Accelerometer-Derived Physical Activity Associated With Incidence and Progression Trajectory of Cardiometabolic Multimorbidity

Abstract

Objective

To examine the associations between physical activity (PA) and the transition from healthy status to first cardiometabolic disease (FCMD), subsequently to cardiometabolic multimorbidity (CMM), and further to death.

Patients and Methods

Objectively measured PA was derived from wrist-worn accelerometer data collected during 7 days in a separate cohort of 59,161 participants during 2013 to 2015. Cardiometabolic multimorbidity was defined as the occurrence of at least 2 cardiometabolic diseases including type 2 diabetes, ischemic heart disease, and stroke. Multistate models were used to examine the impact of PA on the incidence and progression trajectory of CMM.

Results

During a median 7.9 years of follow-up, FCMD developed in 4074 individuals, CMM developed in 295, and 2893 died in the accelerometer-derived cohort. Performing guideline-adherent moderate-intensity physical activity (MPA; 150-300 min/wk) was related to a 29% lower risk of FCMD (hazard ratio [HR], 0.71 [0.62 to 0.81]) and a 40% lower risk of CMM (HR, 0.60 [0.39 to 0.93]). The strength of the association of MPA with the transition from healthy baseline to FCMD was greater than that of the transition from FCMD to CMM, with HRs (95% CIs) per 244.7 min/wk increase of 0.75 (0.71 to 0.80) and 0.92 (0.87 to 0.98), respectively. On dividing FCMD into 3 specific cardiometabolic diseases, there were comparable trends of MPA on the disease-specific transitions from healthy baseline to FCMD and subsequent CMM.

Conclusion

Physical activity played comparable roles in transitions from healthy baseline to FCMD and then to CMM. These findings suggest that improving PA is a potential strategy for preventing CMM development.