Wearable sensor-derived continuous physical activity dimensions and all-cause mortality in adults with diabetes and hypertension: insights from two population-based accelerometry cohorts.

Authors

Tianchen Niu, Lingjie Fan, Rongna Lian, Fengyi Wang, Junhan Zhao, Tao Lin

Published in

Acta diabetologica. Aug 06, 2026. Epub Aug 06, 2026.

Abstract

Adults 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.
We 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.
Both 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.
Wearable 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.

PMID:
42560389
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.