ArticleFrontiers in endocrinology2026
Sedentary behavior and type 2 diabetes in community-dwelling middle-aged and older adults: indirect cross-sectional correlation of sarcopenic obesity.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Type 2 diabetes mellitus (T2DM) represents a major public health challenge among middle-aged and older populations worldwide. The underlying mechanisms linking sedentary behavior to T2DM remain incompletely understood. Sarcopenic obesity (SO), a phenotype defined by concurrent low muscle mass and excess adiposity, may represent a key intermediate correlate linking sedentary behavior with T2DM in cross-sectional observations. This study aimed to explore the indirect cross-sectional correlation of SO in the correlation between sedentary behavior and T2DM and to clarify age- and sex-specific characteristics of this association. Methods: A cross-sectional study design was employed, consecutively enrolling 2, 480 community-dwelling middle-aged and older individuals (≥35 years) undergoing physical examinations. Daily sedentary time was assessed using the Sedentary Behavior Questionnaire (SBQ). Body composition was measured with the InBody 770 bioelectrical impedance analyzer. Logistic regression combined with bias-corrected, non-parametric Bootstrap methods validated the statistical mediation, with sensitivity analyses stratified by sex, age, and the age-sex interaction. Results: In the overall cohort, the statistical mediation of SO was significant (without covariates: mean ACME = 0.105, 95% CI: 0.078-0.130, proportion of the statistical indirect correlation = 22.43%; with covariates: mean ACME = 0.029, 95% CI: 0.013-0.043, proportion of the statistical indirect correlation = 14.97%;both Conclusion: Sedentary behavior is significantly associated with type 2 diabetes among community-dwelling middle-aged and older adults, and SO shows a significant statistical mediation in the cross-sectional correlation between sedentary behavior and T2DM. This statistical mediation shows distinct population differences and is most prominent among women aged 65 years or older.
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