Device-measured sitting time and musculoskeletal pain in adults with normal glucose metabolism, prediabetes and type 2 diabetes-The Maastricht Study

Francis Q S Dzakpasu; Annemarie Koster; Neville Owen; Bastiaan E de Galan; Alison Carver; Christian J Brakenridge; Annelies Boonen; Hans Bosma; Pieter C Dagnelie; Simone J P M Eussen; Parneet Sethi; Coen D A Stehouwer; Nicolaas C Schaper; David W Dunstan

doi:10.1371/journal.pone.0285276

Device-measured sitting time and musculoskeletal pain in adults with normal glucose metabolism, prediabetes and type 2 diabetes-The Maastricht Study

PLoS One. 2023 May 4;18(5):e0285276. doi: 10.1371/journal.pone.0285276. eCollection 2023.

Authors

Francis Q S Dzakpasu^{1

2}, Annemarie Koster^{3

4}, Neville Owen^{2

5}, Bastiaan E de Galan^{6

7

8}, Alison Carver⁹, Christian J Brakenridge^{2

10}, Annelies Boonen^{4

11}, Hans Bosma^{3

4}, Pieter C Dagnelie^{6

7}, Simone J P M Eussen^{4

7

12}, Parneet Sethi², Coen D A Stehouwer^{6

7}, Nicolaas C Schaper^{4

6

7}, David W Dunstan^{2

13}

Affiliations

¹ Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
² Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
³ Department of Social Medicine, Maastricht University, Maastricht, the Netherlands.
⁴ CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
⁵ Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia.
⁶ Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
⁷ CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
⁸ Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands.
⁹ National Centre for Healthy Ageing, Peninsula Clinical School, Monash University, Frankston, Victoria, Australia.
¹⁰ Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland.
¹¹ Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.
¹² Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
¹³ Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.

Abstract

Background: Detrimental associations of sedentary behaviour (time spent sitting) with musculoskeletal pain (MSP) conditions have been observed. However, findings on those with, or at risk of, type 2 diabetes (T2D) have not been reported. We examined the linear and non-linear associations of device-measured daily sitting time with MSP outcomes according to glucose metabolism status (GMS).

Methods: Cross-sectional data from 2827 participants aged 40-75 years in the Maastricht Study (1728 with normal glucose metabolism (NGM); 441 with prediabetes; 658 with T2D), for whom valid data were available on activPAL-derived daily sitting time, MSP [neck, shoulder, low back, and knee pain], and GMS. Associations were examined by logistic regression analyses, adjusted serially for relevant confounders, including moderate-to-vigorous intensity physical activity (MVPA) and body mass index (BMI). Restricted cubic splines were used to further examine non-linear relationships.

Results: The fully adjusted model (including BMI, MVPA, and history of cardiovascular disease) showed daily sitting time to be significantly associated with knee pain in the overall sample (OR = 1.07, 95%CI: 1.01-1.12) and in those with T2D (OR = 1.11, 95%CI: 1.00-1.22); this was not statistically significant in those with prediabetes (OR = 1.04, 95%CI: 0.91-1.18) or NGM (OR = 1.05, 95%CI: 0.98-1.13). There were no statistically significant associations between daily sitting time and neck, shoulder, or low back pain in any of the models. Furthermore, the non-linear relationships were statistically non-significant.

Conclusion: Among middle-aged and older adults with T2D, daily sitting time was significantly associated with higher odds of knee pain, but not with neck, shoulder, or low back pain. No significant association was observed in those without T2D for neck, shoulder, low back, or knee pain. Future studies, preferably those utilising prospective designs, could examine additional attributes of daily sitting (e.g., sitting bouts and domain-specific sitting time) and the potential relationships of knee pain with mobility limitations.

Copyright: © 2023 Dzakpasu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / epidemiology
Glucose
Humans
Low Back Pain*
Middle Aged
Musculoskeletal Pain* / epidemiology
Prediabetic State* / epidemiology
Risk Factors
Sitting Position

Substances

Glucose

Grants and funding

The Maastricht Study was supported by the European Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs (grant 31O.041), Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), the Cardiovascular Center (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), CAPHRI Care and Public Health Research Institute (Maastricht, the Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands) and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands) and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands). Dzakpasu was supported by the Australian Government Research Training Program Scholarship. Owen was supported by the National Health and Medical Research Council (NHMRC) of Australia through a Senior Principal Research Fellowships (#1003960) and by the Victorian Government’s Operational Infrastructure Support Program. Dunstan was supported by an NHMRC Senior Research Fellowship (#1078360) and the Victorian Government’s Operational Infrastructure Support Program. The funders played no role in the design, data analysis, and realization of this manuscript.