Nine-year follow-up of 24-hour movement behaviors and glucose metabolism status among adults from the Maastricht study

Impaired glucose tolerance (IGM) and type 2 diabetes mellitus (T2DM) are associated with less optimal time spent in 24-hour movement behaviors (24 h-MBs) compared to people with normoglycemia (NG). We aimed to investigate how 24 h-MBs change over time and whether changes in 24 h-MBs differ between adults according to glycemic trajectories over time. Participants (n = 1724, median age of 60 [54.0, 64.0] years) were drawn from two time-points (9.0 ± 0.6 years follow-up) of The Maastricht Study. Data included objectively collected 24 h-MBs using a thigh-worn accelerometer (ActivPAL), sociodemographic information and cardiometabolic health variables measured at two timepoints (9 years in between). Six glycemic trajectory groups were created based on results of the 2 h-oral glucose tolerance test and the intake of glucose lowering medication: (1) Stable NG, (2) Stable IGM, (3) Stable T2DM, (4) Progression to IGM, (5) Progression to T2DM and (6) Improvers of their glycemic status. Compositional linear mixed effects models were used to examine differences in the changes of 24 h-MB compositions over time between the six groups. All groups showed an increase in sedentary behavior (SB) and a decrease in light physical activity (LPA), while sleep duration remained relatively stable. Moreover, moderate-to-vigorous PA (MVPA) decreased in five of the trajectory groups but remained stable in the Improvers group. Compared to the stable NG group, SB increased by 26.4 min/day [95%CI 5.3; 42.4] and 31.1 min/day [95%CI 8.3; 55.6] more in the stable T2DM group and Progression to T2DM group, respectively, whereas LPA decreased by -19.2 min/day [95%CI -3.3; -32.4 ] and − 20.7 min/day [95%CI -2.0; -40.8] more in these two groups. The stable T2DM had a bigger decrease in MVPA of -8.7 min/day [95%CI -4.1; -12.4] compared to the stable NG group, whereas, the Improvers had a bigger increase in MVPA of 10.2 min/day [95%CI 3.1; 18.2] compared to the Stable T2DM group. Over 9 years, 24 h-MBs became less optimal for all groups with more deterioration over time for those with or progressing to T2DM. However, MVPA levels only remained stable over time in the improvers, suggesting that higher levels of MVPA within the overall composition may have beneficial effects. More research is needed to uncover the mechanisms explaining the deterioration of 24 h-MBs over time.