These results suggest that higher ST may not be a risk factor for future metabolic outcomes, but more research with repeated ST measurement and longer follow-up is needed.
Assuntos
Doença da Artéria Coronariana/etiologia , Doenças Metabólicas/etiologia , Comportamento Sedentário , Adolescente , Adulto , Glicemia/metabolismo , Doença da Artéria Coronariana/metabolismo , Estudos Transversais , Angiopatias Diabéticas/etiologia , Angiopatias Diabéticas/metabolismo , Exercício Físico/fisiologia , Jejum/sangue , Feminino , Intolerância à Glucose/metabolismo , Hemoglobinas Glicadas/metabolismo , Humanos , Insulina/metabolismo , Resistência à Insulina/fisiologia , Masculino , Doenças Metabólicas/metabolismo , Estado Pré-Diabético/metabolismo , Fatores de Risco , Adulto JovemRESUMO
Factors influencing gestational weight gain are incompletely understood, particularly among Hispanic women. We assessed medical, sociodemographic, behavioral, and psychosocial predictors of overall gestational weight gain, as well as gains below, within, or above the range recommended by the Institute of Medicine (IOM) within a prospective study of 770 Hispanic (predominantly Puerto Rican) prenatal care patients at a large tertiary care facility in Western Massachusetts. One third of women gained within the recommended range, 22% gained below, and 45% gained above the range. In multivariate analysis, women in the highest category of BMI (P(trend)<0.001) and parity (P(trend)<0.001) gained on average 9 lbs less than those in the lowest category. Increasing time in residence in the continental United States (P(trend)<0.01) as well as a number of prenatal care visits (P(trend)=0.03) were positively associated with weight gain. Overweight women (odds ratio (OR)=2.2, 95% confidence interval (CI) 1.3, 3.8) and those over age 30 years (OR=2.5, 95% CI 1.2, 5.0) were more likely to gain above the IOM range as compared to normal-weight women and those aged 20-24, respectively. Women with <10 years of residence in the United States were 50% less likely to gain above the IOM range as compared to third-generation women (95% CI 0.3, 0.9). Findings identify determinants of gestational weight gain which can form the basis of targeted interventions in this rapidly growing ethnic group.