Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study

Background and purpose Sedentary behaviour is a risk factor for vascular disease and stroke patients are more sedentary than their age-matched peers. The association with glucose levels, as a potential mediator, is unclear, and we have investigated the association between long-bout sedentary behavio...

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Main Authors: Coralie English, Katinka Nordheim Alme, Anne-Brita Knapskog, Halvor Næss, Mala Naik, Mona Beyer, Hanne Ellekjaer, Hege Ihle Hansen, Camilla Sollesnes Kummeneje, Ragnhild Munthe-Kaas, Ingvild Saltvedt, Yngve Seljeseth, Xiangchung Tan, Pernille Thingstad, Torunn Askim
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e037475.full
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author Coralie English
Katinka Nordheim Alme
Anne-Brita Knapskog
Halvor Næss
Mala Naik
Mona Beyer
Hanne Ellekjaer
Hege Ihle Hansen
Camilla Sollesnes Kummeneje
Ragnhild Munthe-Kaas
Ingvild Saltvedt
Yngve Seljeseth
Xiangchung Tan
Pernille Thingstad
Torunn Askim
author_facet Coralie English
Katinka Nordheim Alme
Anne-Brita Knapskog
Halvor Næss
Mala Naik
Mona Beyer
Hanne Ellekjaer
Hege Ihle Hansen
Camilla Sollesnes Kummeneje
Ragnhild Munthe-Kaas
Ingvild Saltvedt
Yngve Seljeseth
Xiangchung Tan
Pernille Thingstad
Torunn Askim
author_sort Coralie English
collection DOAJ
description Background and purpose Sedentary behaviour is a risk factor for vascular disease and stroke patients are more sedentary than their age-matched peers. The association with glucose levels, as a potential mediator, is unclear, and we have investigated the association between long-bout sedentary behaviour and long-term glucose levels in stroke survivors.Methods This study uses data from the Norwegian Cognitive Impairment After Stroke study, a multicentre cohort study. The patients were recruited at hospital admission for acute stroke, and the follow-up was done at the outpatient clinic. Sedentary behaviour—being in a sitting or reclining position—was registered 3 months after stroke using position transition data from the body-worn sensor activPAL attached to the unaffected thigh. A MATLAB script was developed to extract activity data from 08:00 to 10:00 for 4 days and to categorise the data into four bout-length categories. The primary outcome was glycated haemoglobin (HbA1c), analysed at 3 months. Regression models were used to analyse the association between HbA1c and sedentary behaviour in the whole population and stratified based on a diagnosis of diabetes mellitus (DM). Age, body mass index and the use of antidiabetic drugs were added as covariates into the models.Results From a total of 815 included patients, 379 patients fulfilled the inclusion criteria for this study. We found no association between time in sedentary behaviour and HbA1c in the whole stroke population. We found time in sedentary behaviour in bouts of ≥90 min to be associated with a higher HbA1c in patients with DM.Conclusion Long-bout sedentary time is associated with a higher HbA1c in patients with DM 3 months after ischaemic stroke. Future research should investigate the benefit of breaking up sedentary time as a secondary preventive measure.Trial registration number NCT02650531, https://clinicaltrials.gov/ct2/show/NCT02650531
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spelling doaj-art-be8e499ef6f34e3db91cfbf4d92731ae2024-11-25T10:15:07ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-037475Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort studyCoralie English0Katinka Nordheim Alme1Anne-Brita Knapskog2Halvor Næss3Mala Naik4Mona Beyer5Hanne Ellekjaer6Hege Ihle Hansen7Camilla Sollesnes Kummeneje8Ragnhild Munthe-Kaas9Ingvild Saltvedt10Yngve Seljeseth11Xiangchung Tan12Pernille Thingstad13Torunn Askim14Heart and Stroke Research Program, The University of Newcastle Hunter Medical Research Institute, Newcastle, New South Wales, AustraliaDepartment of Clinical Medicine (K1), University of Bergen, Bergen, NorwayDepartment of Geriatric Medicine, Oslo University Hospital Ullevaal, Oslo, NorwayDepartment of Clinical Medicine (K1), University of Bergen, Bergen, NorwayDepartment of Clinical Science, University of Bergen, Bergen, NorwayInstitute of Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, NorwayOslo Stroke Unit, Neurological Department, Oslo University Hospital, Ullevål, Oslo, NorwayDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, NorwayInstitute of Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Geriatric Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, NorwayDepartment of Medicine, Ålesund Hospital, Helse More og Romsdal HF, Ålesund, NorwayDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, NorwayBackground and purpose Sedentary behaviour is a risk factor for vascular disease and stroke patients are more sedentary than their age-matched peers. The association with glucose levels, as a potential mediator, is unclear, and we have investigated the association between long-bout sedentary behaviour and long-term glucose levels in stroke survivors.Methods This study uses data from the Norwegian Cognitive Impairment After Stroke study, a multicentre cohort study. The patients were recruited at hospital admission for acute stroke, and the follow-up was done at the outpatient clinic. Sedentary behaviour—being in a sitting or reclining position—was registered 3 months after stroke using position transition data from the body-worn sensor activPAL attached to the unaffected thigh. A MATLAB script was developed to extract activity data from 08:00 to 10:00 for 4 days and to categorise the data into four bout-length categories. The primary outcome was glycated haemoglobin (HbA1c), analysed at 3 months. Regression models were used to analyse the association between HbA1c and sedentary behaviour in the whole population and stratified based on a diagnosis of diabetes mellitus (DM). Age, body mass index and the use of antidiabetic drugs were added as covariates into the models.Results From a total of 815 included patients, 379 patients fulfilled the inclusion criteria for this study. We found no association between time in sedentary behaviour and HbA1c in the whole stroke population. We found time in sedentary behaviour in bouts of ≥90 min to be associated with a higher HbA1c in patients with DM.Conclusion Long-bout sedentary time is associated with a higher HbA1c in patients with DM 3 months after ischaemic stroke. Future research should investigate the benefit of breaking up sedentary time as a secondary preventive measure.Trial registration number NCT02650531, https://clinicaltrials.gov/ct2/show/NCT02650531https://bmjopen.bmj.com/content/10/11/e037475.full
spellingShingle Coralie English
Katinka Nordheim Alme
Anne-Brita Knapskog
Halvor Næss
Mala Naik
Mona Beyer
Hanne Ellekjaer
Hege Ihle Hansen
Camilla Sollesnes Kummeneje
Ragnhild Munthe-Kaas
Ingvild Saltvedt
Yngve Seljeseth
Xiangchung Tan
Pernille Thingstad
Torunn Askim
Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study
BMJ Open
title Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study
title_full Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study
title_fullStr Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study
title_full_unstemmed Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study
title_short Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study
title_sort is long bout sedentary behaviour associated with long term glucose levels 3 months after acute ischaemic stroke a prospective observational cohort study
url https://bmjopen.bmj.com/content/10/11/e037475.full
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