title: Associations of reallocating sitting time into standing or stepping with glucose, insulin and insulin sensitivity: a cross-sectional analysis of adults at risk of type 2 diabetes.
abstract: To quantify associations between sitting time and glucose, insulin and insulin sensitivity by considering reallocation of time into standing or stepping.
  
  
  
  Cross-sectional.
  
  
  
  Leicestershire, UK, 2013.
  
  
  
  Adults aged 30-75 years at high risk of impaired glucose regulation (IGR) or type 2 diabetes. 435 adults (age 66.8±7.4 years; 61.7% male; 89.2% white European) were included.
  
  
  
  Participants wore an activPAL3 monitor 24 hours/day for 7 days to capture time spent sitting, standing and stepping. Fasting and 2-hour postchallenge glucose and insulin were assessed; insulin sensitivity was calculated by Homeostasis Model Assessment of Insulin Secretion (HOMA-IS) and Matsuda-Insulin Sensitivity Index (Matsuda-ISI). Isotemporal substitution regression modelling was used to quantify associations of substituting 30 min of waking sitting time (accumulated in prolonged (≥30 min) or short (<30 min) bouts) for standing or stepping on glucose regulation and insulin sensitivity. Interaction terms were fitted to assess whether the associations with measures of glucose regulation and insulin sensitivity was modified by sex or IGR status.
  
  
  
  After adjustment for confounders, including waist circumference, reallocation of prolonged sitting to short sitting time and to standing was associated with 4% lower fasting insulin and 4% higher HOMA-IS; reallocation of prolonged sitting to standing was also associated with a 5% higher Matsuda-ISI. Reallocation to stepping was associated with 5% lower 2-hour glucose, 7% lower fasting insulin, 13% lower 2-hour insulin and a 9% and 16% higher HOMA-IS and Matsuda-ISI, respectively. Reallocation of short sitting time to stepping was associated with 5% and 10% lower 2-hour glucose and 2-hour insulin and 12% higher Matsuda-ISI. Results were not modified by IGR status or sex.
  
  
  
  Reallocating a small amount of short or prolonged sitting time with standing or stepping may improve 2-hour glucose, fasting and 2-hour insulin and insulin sensitivity. Findings should be confirmed through prospective and intervention research.
  
  
  
  ISRCTN31392913, Post-results.
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK.|NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.|Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Edwardson
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK.|NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.|Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
authors.forename: Joe
authors.initials: J
authors.lastname: Henson
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK.|Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.|NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Leicester, UK.
authors.forename: Danielle H
authors.initials: DH
authors.lastname: Bodicoat
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK.|NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.|Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.|NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Leicester, UK.
authors.forename: Kishan
authors.initials: K
authors.lastname: Bakrania
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK.|Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.|NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Leicester, UK.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK.|NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.|Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK.|NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.|Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Yates
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D015444:Exercise / Q000502:physiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D011187:Posture / Q000502:physiology*; D012307:Risk Factors; D057185:Sedentary Behavior; D013997:Time Factors; D055105:Waist Circumference / Q000502:physiology; D016138:Walking / Q000502:physiology
chemical_list: D015415:Biomarkers
keywords: Posture; activPAL; health; isotemporal substitution; objective; sedentary behaviour