Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study
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
Affiliations
Coralie English
Heart and Stroke Research Program, The University of Newcastle Hunter Medical Research Institute, Newcastle, New South Wales, Australia
Katinka Nordheim Alme
Department of Clinical Medicine (K1), University of Bergen, Bergen, Norway
Anne-Brita Knapskog
Department of Geriatric Medicine, Oslo University Hospital Ullevaal, Oslo, Norway
Halvor Næss
Department of Clinical Medicine (K1), University of Bergen, Bergen, Norway
Mala Naik
Department of Clinical Science, University of Bergen, Bergen, Norway
Mona Beyer
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Hanne Ellekjaer
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
Hege Ihle Hansen
Oslo Stroke Unit, Neurological Department, Oslo University Hospital, Ullevål, Oslo, Norway
Camilla Sollesnes Kummeneje
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
Ragnhild Munthe-Kaas
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Ingvild Saltvedt
Department of Geriatric Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
Yngve Seljeseth
Department of Medicine, Ålesund Hospital, Helse More og Romsdal HF, Ålesund, Norway
Xiangchung Tan
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
Pernille Thingstad
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
Torunn Askim
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
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
