Sedentary behavior with atrial fibrillation-related biomarkers in overweight or obese adults

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Overweight or obese adults at high risk of cardiovascular disease (n=252). Intervention: Replacing sedentary time with low-intensity physical activity (LPA) vs. Sedentary time. Primary outcome: 5-year change in high-sensitivity troponin T (hs-TnT) concentration (-4% change, 95% CI -8%, -1%).

Linzi Li; Amit Shah; Yi-An Ko; Dayna A. Johnson; Dora Romaguera; Angel M. Alonso-Gómez; Estefania Toledo; Cristina Razquín; Jadwiga Konieczna; Miguel Angel Martinez-Gonzalez; Julia Wärnberǵ; Montserrat Fitó; Alvaro Alonso

doi:10.1186/s12872-026-05970-y

May 13, 2026BMC Cardiovascular DisordersOpen Access

Sedentary behavior with atrial fibrillation-related biomarkers in overweight or obese adults

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Key result

Replacing 30 daily sedentary minutes with low-intensity activity links to ~4% lower hs-TnT in overweight adults.

-4% change
95% CI -8%, -1%
n=252

Figures

Why the study?

Blood biomarkers characterize the atrial substrate and AF mechanisms, but whether sedentary behavior affects AF-related biomarkers was unclear.

Does replacing sedentary time with physical activity improve atrial fibrillation-related biomarkers in overweight or obese adults?

Key Points

To examine whether substituting sedentary time with physical activity or sleep influences circulating atrial fibrillation-related biomarkers in overweight or obese adults over five years.
Analyzed N=252 participants (mean age 65 ± 4.9 years, BMI 32.2 ± 3.3 kg/m², 40% women) from PREDIMED-Plus, a multicenter randomized trial in Spain (ISRCTN89898870).
Movement was measured using wrist accelerometers for one week at baseline and during follow-up at years 3 or 5.
Isotemporal substitution linear regression and mixed models estimated the effect of replacing 30 min/day of sedentary time (< 1.5 METs) with light physical activity, moderate-to-vigorous physical activity, or time in bed on log-transformed biomarkers.
Replacing 30 min/day of baseline sedentary time with light physical activity was associated with lower high-sensitivity troponin T at 5 years (-4%, 95% CI -8%, -1%), whereas moderate-to-vigorous substitution showed -2% (95% CI -7%, 4%).
Reallocating 30 min/day of sedentary time to light or moderate-to-vigorous activity produced nonsignificant reductions in NT-proBNP (-3%, 95% CI -11%, 5% and -8%, 95% CI -20%, 5%, respectively).
No significant cross-sectional associations were detected at baseline, and no consistent long-term associations were found for procollagen type I propeptide, high-sensitivity C-reactive protein, or 3-nitrotyrosine.

Study Design

Type

Observational (n=252)

Multicenter

Yes

Structured PICO

Does replacing sedentary time with physical activity improve atrial fibrillation-related biomarkers in overweight or obese adults?

P

Population

252 overweight or obese adults (mean age 65 ± 4.9 years, BMI 32.2 ± 3.3 kg/m², 40% women) participating in the PREDIMED-Plus multicenter randomized trial for the primary prevention of cardiovascular disease in Spain.

I

Intervention

Replacing 30 min/day of sedentary time (< 1.5 METs in waking time) with low-intensity physical activity (LPA, 1.5–3 METs), moderate-to-vigorous PA (MVPA, > 3 METs), or time in bed (isotemporal substitution).

C

Comparator

Baseline sedentary time (modeled via isotemporal substitution).

O

Outcome

Log-transformed levels of atrial fibrillation-related biomarkers (propeptide of procollagen type I, hsTnT, hs-CRP, 3-nitrotyrosine, and NT-proBNP) measured cross-sectionally and longitudinally at 3 or 5 years.surrogate

Main Result

Effect estimate: -4% change (95% CI -8%, -1%)

Replacing 30 minutes of daily sedentary time with physical activity is associated with favorable long-term reductions in high-sensitivity troponin T among overweight and obese adults.

Limitations

Small sample size of participants with both accelerometry and biomarker data
Wrist-worn accelerometer cannot distinguish standing from sitting or reclining postures
Time in bed used instead of actual sleep duration, leading to potential misclassification
Older, overweight or obese population at high risk of CVD limits generalizability
Potential residual confounding

Implication

Hypothesis-generating for activity counseling in obese adults; prospective trials needed before changing AF biomarker practice.

Abstract

Background Blood biomarkers can characterize the atrial substrate and help elucidate mechanisms of atrial fibrillation (AF) development. Understanding whether sedentary behavior affects AF-related biomarkers may inform prevention strategies. Methods We studied 252 participants in PREDIMED-Plus, a multicenter randomized trial in Spain for the primary prevention of cardiovascular disease. Participants wore wrist accelerometers for one week at baseline and at least once during follow-up (years 3 or 5). Blood samples were collected at each time point to measure selected biomarkers: propeptide of procollagen type I, high-sensitivity (hs) troponin T (hsTnT), hs C-reactive protein, 3-nitrotyrosine, and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP). Using isotemporal substitution, we estimated the effect of replacing 30 min/day of sedentary time (< 1.5 METs in waking time) with low-intensity physical activity (LPA, 1.5–3 METs), moderate-to-vigorous PA (MVPA, > 3 METs), or time in bed (bedtime to wake-up) on log-transformed biomarker levels, cross-sectionally and longitudinally, via linear regression and mixed models. Results At baseline, participants (mean age 65 ± 4.9 years, BMI 32.2 ± 3.3 kg/m², 40% women) showed no significant cross-sectional associations between substituting sedentary time and biomarker levels. After 5 years, replacing baseline 30-min of sedentary time per day with LPA or MVPA was associated with lower hs-TnT concentrations compared to baseline (-4%, 95% CI -8%, -1%; and − 2%, 95% CI -7%, 4%). Substitutions showed nonsignificant reductions in NT-proBNP but no consistent associations with other biomarkers. Conclusions Among overweight/obese individuals, replacing sedentary time with PA was associated with favorable 5-year changes of hs-TnT, but not other AF-related biomarkers. Trial registration The trial was registered on July 24, 2014, at ISRCTN (ISRCTN89898870) [www.isrctn.com/ISRCTN89898870 (accessed on December 10, 2025)].

Discussion

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Cite This Study

Li et al. (2026) conducted an observational in Overweight or obese adults at high risk of cardiovascular disease (n=252). Replacing sedentary time with low-intensity physical activity (LPA) vs. Sedentary time was evaluated on 5-year change in high-sensitivity troponin T (hs-TnT) concentration (-4% change, 95% CI -8%, -1%). Among overweight or obese adults, replacing 30 minutes of sedentary time per day with low-intensity physical activity was associated with a 4% reduction in hs-TnT concentrations over 5 years.

synapsesocial.com/papers/6a056a3ba550a87e60a210a6 https://doi.org/10.1186/s12872-026-05970-y

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Sedentary behavior with atrial fibrillation-related biomarkers in overweight or obese adults

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Sedentary behavior with atrial fibrillation-related biomarkers in overweight or obese adults

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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