Association of physical activity with arterial stiffness: the mediating role of the visceral fat metabolism score.

OBJECTIVE: We investigated the association between physical activity (PA) and arterial stiffness (AS) in Chinese middle-aged and older adults, systematically evaluating the potential mediating role of the Metabolic Score For Visceral Fat. SUBJECTS AND METHODS: Data were drawn from the 2015 China Health and Retirement Longitudinal Study. PA was assessed using the International Physical Activity Questionnaire, and AS was determined by estimated pulse wave velocity. Multivariable logistic regression, restricted cubic spline models, and Bootstrap mediation analysis were applied for statistical analyses. RESULTS: In the fully adjusted model, each standard deviation increase in PA intensity was associated with a 22% reduction in AS risk (odds ratio [OR] = 0.78, 95% confidence interval [CI]: 0.72-0.84, p < 0.001). Compared to low-intensity PA, both moderate-intensity (OR = 0.75, 95% CI: 0.61-0.92, p = 0.005) and high-intensity PA (OR = 0.57, 95% CI: 0.48-0.68, p < 0.001) were significantly associated with a lower risk of AS. Restricted cubic spline analysis revealed a nonlinear association, with AS risk decreasing as PA intensity increased (p-nonlinear = 0.034). Mediation analysis indicated that Metabolic Score For Visceral Fat significantly mediated the negative correlation between PA and AS, accounting for 11.4% of the total effect. CONCLUSION: Among middle-aged and older Chinese adults, higher levels of PA are associated with a lower risk of AS, with this association partially mediated by improvements in visceral fat metabolism.