{"doi":"10.2337/dc20-0557","title":"Cross-sectional and Prospective Associations of Rest-Activity Rhythms With Metabolic Markers and Type 2 Diabetes in Older Men","abstract":"OBJECTIVE Disruption of rest-activity rhythms is cross-sectionally associated with metabolic disorders, including type 2 diabetes, yet it remains unclear whether it predicts impaired glucose metabolism and homeostasis. The aim of this study is to examine the cross-sectional and prospective associations between rest-activity rhythm characteristics and glycemic measures in a cohort of older men. RESEARCH DESIGN AND METHODS Baseline rest-activity rhythms were derived from actigraphy with use of extended cosine model analysis. With subjects fasting, glucose, insulin, and HOMA of insulin resistance (HOMA-IR) were measured from blood at baseline and after ∼3.5 years. Type 2 diabetes was defined based on self-report, medication use, and fasting glucose. RESULTS In the cross-sectional analysis (n = 2,450), lower 24-h amplitude-to-mesor ratio (i.e., mean activity-adjusted rhythm amplitude) and reduced overall rhythmicity were associated with higher fasting insulin and HOMA-IR (all Ptrend < 0.0001), indicating increased insulin resistance. The odds of baseline type 2 diabetes were significantly higher among those in the lowest quartile of amplitude (Q1) (odds ratio [OR]Q1 vs. Q4 1.63 [95% CI 1.14, 2.30]) and late acrophase group (ORlate vs. normal 1.46 [95% CI 1.04, 2.04]). In the prospective analysis (n = 861), multiple rest-activity characteristics predicted a two- to threefold increase in type 2 diabetes risk, including a lower amplitude (ORQ1 vs. Q4 3.81 [95% CI 1.45, 10.00]) and amplitude-to-mesor ratio (OR 2.79 [95% CI 1.10, 7.07]), reduced overall rhythmicity (OR 3.49 [95% CI 1.34, 9.10]), and a late acrophase (OR 2.44 [1.09, 5.47]). CONCLUSIONS Rest-activity rhythm characteristics are associated with impaired glycemic metabolism and homeostasis and higher risk of incident type 2 diabetes.","journal":"Diabetes Care","year":2020,"id":61942,"datarank":1.9830806520842077,"base_score":4.007333185232471,"endowment":4.007333185232471,"self_citation_contribution":0.6010999777848708,"citation_network_contribution":1.381980674299337,"self_endowment_contribution":0.6010999777848708,"citer_contribution":1.381980674299337,"corpus_percentile":null,"corpus_rank":null,"citation_count":54,"citer_count":38,"citers_with_citation_signal":32,"citers_with_endowment":32,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9491,"is_data_producer":true,"deposit_databanks":{"figshare":["10.2337/figshare.12816059"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":249991,"name":"Jingyi Qian","orcid":"0000-0002-8793-9330","position":1,"is_corresponding":false},{"id":304549,"name":"Daniel S. Evans","orcid":"0000-0003-4185-7687","position":2,"is_corresponding":false},{"id":17008,"name":"Susan Redline","orcid":"0000-0002-6585-1610","position":3,"is_corresponding":false},{"id":50680,"name":"Nancy E. Lane","orcid":"0000-0002-0177-2198","position":4,"is_corresponding":false},{"id":327141,"name":"Sonia Ancoli‐Israel","orcid":"0000-0002-0662-8865","position":5,"is_corresponding":false},{"id":249994,"name":"Frank A. J. L. Scheer","orcid":"0000-0002-2014-7582","position":6,"is_corresponding":false},{"id":245151,"name":"Katie L. Stone","orcid":"0000-0003-2797-3171","position":7,"is_corresponding":false},{"id":308801,"name":"Qian Xiao","orcid":"0000-0002-8388-1178","position":0,"is_corresponding":true}],"reference_count":51,"raw_metadata":null,"created_at":"2026-07-18T21:09:47.114172Z","pmid":"32887712","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}