title: Associations of total amount and patterns of sedentary behaviour with type 2 diabetes and the metabolic syndrome: The Maastricht Study.
abstract: OBJECTIVE
  The study investigated cross-sectional associations of total amount and patterns of sedentary behaviour with glucose metabolism status and the metabolic syndrome.
  
  
  METHODS
  We included 2,497 participants (mean age 60.0 ± 8.1 years, 52% men) from The Maastricht Study who were asked to wear an activPAL accelerometer 24 h/day for 8 consecutive days. We calculated the daily amount of sedentary time, daily number of sedentary breaks and prolonged sedentary bouts (≥30 min), and the average duration of the sedentary bouts. To determine glucose metabolism status, participants underwent an oral glucose tolerance test. Associations of sedentary behaviour variables with glucose metabolism status and the metabolic syndrome were examined using multinomial logistic regression analyses.
  
  
  RESULTS
  Overall, 1,395 (55.9%) participants had normal glucose metabolism, 388 (15.5%) had impaired glucose metabolism and 714 (28.6%) had type 2 diabetes. The odds ratio per additional hour of sedentary time was 1.22 (95% CI 1.13, 1.32) for type 2 diabetes and 1.39 (1.27, 1.53) for the metabolic syndrome. No significant or only weak associations were seen for the number of sedentary breaks, number of prolonged sedentary bouts or average bout duration with either glucose metabolism status or the metabolic syndrome.
  
  
  CONCLUSIONS
  An extra hour of sedentary time was associated with a 22% increased odds for type 2 diabetes and a 39% increased odds for the metabolic syndrome. The pattern in which sedentary time was accumulated was weakly associated with the presence of the metabolic syndrome. These results suggest that sedentary behaviour may play a significant role in the development and prevention of type 2 diabetes, although longitudinal studies are needed to confirm our findings.
authors.affiliation: Department of Social Medicine, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands. j.vanderberg@maastrichtuniversity.nl.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands. j.vanderberg@maastrichtuniversity.nl.
authors.forename: Julianne D
authors.initials: JD
authors.lastname: van der Berg
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.affiliation: Department of Social Medicine, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Bosma
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands.|NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
authors.forename: Jeroen H P M
authors.initials: JH
authors.lastname: van der Velde
authors.affiliation: Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands.|NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
authors.forename: Paul J B
authors.initials: PJ
authors.lastname: Willems
authors.affiliation: Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands.|NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
authors.forename: Hans H C M
authors.initials: HH
authors.lastname: Savelberg
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
authors.forename: Miranda T
authors.initials: MT
authors.lastname: Schram
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
authors.forename: Simone J S
authors.initials: SJ
authors.lastname: Sep
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
authors.forename: Carla J H
authors.initials: CJ
authors.lastname: van der Kallen
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
authors.forename: Ronald M A
authors.initials: RM
authors.lastname: Henry
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.|Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.|Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
authors.forename: Nicolaas C
authors.initials: NC
authors.lastname: Schaper
authors.affiliation: Department of Social Medicine, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Koster
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D057185:Sedentary Behavior
keywords: Accelerometry; Diabetes mellitus type 2; Metabolic syndrome; Sedentary bouts; Sedentary breaks; Sedentary lifestyle; Sedentary time
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