Around the Clock: How 24-Hour Movement Patterns Shape Cardiometabolic Health in Men with and without HIV - PROJECT SUMMARY/ABSTRACT Cardiometabolic disease (CMD) is a leading cause of morbidity, mortality, and U.S. health care costs, with $117 billion annually attributable to insufficient physical activity (PA). People with HIV (PWH) have a two-fold higher CMD risk, especially cardiovascular disease, due to chronic inflammation and accelerated vascular aging. Current PA guidelines recommend 150 minutes/week of moderate-to-vigorous physical activity (MVPA) and reduced sedentary behavior (SB), but do not address how movement is accumulated or account for light- intensity PA. The emerging 24-hour movement framework considers sleep, light PA, MVPA, and SB as interdependent. In light of this aspect, “pure movement dispersion” measures the spread of movement without intensity; “total movement dispersion” incorporates intensity. These novel metrics may relate more strongly to CMD risk than duration-based measures, especially for high-risk groups such as PWH. Using data from the MACS/WIHS Combined Cohort Study (MWCCS), we will conduct a secondary analysis of accelerometry, clinical measures, and serum biomarkers. CMD severity risk will be quantified using the metabolic syndrome severity index (MSSI), and inflammation assessed via cytokines (hs-CRP, IL-6, IL-1α, IL-1β, TNF-α) and the systemic immune-inflammation index (SII). Specific Aim 1 will estimate cross-sectional associations of pure and total movement dispersion with MSSI compared to MVPA and SB duration. Specific Aim 2 will estimate associations of pure and total movement dispersion with inflammatory cytokines and SII compared to MVPA and SB duration. Specific Aim 3 will develop an R Shiny application to calculate and visualize movement dispersion, enabling reproducibility and broad dissemination. The candidate has a background in kinesiology and nursing with a strong foundation in research related to PA and movement. The proposed research and career development plan build directly on prior experiences in measurements of daily PA, including among PWH. In line with the NHLBI’s Objective 1, this proposed project seeks to explore behaviors that enable wellness in the face of aging, specifically in managing cardiometabolic risk for improved health among PWH. This award will enhance Dr. Klamm’s career development and ability to conduct future independent research in the area of actigraphy-based 24-hour movement by 1) developing her expertise in accelerometry data management, 2) enhancing her skills in advanced biostatistics, 3) acquiring necessary skills for Shiny app development in R, and 4) broadening her understanding of the role of inflammation in CMD, with emphasis on PWH. Dr. Klamm’s mentorship team is well-suited to facilitate the research and development plan. This project has the potential to clarify the role of 24-hour movement patterns in CMD risk, inform interventions to optimize movement dispersion, and deliver accessible tools, advancing cardiometabolic health for people with and without HIV.
