Standing is associated with insulin sensitivity in adults with metabolic syndrome

Taru Garthwaite; Tanja Sjöros; Mikko Koivumäki; Saara Laine; Henri Vähä-Ypyä; Maria Saarenhovi; Petri Kallio; Eliisa Löyttyniemi; Harri Sievänen; Noora Houttu; Kirsi Laitinen; Kari Kalliokoski; Tommi Vasankari; Juhani Knuuti; Ilkka Heinonen

doi:10.1016/j.jsams.2021.08.009

Standing is associated with insulin sensitivity in adults with metabolic syndrome

J Sci Med Sport. 2021 Dec;24(12):1255-1260. doi: 10.1016/j.jsams.2021.08.009. Epub 2021 Aug 14.

Authors

Affiliations

¹ Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland. Electronic address: taru.garthwaite@utu.fi.
² Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
³ The UKK Institute for Health Promotion Research, Tampere, Finland.
⁴ Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland.
⁵ Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland; Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland.
⁶ Department of Biostatistics, University of Turku, Turku, Finland.
⁷ Institute of Biomedicine, University of Turku, Turku, Finland.
⁸ The UKK Institute for Health Promotion Research, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
⁹ Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland; Rydberg Laboratory of Applied Sciences, University of Halmstad, Halmstad, Sweden.

PMID: 34489177
DOI: 10.1016/j.jsams.2021.08.009

Abstract

Objectives: To determine how components of accelerometer-measured sedentary behavior (SB) and physical activity (PA), and fitness are associated with insulin sensitivity in adults with metabolic syndrome.

Design: Cross-sectional.

Methods: Target population was middle-aged (40-65 years) sedentary adults with metabolic syndrome. SB, breaks in SB, standing, and PA were measured for four weeks with hip-worn accelerometers. VO₂max (ml/min/kg) was measured with maximal cycle ergometry. Insulin sensitivity was determined by hyperinsulinaemic-euglycaemic clamp (M-value) and fasting blood sampling (HOMA-IR, insulin). Multivariable regression was used for analyses.

Results: Sixty-four participants (37 women; 58.3 [SD 6.8] years) were included. Participants spent 10.0 (1.0) h sedentary, 1.8 (0.6) h standing, and 2.7 (0.6) h in PA and took 5149 (1825) steps and 29 (8) breaks daily. In sex-, age- and accelerometer wear time-adjusted model SB, standing, steps and VO₂max were associated with M-value (β = -0.384; β = 0.400; β = 0.350; β = 0.609, respectively), HOMA-IR (β = 0.420; β = -0.548; β = -0.252; β = -0.449), and insulin (β = 0.433; β = -0.541; β = -0.252; β = -0.453); all p-values < 0.05. Breaks associated only with M-value (β = 0.277). When further adjusted for body fat %, only standing remained significantly associated with HOMA-IR (β = -0.381) and insulin (β = -0.366); significance was maintained even when further adjusted for SB, PA and fitness. Light and moderate-to-vigorous PA were not associated with insulin sensitivity.

Conclusions: Standing is associated with insulin sensitivity markers. The association with HOMA-IR and insulin is independent of adiposity, PA, SB and fitness. Further studies are warranted, but these findings encourage replacing sitting with standing for potential improvements in insulin sensitivity in adults at increased type 2 diabetes risk.

Keywords: Cardiorespiratory fitness; Insulin resistance; Metabolic syndrome; Physical activity; Sedentary behavior.

MeSH terms

Accelerometry
Adult
Aged
Cross-Sectional Studies
Exercise / physiology*
Female
Humans
Insulin / blood
Insulin Resistance / physiology*
Male
Metabolic Syndrome / physiopathology*
Middle Aged
Physical Fitness / physiology*
Sedentary Behavior*
Standing Position*

Substances

Insulin