Browsing by Author "Eriksson, Marika Ingeborg"
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Seppälä, Matias; Tikkanen, Heidi; Wadén, Johan; Eriksson, Marika Ingeborg; Harjutsalo, Valma; Groop, Per-Henrik; Thorn, Lena (2024)Background Sedentary behavior, such as excessive sitting, is associated with an increased risk of cardiovascular disease and premature mortality in the general population, but this has not been assessed in type 1 diabetes. Occupational sitting is increasingly ubiquitous and often composes the largest portion of individuals´ daily sitting time. Our aim was, therefore, to identify clinical factors associated with excessive occupational sitting in individuals with type 1 diabetes, and additionally, in a prospective setting, to explore the association between excessive occupational sitting and cardiovascular events and all-cause mortality, independently of leisure-time physical activity. Methods Observational follow-up study, including 1,704 individuals (mean age 38.9 ± 10.1 years) from the Finnish Diabetic Nephropathy Study. Baseline assessments of occupational sitting and leisure-time physical activity were conducted using a validated self-report questionnaire. Excessive occupational sitting was defined as ≥ 6 hours of daily workplace sitting. Data on cardiovascular events and mortality were retrieved from national registries. Multivariable logistic regression analysis was applied to determine independently associated factors. Kaplan-Meier curves and Cox proportional hazard models were performed regarding prospective analyses. Results Factors independently and positively associated with excessive occupational sitting included a high educational level [OR 6.53, 95% CI (4.09‒10.40)] and older age [1.02 (1.00‒1.03)], whereas negatively associated factors included current smoking [0.68 (0.50‒0.92)], moderate albuminuria [0.55 (0.38‒ 0.80)], and high amounts of leisure-time physical activity [0.52 (0.36‒0.74)]. During a median followup of 12.5 (6.5-16.4) years, 163 (9.6%) individuals suffered a cardiovascular event. Respectively, during a median follow-up of 13.7 (9.4-16.6) years, 108 (6.3%) deaths occurred. Excessive occupational sitting increased the risk of cardiovascular events (hazard ratio [HR] 1.43 [95% CI 1.02‒2.01]) after adjustment for confounders. In a stratified multivariable analysis among current smokers, excessive occupational 5 sitting increased the risk of cardiovascular events (1.93 [1.03‒3.62]) and all-cause mortality (2.16 [1.10‒ 4.21]). Conclusions Excessive occupational sitting is associated with an increased risk of cardiovascular events and all-cause mortality in individuals with type 1 diabetes, especially among current smokers, regardless of leisuretime physical activity. These findings highlight the importance of recommendations for reducing sedentary time, as part of the physical activity guidelines for individuals with type 1 diabetes.
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