BACKGROUND: This cohort study aimed to identify the accumulation patterns of objectively measured ambulatory activity (AA) variables in the middle-aged and older Japanese women and examine the relationship of these derivative patterns with onset of metabolic syndrome (MetS). METHODS: A total of 794 women (mean age: 56.2 years) provided objectively assessed AA data using a uniaxial accelerometer. The number of steps, time accumulated in light-intensity AA (LIAA) and moderate-to-vigorous intensity AA (MVAA) and the ratio of MVAA to total AA (LIAA + MVAA) were calculated. Latent profile analysis was used to identify participant groups based on their distinct AA patterns. Logistic regression models were used to assess the association of groups with the onset of MetS after adjusting for age, sex, education, alcohol habit, smoking habit, energy intake, and the number of MetS components present at baseline. RESULTS: Four distinct groups were identified: Group A had low levels of the AA variable
group B accumulated a certain number or more steps primarily through MVAA
group C accumulated a certain number or more steps primarily through LIAA
and group D had high level of the AA variables. Over the course of the 5-year follow-up period, 61 participants (7.7%) developed MetS. The multivariate-adjusted odds ratio (95% confidence interval) for onset of MetS in groups B, C, and D relative to group A were 0.416 (0.166-1.218), 0.451 (0.223-0.914), and 0.933 (0.365-2.382), respectively. Group C had a significantly lower odds ratio of MetS onset than group A. CONCLUSION: AA patterns accumulating a certain number or more steps, regardless of the intensity of AA, may help reduce the risk of MetS compared to inactive AA patterns.