Associations Between Wearable-Specific Indicators of Physical Activity Behaviour and Insulin Sensitivity and Glycated Haemoglobin in the General Population: Results from the ORISCAV-LUX 2 Study

(2022) 8:146 Backes et al. Sports Medicine - Open https://doi.org/10.1186/s40798-022-00541-9 ORIGINAL RESEARCH ARTICLE Open Access Associations Between Wearable‑Specific Indicators of Physical Activity Behaviour and Insulin Sensitivity and Glycated Haemoglobin in the General Population: Results from the ORISCAV‑LUX 2 Study Anne Backes1* , Gloria A. Aguayo2 , Paul J. Collings1 , Douae El Fatouhi3 , Guy Fagherazzi2 , Laurent Malisoux1   and ORISCAV-LUX Study Group Abstract Background: Parameters derived from an acceleration signal, such as the time accumulated in sedentary behaviour or moderate to vigorous physical activity (MVPA), may not be sufficient to describe physical activity (PA) which is a complex behaviour. Incorporating more advanced wearable-specific indicators of PA behaviour (WIPAB) may be useful when characterising PA profiles and investigating associations with health. We investigated the associations of novel objective measures of PA behaviour with glycated haemoglobin (HbA1c) and insulin sensitivity (Quicki index). Methods: This observational study included 1026 adults (55% women) aged 18-79y who were recruited from the general population in Luxembourg. Participants provided ≥ 4 valid days of triaxial accelerometry data which was used to derive WIPAB variables related to the activity intensity, accumulation pattern and the temporal correlation and regularity of the acceleration time series. Results: Adjusted general linear models showed that more time spent in MVPA and a higher average acceleration were both associated with a higher insulin sensitivity. More time accumulated in sedentary behaviour was associated with lower insulin sensitivity. With regard to WIPAB variables, parameters that were indicative of higher PA intensity, including a shallower intensity gradient and higher average accelerations registered during the most active 8 h and 15 min of the day, were associated with higher insulin sensitivity. Results for the power law exponent alpha, and the proportion of daily time accumulated in sedentary bouts > 60 min, indicated that activity which was characterised by long sedentary bouts was associated with lower insulin sensitivity. A greater proportion of time spent in MVPA bouts > 10 min was associated with higher insulin sensitivity. A higher scaling exponent alpha at small time scales (< 90 min), which shows greater correlation in the acceleration time series over short durations, was associated with higher insulin sensitivity. When measured over the entirety of the time series, metrics that reflected a more complex, irregular and unpredictable activity profile, such as the sample entropy, were associated with lower HbA1c levels and higher insulin sensitivity. *Correspondence: 1 Physical Activity, Sport and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, 1A‑B, rue Thomas Edison, L‑1445 Strassen, Luxembourg Full list of author information is available at the end of the article © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Backes et al. Sports Medicine - Open (2022) 8:146 Page 2 of 13 Conclusion: Our investigation of novel WIPAB variables shows that parameters related to activity intensity, accumulation pattern, temporal correlation and regularity are associated with insulin sensitivity in an adult general population. Keywords: Accelerometry, Wearable sensors, Physical activity pattern, Glycaemic control Key points • Many wearable-specific indicators of physical activity behaviour (WIPAB) were associated with insulin sensitivity (Quicki index) in an adult general population. • Insulin sensitivity appears to be more sensitive to differences in physical activity than glycated haemoglobin (HbA1c). • Using WIPAB enables the investigation of new features of physical activity that may be useful when investigating relationships with health. Background Worldwide, one in nine deaths among adults aged 20–79 years is attributable to diabetes, which increased in prevalence by 88% between 2006 and 2019 [1]. In addition to a significant mortality and morbidity burden, a high prevalence of diabetes and prediabetes incurs huge economic cost [2]. Successful strategies to prevent the diabetic state are imperative. Regular physical activity (PA) is believed to be beneficially associated with insulin sensitivity [3], whereas prolonged and uninterrupted sedentary behaviour (SB) is detrimental [4–6]. The rise of wearable sensors as research tools has opened the door to a more detailed and objective assessment of PA behaviour, compared to self-reported techniques that have primarily been used to date. The most commonly investigated variables over the last decades—and hereafter called “conventional” variables—have been related to the FITT framework: F (frequency), I (intensity), T (time) and T (type) [7] of activity, such as the energy expenditure or the time spent in MVPA or sedentary time. The framework highlights that for a comprehensive description of PA behaviours multiple dimensions need to be considered. However, it was developed with subjective measures in mind. Now, with the increased potential to extract raw acceleration signals from wearable devices, other features can be explored. For instance, how an individual accumulates active or sedentary time might provide important complementary information to conventional variables [8]. A recent scoping review identified several Wearable Indicators of Physical Activity Behaviour (WIPAB) that can been used to quantify the complex and multidimensional nature of PA behaviour [9]. They belong to three different categories that signify: (1) the activity intensity distribution, (2) the accumulation pattern and (3) the temporal correlation and regularity of activity. Additional research is warranted to investigate these parameters, to aid understanding about their added value and their practical feasibility relative to the conventional variables. The objective of the present study was to investigate the associations of novel WIPAB parameters with HbA1c and insulin sensitivity in a general adult population. We hypothesised that WIPAB metrics would be useful (...truncated)