Physical activity ameliorates the association between sedentary behavior and cardiometabolic risk among inpatients with schizophrenia: A comparison versus controls using accelerometry.
A lack of clarity exists regarding the relationship between objectively measured physical activity (PA) and sedentary behavior (SB) and cardiometabolic outcomes in people with schizophrenia. We conducted a large study investigating the independent relationships of PA and SB among inpatients with schizophrenia versus healthy controls (HCs).



A cross sectional study including 199 inpatients with schizophrenia (mean age 44.0years, mean illness duration 23.8years) versus 60 age/sex/body mass index matched HCs. Participants wore accelerometers for 7days to capture SB and daily steps. Cardiometabolic outcomes included blood pressure, fasting blood glucose (FBG), triglycerides, high-density lipoprotein cholesterol (HDL-C) and waist circumference (WC). Multivariate regression analyses adjusting for multiple confounders were undertaken.



Compared to HCs, patients engaged in more sedentary behavior and less daily steps versus HCs (p<0.001). Patients with higher levels of SB (n=89) had increased fasting glucose compared to patients with low levels of SB (105.2 vs. 96.3mg/dl, p<0.05). In the multivariate analysis, sedentary behavior was associated with higher FBG (β = .146, p=.041) but this was ameliorated when daily steps were inserted in to the model (β = .141, p=.059). In the final model, higher daily steps were associated with more favorable HDL-C (β=-.226, p=.004), independent of SB and other confounders.



Our data suggest that higher than while sedentary behavior is related to worse fasting glucose, this relationship is attenuated when PA is taken into account. Physical activity is also associated with favorable HDL-C. Interventions targeting replacing sedentary behavior with PA may improve metabolic risk.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom. Electronic address: brendon.stubbs@kcl.ac.uk.
Brendon
B
Stubbs
Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City 404, Taiwan; Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK. Electronic address: ljchen@ntupes.edu.tw.
Li-Jung
LJ
Chen
Jianan Psychiatric Center, Ministry of Health and Welfare, 80, Lane 870, Zhongshan Road, Tainan 717, Taiwan. Electronic address: mschung3@gmail.com.
Ming-Shun
MS
Chung
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK; Graduate Institute of Sports and Health, National Changhua University of Education, 1, Jin-De Road, Changhua 500, Taiwan. Electronic address: powen.ku@gmail.com.
Po-Wen
PW
Ku
D061725:Accelerometry / Q000379:methods*; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000503:physiopathology / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008659:Metabolic Diseases / Q000097:blood* / Q000503:physiopathology / Q000517:prevention & control; D008875:Middle Aged; D012307:Risk Factors; D012559:Schizophrenia / Q000097:blood* / Q000503:physiopathology; D057185:Sedentary Behavior; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology
D008076:Cholesterol, HDL; D014280:Triglycerides