Physical Activity, Sedentary Behavior, and the Risk of Cardiovascular Disease in Type 2 Diabetes Mellitus Patients: The MIDiab Study

The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity (MVPA) time and sedentary (SED) time with a history of cardiovascular disease (CVD) and multifactorial (i.e., blood pressure (BP), body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), and gly-cated hemoglobin A1c (HbA1c)) control status among type 2 diabetes mellitus (T2DM) patients in China. A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes (MIDiab) study was performed. Patients were grouped according to their self-reported MVPA time (low, < 150 min center dot week-1; moderate, 150 to < 450 min center dot week-1; high, >= 450 min center dot week-1) and SED time (low, < 4 h center dot d-1; moderate, 4 to < 8 h center dot d-1; high, >= 8 h center dot d-1). Participants who self-reported a history of CVD were identified as having a CVD risk. Odds ratios (ORs) and 95% confidence intervals (CIs) of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models, adjusting for China's geographical region characteristics. The participants had a mean +/- standard deviation (SD) age of (60.87 +/- 8.44) years, 44.5% were women, and 25.1% had CVD. After adjustment for potential confounding factors, an inverse association between high MVPA time and CVD risk that was independent of SED time was found, whereas this association was not observed in the moderate-MVPA group. A higher MVPA time was more likely to have a positive effect on the control of BMI. Compared with the reference group (i.e., those with MVPA time >= 450 min center dot week-1 and SED time < 4 h center dot d-1), CVD risk was higher in the low-MVPA group: The OR associated with an SED time < 4 h center dot d-1 was 1.270 (95% CI, 1.040-1.553) and that associated with an SED time >= 8 h center dot d-1 was 1.499 (95% CI, 1.149-1.955). We found that a high MVPA time (i.e., >= 450 min center dot week-1) was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.(c) 2022 THE AUTHORS. Published by Elsevier LTD on behalf of Chinese Academy of Engineering and Higher Education Press Limited Company. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).