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Background <p>Both sedentary lifestyles and metabolic multimorbidity are experiencing a rising global prevalence, representing growing public health concerns. Although the detrimental effects of sedentary behavior on metabolic diseases are well-documented, the association between sedentary time and early-onset metabolic multimorbidity, especially potential sex-specific differences in this association, remains unexplored. This study aimed to investigate the sex-specific effects of sedentary time on the prevalence of early-onset metabolic multimorbidity.</p> Methods <p>We recruited 21,444 young adults (18–45 years; 50.6% women) and assessed their sedentary time using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Metabolic multimorbidity was defined as the coexistence of at least two of the following conditions: obesity, hypertension, dyslipidemia, diabetes, and non-alcoholic fatty liver disease. Logistic regression models were used to evaluate the sex-specific association between sedentary time and metabolic multimorbidity. Subgroup analyses by sociodemographic characteristics and lifestyle factors were performed to identify potential interactions and susceptible subpopulations. Sensitivity analysis was conducted to assess the robustness of the results.</p> Results <p>The overall prevalence of metabolic multimorbidity was 25.35%, with a significantly higher prevalence in males than in females (40.72% vs. 10.35%), despite a higher proportion of females reporting longer sedentary time. In males, sedentary time exhibited a linear positive association with the increased odds of metabolic multimorbidity, whereas no such association was observed in females. Males reporting 6-&lt;8 and ≥ 8&#xa0;h/day sedentary time had 22% (95% CI 1.01–1.47) and 26% (95% CI 1.05–1.50) higher odds of metabolic multimorbidity, respectively, compared to those reporting &lt; 4&#xa0;h/day sedentary time (<i>P</i> <sub>for trend</sub> = 0.019). Education level, smoking status and physical activity level were found to modify the association between sedentary time and metabolic multimorbidity.</p> Conclusion <p>Longer sedentary time is associated with increased odds of early-onset metabolic multimorbidity in men, but this association is not observed in women. These findings suggest that targeted, sex-specific interventions may reduce metabolic risk and improve long-term outcomes, highlighting the need to consider sex differences in both prevention strategies and expected health benefits.</p>

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Sex differences in the impact of sedentary time on early-onset metabolic multimorbidity: evidence from a study of over 20,000 young adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月28日

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  • Chunjun Li,
  • Mianzhi Zhang,
  • Li Zhang,
  • Fenghua Guo,
  • Binbin Zhang,
  • Shuo Chen,
  • Yujie Niu,
  • Feng Liu,
  • Minying Zhang

摘要

Background

Both sedentary lifestyles and metabolic multimorbidity are experiencing a rising global prevalence, representing growing public health concerns. Although the detrimental effects of sedentary behavior on metabolic diseases are well-documented, the association between sedentary time and early-onset metabolic multimorbidity, especially potential sex-specific differences in this association, remains unexplored. This study aimed to investigate the sex-specific effects of sedentary time on the prevalence of early-onset metabolic multimorbidity.

Methods

We recruited 21,444 young adults (18–45 years; 50.6% women) and assessed their sedentary time using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Metabolic multimorbidity was defined as the coexistence of at least two of the following conditions: obesity, hypertension, dyslipidemia, diabetes, and non-alcoholic fatty liver disease. Logistic regression models were used to evaluate the sex-specific association between sedentary time and metabolic multimorbidity. Subgroup analyses by sociodemographic characteristics and lifestyle factors were performed to identify potential interactions and susceptible subpopulations. Sensitivity analysis was conducted to assess the robustness of the results.

Results

The overall prevalence of metabolic multimorbidity was 25.35%, with a significantly higher prevalence in males than in females (40.72% vs. 10.35%), despite a higher proportion of females reporting longer sedentary time. In males, sedentary time exhibited a linear positive association with the increased odds of metabolic multimorbidity, whereas no such association was observed in females. Males reporting 6-<8 and ≥ 8 h/day sedentary time had 22% (95% CI 1.01–1.47) and 26% (95% CI 1.05–1.50) higher odds of metabolic multimorbidity, respectively, compared to those reporting < 4 h/day sedentary time (P for trend = 0.019). Education level, smoking status and physical activity level were found to modify the association between sedentary time and metabolic multimorbidity.

Conclusion

Longer sedentary time is associated with increased odds of early-onset metabolic multimorbidity in men, but this association is not observed in women. These findings suggest that targeted, sex-specific interventions may reduce metabolic risk and improve long-term outcomes, highlighting the need to consider sex differences in both prevention strategies and expected health benefits.