Highlights
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Biomarkers of endothelial dysfunction and low-grade inflammation play an important role in the pathogenesis of CVD. Lifestyle factors, particularly physical activity and diet, are thought to be important modifiable risk factors for the development of endothelial dysfunction and low-grade inflammation.
Physical activity in particular has been shown to be inversely related to biomarkers of endothelial dysfunction and low-grade inflammation, possibly because physical activity increases blood flow and shear stress, which improves NO bioavailability, and because physical activity reduces visceral adipose tissue, which in turn reduces low-grade inflammation.
The effects of physical activity on biomarkers of endothelial dysfunction may be especially prominent in people with type 2 diabetes mellitus. Hyperglycemia impairs microvascular endothelial function and specifically reduces NO availability. Furthermore, microvascular endothelial dysfunction (of which these biomarkers are a representative) is thought to worsen hyperglycemia through impairment of both insulin-induced glucose uptake and insulin secretion, thus establishing a vicious cycle of biomarkers of endothelial dysfunction and hyperglycemia
Physical activity is a complex behavior in which several dimensions can be recognized, such as quantity, intensity (light, moderate and vigorous) and weekly pattern. Additionally, sedentary behavior should be taken into account and may be related to adverse health outcomes regardless of moderate to vigorous intensity physical activity. Such distinctions may be relevant to providing public health guidelines that are more detailed than the weekly amount of moderate to vigorous intensity physical activity.
In view of the above, in a large population-based cohort with an oversampling of type 2 diabetes, we investigated the relationship between the amount and pattern of physical activity and sedentary behavior on the one hand and biomarkers of endothelial dysfunction and low-grade inflammation on the other. the other. Specifically, we focused on the influence of prediabetes (defined as impaired glucose tolerance and impaired fasting glucose) and type 2 diabetes on these associations.
Objectives and hypotheses
Biomarkers of endothelial dysfunction and low-grade inflammation are important in the pathogenesis of CVD and can potentially be modified by physical activity and sedentary behavior. The effects of physical activity on biomarkers of endothelial dysfunction may be especially prominent in type 2 diabetes.
Methods
In the population-based Maastricht Study (n = 2363, 51.5% men, 28.3% type 2 diabetes, 15.1% prediabetes [defined as impaired glucose tolerance and impaired fasting glucose ]), we determined biomarkers of endothelial dysfunction and low-grade inflammation, and combined z scores were calculated.
Physical activity and sedentary behavior were measured using activPAL. Linear regression analyzes were used with adjustment for demographics, lifestyle, and cardiovascular risk factors.
Results
The association between full-intensity, light, moderate-to-vigorous, and vigorous physical activity and sedentary time on the one hand and biomarkers of endothelial dysfunction on the other were generally significant and consistently stronger in prediabetes and type 2 diabetes compared with normal glucose metabolism status (p for interaction <0.05).
The associations between physical activity and sedentary behavior on the one hand and low-grade inflammation on the other were also significant and similar in individuals with and without (pre)diabetes (p for interaction >0.05).
Conclusions
In conclusion, this study shows that, regardless of demographics, lifestyle, and cardiovascular risk factors, different intensities of physical activity are inversely associated with biomarkers of endothelial dysfunction and low-grade inflammation. Furthermore, greater regularity of moderate-to-vigorous intensity physical activity is advantageous with respect to biomarkers of endothelial dysfunction and low-grade inflammation.
Sedentary time was directly associated with biomarkers of endothelial dysfunction, and sedentary time, prolonged sedentary sessions (positively), and sedentary breaks (inversely) were associated with low-grade inflammation, and this was independent of moderate-intensity physical activity. to vigorous. Associations of physical activity and biomarkers of endothelial dysfunction were consistently stronger in prediabetes and type 2 diabetes.
Together, these results support increasing physical activity and limiting sedentary behavior as a means to prevent or improve biomarkers of endothelial dysfunction and low-grade inflammation, especially in people with prediabetes and type 2 diabetes.
Final message
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