Cross-sectional analysis of the association between physical activity and metabolic syndrome in the elderly

Metabolic syndrome (MetS) is a critical cluster of risk factors for cardiovascular and cerebrovascular diseases. Exploring effective prevention and management strategies for MetS is of great significance for promoting healthy aging. Although physical activity (PA) is widely recommended for MetS prevention, the association between PA levels and MetS, as well as its diagnostic components, in the elderly population remains insufficiently studied.

A cross-sectional study design was employed, involving 1,651 permanent residents aged ≥60 years who participated in a community health examination in Linping District from June to July 2024. PA levels, weekly activity duration, and total activity volume were assessed using the International Physical Activity Questionnaire (IPAQ). MetS and its components were diagnosed according to the International Diabetes Federation (IDF) criteria. Multivariate logistic regression was used to analyze the association between PA and MetS and its components, with sensitivity analyses and subgroup analyses stratified by body mass index (BMI) performed.

The prevalence of MetS in the study population was 49.12%. Multivariate regression analysis showed no significant association between PA levels and overall MetS risk after adjusting for confounding factors (P > 0.05). Increased weekly activity duration was weakly positively associated with MetS risk (OR = 1.01, 95% CI: 1.01~1.01, P = 0.025). Moderate PA level (OR = 1.35, 95% CI: 1.05~1.73), weekly activity duration (OR = 1.01), and total activity volume (OR = 1.00) were all positively associated with elevated triglyceride (TG) risk (all P < 0.05). Subgroup analysis revealed a significant interaction with BMI (P for interaction = 0.006): moderate-to-vigorous physical activity (MVPA) was positively associated with elevated TG risk only in the normal-weight group (OR = 1.71, 95% CI: 1.25~2.35, P < 0.001), with no such association observed in underweight, overweight, or obese groups.

In this elderly population, no expected inverse association was found between overall PA levels and MetS risk. Instead, longer activity duration and moderate PA were associated with an increased risk of elevated TG, particularly among normal-weight elderly individuals. These findings suggest that metabolic health management for the elderly should adopt an integrated strategy combining PA, weight control, and individualized assessment.