Abstract
BACKGROUND: Given the influence of lifestyle on type 2 diabetes mellitus (T2DM), the present study aimed to investigate the association between physical activity (PA) intensity and T2DM among sedentary and active participants in the Zahedan Adult Cohort Study (ZACS), Iran. METHODS: This cross-sectional study was conducted as part of the population-based Persian Prospective Epidemiological Research Studies in Iran (Persian Cohort). The baseline data from the ZACS collected between 2015 and 2019 were utilized. A total of 10,004 adults aged 35-70 years were included in the analysis. Data were gathered through self-reported questionnaires covering general information, socioeconomic status, sleep status, medical history, and PA. Anthropometric measurements and biochemical parameters were obtained from participants after a 12-h fasting period. The data were analyzed using descriptive statistics, independent-sample t-test, chi-square, and logistic regression tests in SPSS22. RESULTS: The study found that the majority of the 10,004 adult participants (81.2%) were sedentary, while only 18.8% were classified as active. Sedentary participants exhibited significantly higher mean values for various health markers, including age, education, sleep duration, weight, body mass index (BMI), and blood lipid levels, as well as higher prevalence of hypertension, cardiac conditions, and stroke compared to active participants. Additionally, 21.7% of the participants had T2DM, which was associated with older age, longer sleep duration, higher weight and BMI, and abnormal waist circumference. The prevalence of diabetes increased with higher BMI, from 4.8% in underweight to 27.1% in obese participants, and was 77% in sedentary individuals compared to 16% in active individuals. Even after adjusting for demographic factors (OR = 0.65, p < 0.001), lipid levels (odds ratio [OR] = 0.68, p = 0.001), sleep status (OR = 0.72, p = 0.001), and family history (OR = 0.66, p = 0.001), active individuals were found to have a significantly lower likelihood of being diabetic compared to their sedentary counterparts. CONCLUSIONS: The findings revealed a clear association between sedentary lifestyles and an increased risk of T2DM. Physical inactivity was correlated with adverse health markers and an elevated incidence of T2DM, which was mitigated by an active lifestyle. These results underscore the importance of public health initiatives to promote PA as a critical strategy for diabetes prevention.