The effects of objectively measured sedentary behavior on all-cause mortality in a national sample of adults with diabetes

Background. Diabetes is a highly prevalent chronic disease that has been increasing globally and is the seventh leading cause of death in the United States. Sedentary behavior is associated with increased risk of diabetes and is unfavorably related to all-cause mortality, but there are limited studies examining the sedentary-mortality relationship among those with diabetes, which was the purpose of this study. Methods. Using data from the 2003-2006 NHANES, 712 adult participants with evidence of diabetes had complete data on the study variables. A multivariable Cox proportional hazard model was used to examine the association between objectively measured sedentary behavior and all-cause mortality among this diabetic sample. Results. Results showed that for every 60min/day increase in sedentary behavior, independent of moderate-to-vigorous physical activity (MVPA) and other covariates, adults with diabetes had a 13% increased risk of all-cause mortality (HRadjusted = 1.13; 95% CI = 1.03-1.24; P = 0.01). However, after adjusting for total physical activity (light and MVPA), sedentary behavior was no longer associated with mortality risk (HRadjusted = 1.04; 95% CI = 0.92-1.16; P = 0.46). Conclusion. Among those with diabetes, sedentary behavior may not have increased mortality risk independent of total physical activity behavior. (C) 2016 Elsevier Inc. All rights reserved.