Association of sedentary time and carotid atherosclerotic plaques in patients with type 2 diabetes

Abstract

Background Atherosclerosis is a common complication in patients with type 2 diabetes (T2DM). Multiple factors are involved in the development and progress of atherosclerosis. We evaluated the association of weekly sedentary time (WST) with carotid plaque formation. Methods After data cleaning, a total of 26 664 participants with T2DM from 10 National Metabolic Management Centers (MMCs) from June 2017 to April 2021 were enrolled. Self‐reported lifestyle data including WST, sleeping time, smoking and drinking information, carotid artery ultrasound, and biochemical parameters were obtained. The independent association of carotid plaue with sedentary and other lifestyle behaviors was evaluated using multivariable logistic regression models, and odds ratio (OR) with 95% confidence interval (CI) were reported. Moreover, stratified analysis was conducted to demonstrate the influence of confounding factors. Results The mean (SD) age of the participants was 54.0 (11.6) years, and the median (interquartile range) WST was 35.0 (21.0, 42.0) h. Comparing with participants in the first tertile of WST, those in the second or third tertile of WST were younger and with a shorter duration of diabetes. There were positive associations between longer sedentary time and odds of artery plaque after adjustment, with corresponding ORs in the second and third tertile were 1.40 (95% CI: 1.31–1.50) and 1.67 (95% CI: 1.56–1.79), respectively. However, the effect of WST on plaque in patients aged 18–40 years old had no statistical significance; the p value in the third tertile was 0.163. Conclusions In summary, higher WST appears to be associated with higher prevalence of carotid plaque in patients with T2DM, especially in aged populations.

Follow‐up frequency and clinical outcomes in patients with type 2 diabetes: A prospective analysis based on multicenter real‐world data

“…T2DM was identified according to the WHO criteria 16 . A detailed introduction of the MMC program can be found in previous publications (http://clinicaltrials.gov number NCT03811470) 5‐7,17,18 . Briefly, the MMCs are an innovative project for the management of diabetes and other metabolic diseases throughout China, with “one center, one stop, and one standard” as its core principle.…”

“… 16 A detailed introduction of the MMC program can be found in previous publications ( ClinicalTrials.gov number NCT03811470). 5 , 6 , 7 , 17 , 18 Briefly, the MMCs are an innovative project for the management of diabetes and other metabolic diseases throughout China, with “one center, one stop, and one standard” as its core principle. The MMCs have implemented a series of changes to integrate the advanced medical equipment and internet of things into the system and aimed at providing patients with highly efficient diagnosis and care both in and out of hospital.…”

MMC celebrating 6 years of experience and expansion

“…In addition, the nationwide standardized care system also provides a collaborative platform for prospective interventional studies on treatment and prevention of diabetes. [8][9][10] Already, a large body of data and evidence originating from hospital-based care in MMC clinics has helped to achieve long-term optimal health outcomes, 4,7 thus enabling a replicable standard care model across the country, laying the foundation for future medical policy formulation and improvement. The goal of MMC is to reduce the incidence rate of diabetes by 1% and the rate of diabetes-related complications by 10% in China.…”

“…The proprietary electronic medical database in MMC supports dynamic big data analysis on epidemiology, prevention, diagnosis, and treatment of diabetes. In addition, the nationwide standardized care system also provides a collaborative platform for prospective interventional studies on treatment and prevention of diabetes 8‐10 . Already, a large body of data and evidence originating from hospital‐based care in MMC clinics has helped to achieve long‐term optimal health outcomes, 4,7 thus enabling a replicable standard care model across the country, laying the foundation for future medical policy formulation and improvement.…”

The Chinese Metabolic Management Centers

“…Recently, data from 10 MMC centers were analyzed and published in the Journal of Diabetes 15–18 . MMC real‐world data have been used to explore effective and feasible hierarchical strategies for diabetes management, such as those for initiation of insulin treatment for patients failing to achieve glycemic control with non‐insulin medications 17 .…”