Association of Questionnaire-Based Physical Activity Analysis and Body Composition Dynamics in Type 2 Diabetes: A Cross-Sectional Study

Dan-Dan Li; Xue Yang; Yang Yang; Li-Hua Zhao; Tian-Tian Zhang; Yi-Nan Wang; Jian-Bin Su; Li-Hua Wang; Hai-Yan Shi

doi:10.2147/DMSO.S459356

Association of Questionnaire-Based Physical Activity Analysis and Body Composition Dynamics in Type 2 Diabetes: A Cross-Sectional Study

Diabetes Metab Syndr Obes. 2024 Aug 8:17:2955-2966. doi: 10.2147/DMSO.S459356. eCollection 2024.

Authors

Dan-Dan Li^#¹, Xue Yang^#¹, Yang Yang^#², Li-Hua Zhao¹, Tian-Tian Zhang³, Yi-Nan Wang¹, Jian-Bin Su¹, Li-Hua Wang⁴, Hai-Yan Shi³

Affiliations

¹ Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, 226006, People's Republic of China.
² Department of General Practice, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, 226006, People's Republic of China.
³ Department of Hepatobiliary Surgery, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, 226006, People's Republic of China.
⁴ Department of Nursing, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, 226006, People's Republic of China.

^# Contributed equally.

Abstract

Background: Physical activity (PA) exerts an important influence on glycemic control in type 2 diabetes (T2D) patients. Alterations in body composition in patients with T2D may be involved in the overall pathophysiologic process, but PAs and alterations in body composition have been poorly studied.

Methods: A total of 615 patients with T2D were selected by convenient sampling. The patients were investigated with the International Physical Activity Questionnaire (IPAQ-S). Moreover, biochemical indices were collected, and the progression of the body composition of the subjects was determined via dual-energy X-ray absorptiometry (DXA). The variables included lumbar bone mineral density (LSBMD), femoral neck bone mineral density (FNBMD), hip bone mineral density (HBMD), whole-body bone mineral density (TBMD), limb skeletal muscle mass index (ASMI), whole-body fat percentage (B-FAT) and trunk fat percentage (T-FAT). Moreover, the levels of physical activity (high level of physical activity [H-PA], medium level of physical activity [M-PA] and low level of physical activity [L-PA]) were divided into three groups to analyze the changes in patient body composition with changes in physical activity level.

Results: One-way analysis of variance showed that β-CTX, TP1NP, HbA1c, B-FAT and T-FAT increased significantly (p<0.05), while 25(OH)D, LSBMD, FNBMD, HBMD, TBMD and ASMI decreased significantly (p<0.001) with the decrease of physical activity. However, there was no significant difference in serum lipids between lnHOMA-ir and lnHOMA-β (p>0.05). Multiple linear regression model was established to gradually adjust for clinical confounding factors. It was found that physical activity level was independently positively correlated with LSBMD, FNBMD, HBMD, TBMD, and ASMI, and was independently negatively correlated with B-FAT and T-FAT in patients with type 2 diabetes.

Conclusion: A lack of physical activity is an independent risk factor for decreased bone mineral density, decreased skeletal muscle content and increased fat content in patients with T2D.

Keywords: body composition; correlation; physical activity; type 2 diabetes.

Grants and funding

The authors were supported by the 14th Five-Year Key Disciplines of Nantong City, the Clinical Medical Research Center of Nantong Science and Technology Bureau (HS2022004), the research project of Nantong Health Commission (MSZ2023019), and the Clinical Medicine Special Research Fund of Nantong University (2023HZ001).