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Sleep, sedentary behavior (SB), light-intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) collectively constitute a 24-h day. This study used compositional data analysis (CoDA), an approach appropriate for data composed of mutually exclusive parts of a whole, to examine the associations of 24-h movement behaviors with pre-diabetes phenotypes (isolated-impaired fas
Sleep, sedentary behavior (SB), light-intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) collectively constitute a 24-h day. This study used compositional data analysis (CoDA), an approach appropriate for data composed of mutually exclusive parts of a whole, to examine the associations of 24-h movement behaviors with pre-diabetes phenotypes (isolated-impaired fasting plasma glucose [i-IFG], isolated-impaired glucose tolerance [i-IGT], and combined IFG + IGT) and diabetes.
This cross-sectional study analyzed 1222 participants from the National Health and Nutrition Examination Survey 2005–2006. Time spent in SB, LIPA, and MVPA was measured via accelerometer, and sleep duration was determined via self-report. The glycemic status was classified as normoglycemia, pre-diabetes (i-IFG, i-IGT, or combined IFG + IGT), or diabetes based on the American Diabetes Association criteria. The CoDA was performed, adjusting for age, sex, education, and smoking status.
The study sample had a mean age of 41.02 (SD = 12.97) years and comprised 47.22% males. On average, participants spent 6.8 h in sleep, 9.4 h in SB, 7.3 h in LIPA, and 0.5 h in MVPA over a 24-h day. None of the four movement behaviors was associated with i-IFG (all p > 0.05). In contrast, SB was detrimentally associated with i-IGT (OR [95% CI] = 3.49 [1.10, 11.09], p = 0.038), and MVPA was favorably associated with combined IFG + IGT (OR [95% CI] = 0.57 [0.45, 0.71], p < 0.001). For diabetes, more time spent in sleep (OR [95% CI] = 0.47 [0.25, 0.88], p = 0.025) or MVPA (OR [95% CI] = 0.55 [0.39, 0.77], p = 0.005), and less time spent in SB (OR [95% CI] = 2.33 [1.07, 5.08], p = 0.037), were each associated with lower odds.
Findings of this study provide insights for the development of integrated 24-h movement recommendations to optimize diabetes prevention and management. Notably, the associations with 24-h movement behaviors appeared to differ across distinct pre-diabetes phenotypes, providing preliminary evidence for precision prevention strategies.