| Title: | Wearable sensor-derived continuous physical activity dimensions and all-cause mortality in adults with diabetes and hypertension: insights from two population-based accelerometry cohorts |
| Journal: | Acta Diabetologica |
| Published: | 6 Aug 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42560389/ |
| DOI: | https://doi.org/10.1007/s00592-026-02768-4 |
Publication 21063
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Abstract
Aims/IntroductionAdults with coexistent diabetes mellitus and hypertension (DM-HTN) have a substantially elevated risk of all-cause mortality. Physical activity (PA) is a key modifiable factor, yet conventional self-reported or categorical measures may fail to capture clinically relevant variation. We investigated associations between sensor-derived continuous PA dimensions and all-cause mortality in DM-HTN.Materials and MethodsWe analysed 4,294 DM-HTN and 1,482 diabetes-alone adults from the UK Biobank (median follow-up 85.2 months; 731 deaths) and 530 DM-HTN and 235 diabetes-alone participants from NHANES 2011-2014 (mean follow-up 63.5 months; 123 deaths), all with device-measured wrist accelerometry. Continuous sensor-derived metrics included Daily MET/MIMS (volume) and Peak-30 MET/MIMS (peak intensity). Associations with all-cause mortality were examined using multivariable Cox regression, restricted cubic spline modelling, and GBDT models with SHAP attribution.ResultsBoth continuous PA dimensions were independently associated with all-cause mortality in the DM-HTN group across cohorts. In the UK Biobank, fully adjusted hazard ratios were 0.66 for Daily MET and 0.43 for Peak-30 MET. In NHANES, Peak-30 MIMS showed robust associations (HR = 0.57, p < 0.001), while Daily MIMS attenuated to non-significance (HR = 0.95, p = 0.116) after full adjustment. Non-linear dose-response modelling identified lower inflection points for peak intensity in DM-HTN compared with diabetes-alone individuals. SHAP analyses confirmed that continuous peak intensity maintained stable protective contributions across comorbidity strata.ConclusionsWearable sensor-derived continuous PA dimensions capture mortality risk gradients in DM-HTN that are inaccessible to conventional approaches. Population-specific, clinically attainable inflection thresholds identified through continuous monitoring support incorporating sensor-derived PA metrics as digital biomarkers in comorbidity-specific risk stratification frameworks.Graphical Abstract</p>
6 Authors
- Tianchen Niu
- Lingjie Fan
- Rongna Lian
- Fengyi Wang
- Junhan Zhao
- Tao Lin
1 Application
| Application ID | Title |
|---|---|
| 1054018 | Epidemiology and Health Outcomes of Sarcopenia and Sarcopenic Obesity: Evidence from the UK Biobank |
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