Independent and joint associations of serum 25-hydroxyvitamin D concentration and aerobic physical activity with cardiometabolic risk clustering among community-dwelling older adults: a population-based cross-sectional study

This cross-sectional study examined the independent and joint associations of serum 25-hydroxyvitamin D [25(OH)D] concentration and aerobic physical activity with cardiometabolic risk clustering (CMRC) among community-dwelling older adults. Data were obtained from 1,668 adults aged ≥ 65 years in the 2023 Korea National Health and Nutrition Examination Survey. CMRC was defined as three or more of five cardiometabolic risk components. Complex-samples logistic regression incorporated sampling weights, strata, and primary sampling units and adjusted for sociodemographic characteristics, smoking, alcohol consumption, residential area, and body mass index. Weighted CMRC prevalence was 35.2%. Each 5-ng/mL increase in serum 25(OH)D was associated with lower CMRC odds (adjusted odds ratio [aOR] = 0.95, 95% confidence interval [CI] = 0.91–0.99), as was meeting the aerobic physical activity guideline (aOR = 0.73, 95% CI = 0.55–0.98). Compared with participants with serum 25(OH)D < 20 ng/mL who did not meet the guideline, those with serum 25(OH)D ≥ 20 ng/mL who met it had lower CMRC odds (aOR = 0.57, 95% CI = 0.38–0.87). The multiplicative interaction was not significant (p = .201). Higher serum 25(OH)D concentration and guideline adherence were independently associated with lower CMRC odds.