Abstract 10895: Actigraphy-Derived Rest-Activity Rhythms Are Associated With Metabolic Markers and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Introduction: Individual behaviors in the 24h rest-activity cycle have been linked to cardiometabolic health (CMH). Studies that integrate the overall multidimensional pattern of 24-h rest-activity rhythms (RAR) and evaluate its unique relation with CMH and type 2 diabetes (T2D) are limited. Hypothesis: Disrupted RAR are associated with poorer glycemic control and T2D. Methods: Participants were n=2127 adults (mean age: 69 ± 9 y, 54% women, 62% non-White) in the MESA Sleep Study (2010-13). Interdaily stability (IS), intradaily variability (IV), most active 10 h period (M10) and least active 5 h period (L5) timing and counts, and relative amplitude (RA) (defined in Table) were derived from 7-d actigraphy data using nonparametric rhythm analysis. Multivariable linear and logistic regression was used to examine cross-sectional and prospective associations with glycemic markers and T2D at baseline and after 6 y of follow-up (2016-18). Results: Higher IS (more stable sleep-wake and rest-activity patterns across days), M10 counts (more active wake period), and RA (greater overall RAR robustness) were related to lower fasting glucose, insulin, and HOMA-IR, while higher IV (more fragmented RAR, less efficient sleep) and L5 counts (less restful sleep) were related to higher levels of these metabolic markers (Table). In cross-sectional and prospective analyses, those in the highest vs. lowest quintile of IS, M10 counts, and RA had up to 75% lower odds of T2D, while being in the highest vs. lowest quintile of IV, L5 counts, and L5 midpoint (later sleep period) was associated with up to 79% higher T2D odds with evidence of a dose-response relationship (p-trend <0.05 for all outcomes). Conclusions: A less robust and stable RAR, lower wake time activity, and a less restful and later sleep period are associated with T2D. Targeting the strength, timing, and regularity of rest-activity and sleep-wake patterns to enhance the rhythmicity of diurnal behaviors may enhance CMH and prevent T2D.