Abstract

Background: The progression of cardio-metabolic disease is believed to be driven by increasing Insulin resistance (IR). While increased physical activity (PA) is often encouraged among individuals with metabolic syndrome to improve their IR, there is limited information on its impact among individuals without metabolic syndrome (MS) or obesity. We aimed to ascertain the effect of PA on IR across a spectrum of metabolic conditions. Methods: We evaluated 5,795 healthy Brazilian subjects (43±10 years, 79% males) without clinical coronary heart disease between November 2008 and July 2010. We defined IR using Triglyceride: High Density Lipoprotein-Cholesterol ratio (TG: HDL) > 3.0. PA was assessed using the International Physical Activity Questionnaire (IPAQ) scale and MS was classified with the IDF criteria. Obesity was defined as having a BMI ≥ 30. Results: The prevalence of IR was 39% (n=2,233), 1,316 (23%) were obese and 1,161 (20%) had metabolic syndrome. IR was significantly higher among individuals with the metabolic syndrome (84%) vs. individuals with no metabolic syndrome (27%), p<0.001. Overall 1,308 (23%) were sedentary, 2,008 (35%) minimally active and 2,473(42%) very active. There were significant reduction in IR prevalence with increasing physical activity (sed: 48%, minimally active: 43%, active= 31%, p<0.001). As shown in table below, after adjusting for confounding variables, higher activity levels was 20-56% less likely associated with IR. The benefits appeared to extend to individuals with and without MS or Obesity. Conclusions: PA presents a dose response association with insulin resistance independent of the MS or Obesity. Staying active has tremendous benefits in reducing insulin resistance across populations regardless of their metabolic profile.

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