Publication:

Physical activity ameliorates the association between sedentary behavior and cardiometabolic risk among inpatients with schizophrenia: A comparison versus controls using accelerometry

Objective: A lack of clarity exists regarding the relationship between objectively measured physical activity (PA) and sedentary behavior (SB) and cardiometabolic outcomes in people with schizophrenia. We conducted a large study investigating the independent relationships of PA and SB among inpatients with schizophrenia versus healthy controls (HCs).

Methods: A cross sectional study including 199 inpatients with schizophrenia (mean age 44.0 years, mean illness duration 23.8 years) versus 60 age/sex/body mass index matched HCs. Participants wore accelerometers for 7 days to capture SB and daily steps. Cardiometabolic outcomes included blood pressure, fasting blood glucose (FBG), triglycerides, high-density lipoprotein cholesterol (HDL-C) and waist circumference (WC). Multivariate regression analyses adjusting for multiple confounders were undertaken.

Results: Compared to HCs, patients engaged in more sedentary behavior and less daily steps versus HCs (p < 0.001). Patients with higher levels of SB (n = 89) had increased fasting glucose compared to patients with low levels of SB (105.2 vs. 96.3 mg/dl, p < 0.05). In the multivariate analysis, sedentary behavior was associated with higher FBG (beta=.146, p =.041) but this was ameliorated when daily steps were inserted in to the model (beta =.141, p =.059). In the final model, higher daily steps were associated with more favorable HDL-C (beta =.226, p =.004), independent of SB and other confounders.

Conclusions: Our data suggest that higher than while sedentary behavior is related to worse fasting glucose, this relationship is attenuated when PA is taken into account. Physical activity is also associated with favorable HDL-C. Interventions targeting replacing sedentary behavior with PA may improve metabolic risk. (C) 2017 Elsevier Inc. All rights reserved.