title: Associations of moderate-to-vigorous-intensity physical activity and body mass index with glycated haemoglobin within the general population: a cross-sectional analysis of the 2008 Health Survey for England.
abstract: To investigate the associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and body mass index (BMI) with glycated haemoglobin (HbA1c) in a national sample of English adults.
  
  
  
  The 2008 Health Survey for England data were used with 1109 participants aged ≥18 providing complete data. MVPA time was assessed using an accelerometer. Weighted linear regression models, adjusted for several confounders, quantified the associations between continuous measures of MVPA and BMI with HbA1c. Interaction analyses were implemented to observe whether the association of MVPA with HbA1c was modified by BMI or vice versa. Further weighted linear regression models examined the differences in HbA1c across four mutually exclusive categories of MVPA and BMI: (1) 'physically active and non-obese', (2) 'physically active and obese', (3) 'physically inactive and non-obese' and (4) 'physically inactive and obese'. 'Physically active' was defined as: ≥150 min/week of MVPA. 'Obese' was defined as: BMI ≥30.0 kg/m2. A wide range of sensitivity analyses were also implemented.
  
  
  
  Every 30 min/day increment in MVPA was associated with a 0.7 mmol/mol (0.07% (p<0.001)) lower HbA1c level. Each 1 kg/m2increment in BMI was associated with a 0.2 mmol/mol (0.02% (p<0.001)) higher HbA1c level. The association of MVPA with HbA1c was stronger in obese individuals (-1.5 mmol/mol (-0.13% (p<0.001))) than non-obese individuals (-0.7 mmol/mol (-0.06% (p<0.001))); p=0.004 for interaction. The association of BMI with HbA1c remained stable across MVPA categories. Compared with individuals categorised as 'physically inactive and obese', only those categorised as 'physically active and obese' or 'physically active and non-obese' had lower HbA1c levels by 2.1 mmol/mol (0.19% (p=0.005)) and 3.5 mmol/mol (0.32% (p<0.001)), respectively. Sensitivity analyses indicated robustness and stability.
  
  
  
  This study emphasises the importance of physical activity as a determinant of HbA1c, and suggests that the associations may be stronger in obese adults.
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|Lifestyle and Physical Activity Biomedical Research Unit (BRU), National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.|National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care-East Midlands (CLAHRC-EM), Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Kishan
authors.initials: K
authors.lastname: Bakrania
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|Lifestyle and Physical Activity Biomedical Research Unit (BRU), National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Yates
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|Lifestyle and Physical Activity Biomedical Research Unit (BRU), National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Edwardson
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care-East Midlands (CLAHRC-EM), Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Danielle H
authors.initials: DH
authors.lastname: Bodicoat
authors.affiliation: Lifestyle and Physical Activity Biomedical Research Unit (BRU), National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.|School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.
authors.forename: Dale W
authors.initials: DW
authors.lastname: Esliger
authors.affiliation: British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC), Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Jason M R
authors.initials: JM
authors.lastname: Gill
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|Lifestyle and Physical Activity Biomedical Research Unit (BRU), National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Aadil
authors.initials: A
authors.lastname: Kazi
authors.affiliation: Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, Leicestershire, UK.|Department of Older People's Mental Health, Oxleas National Health Service (NHS) Foundation Trust, Bromley, UK.
authors.forename: Latha
authors.initials: L
authors.lastname: Velayudhan
authors.affiliation: Diabetes Frail Ltd, Aston University, Birmingham, UK.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Sinclair
authors.affiliation: British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC), Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia.
authors.forename: Stuart J H
authors.initials: SJ
authors.lastname: Biddle
authors.affiliation: Lifestyle and Physical Activity Biomedical Research Unit (BRU), National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.|School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|Lifestyle and Physical Activity Biomedical Research Unit (BRU), National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, Leicestershire, UK.|National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care-East Midlands (CLAHRC-EM), Diabetes Research Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004739:England; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism*
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Body Mass Index; EPIDEMIOLOGY; Glycated Haemoglobin; Moderate-to-Vigorous-Intensity Physical Activity; Obesity; Type 2 Diabetes Mellitus