Title: Association of Sedentary Behavior and Systemic Inflammatory Biomarkers with Microvascular and Macrovascular Complications in Type 2 Diabetes
Authors: Khawla Salhi Dr, Manal El Halouat Dr, Mohammed Amine Essafi Pr, Zineb El Azime Pr, Hayat Aynaou Pr , Houda Salhi Pr
Volume: 10
Issue: 8
Pages: 20-30
Publication Date: 2026/08/28
Abstract:
Background: Low-grade inflammation plays a crucial role in the pathophysiology of type 2 diabetes mellitus (T2DM) and its complications. Physical activity is recognized as an important modifiable factor associated with improved metabolic control and reduced inflammation. Our study's aim is to determine the impact of physical exercise on systemic inflammatory markers and their association with diabetic complications. Materials and Methods: A retrospective analytical study included patients >18 YO with T2DM followed between January 2025 and January 2026. PA was assessed using the Ricci and Gagnon (RG) score. Systemic inflammation-based scores (SIBS) included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammation index (SII), and us-CRP. Multivariate analysis used with SPSS 26 and p < 0.05 as threshold. Results: 82 patients were included (mean age 58.6 ± 12.3 years, female predominance). Based on RG score, 68.29% were sedentary (RG<18), 19.5% active (RG 18-35), and 12.19% very active (RG>35). Sedentary cases had the highest levels of inflammatory markers (NLR: 3.6, PLR: 154, SII: 804.8, CRP: 9 mg/L) and complication rates (microvascular: 82.1%, macrovascular: 60.7%), while very active patients had lower levels of inflammatory markers (NLR: 2.6, PLR: 109, SII: 504, CRP: 4 mg/L) and 5% macrovascular complications. Multivariate analysis showed a significant independent association between sedentary behavior and higher odds of diabetic retinopathy (OR = 3.40; 95% CI: 1.50-7.80), neuropathy (OR = 2.90), and ischemic heart disease (OR = 4.10; 95% CI: 1.60-10.50) (p<0.05). Conclusion: Sedentary lifestyle was independently associated with both increased systemic inflammation and higher odds of diabetic vascular complications, highlighting the importance of incorporating structured PA programs into patient education.