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

Q: What are the key findings of this study?

High-intensity physical activity was associated with a 43% lower risk of arterial stiffness compared to low-intensity physical activity in middle-aged and older Chinese adults.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Arterial stiffness (n=6356). Intervention: High-intensity physical activity vs. Low-intensity physical activity. Primary outcome: Arterial stiffness (estimated pulse wave velocity ≥10 m/s) (OR 0.57, 95% CI 0.48-0.68, p=<0.001).

Q: What does this research mean for the field?

High-intensity physical activity is associated with a 43% lower risk of arterial stiffness compared to low-intensity physical activity in middle-aged and older Chinese adults, an association partially mediated by visceral fat metabolism. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

Investigate the relationship between physical activity intensity and arterial stiffness in middle-aged and older Chinese adults, and evaluate the mediating role of the Metabolic Score for Visceral Fat.

Huihua Jiang; Xiaoli Shao; Liqin Jiang; Teng Zhang

doi:10.20945/2359-4292-2026-0094

January 1, 2026Archives of Endocrinology and MetabolismOpen Access

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

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Key result

High-intensity physical activity is linked to ~43% lower risk of arterial stiffness vs low-intensity activity.

OR 0.57
95% CI 0.48-0.68
P<0.001
n=6,356

Figures

Why the study?

The association between physical activity and arterial stiffness in middle-aged and older Chinese adults and the mediating role of visceral fat metabolism were not well characterized.

Does higher physical activity reduce arterial stiffness in middle-aged and older Chinese adults?

Key Points

Investigate the relationship between physical activity intensity and arterial stiffness in middle-aged and older Chinese adults, and evaluate the mediating role of the Metabolic Score for Visceral Fat.
Analyzed data from 6,356 participants (mean age 61.0 ± 9.4 years) in the 2015 China Health and Retirement Longitudinal Study (CHARLS).
Assessed physical activity using the International Physical Activity Questionnaire and defined arterial stiffness as estimated pulse wave velocity (ePWV) ≥10 m/s.
Employed multivariable logistic regression, restricted cubic spline models, and bootstrap mediation analyses adjusted for demographic, lifestyle, and clinical confounders.
Each standard deviation increase in physical activity intensity was associated with a 22% reduction in arterial stiffness risk (OR = 0.78, 95% CI: 0.72–0.84, p < 0.001).
Compared to light physical activity, moderate intensity (OR = 0.75, 95% CI: 0.61–0.92, p = 0.005) and high intensity (OR = 0.57, 95% CI: 0.48–0.68, p < 0.001) were significantly associated with lower arterial stiffness risk, exhibiting a nonlinear dose-response relationship (p-nonlinear = 0.034).
Mediation analysis revealed that the Metabolic Score for Visceral Fat significantly mediated the inverse relationship between physical activity and arterial stiffness, accounting for 11.4% of the total effect.

Study Design

Type

Cross-Sectional (n=6,356)

Multicenter

Yes

Structured PICO

Does higher physical activity reduce arterial stiffness in middle-aged and older Chinese adults?

P

Population

6,356 Chinese adults aged 45 years and older were assessed cross-sectionally to investigate the association between physical activity levels and the risk of arterial stiffness.

E

Exposure

Moderate-to-high intensity physical activity (Moderate: 600–3000 MET-min/week; High: >3000 MET-min/week)

C

Comparator

Low-intensity physical activity (<600 MET-min/week)

O

Outcome

Arterial stiffness (AS), defined as estimated pulse wave velocity (ePWV) ≥10 m/ssurrogate

Main Result

Odds Ratio: 0.57 (95% CI 0.48–0.68)

p-value: p=<0.001

Higher levels of physical activity, especially moderate and vigorous, are associated with a reduced risk of arterial stiffness in middle-aged and older adults, an effect partially mediated by improved visceral fat metabolism.

Limitations

Cross-sectional design inherently limits the ability to establish causality
Physical activity, arterial stiffness, and visceral fat were assessed using self-reported data or indirect estimations rather than gold-standard measurements
Age restriction (≥45 years) limits generalizability of findings to younger populations
Diagnostic criteria for dyslipidemia used apply specifically to middle-aged and older Chinese adults
Cross-sectional design inherently limits the ability to establish causality.
Key variables (PA, AS, VF) were assessed using self-reported data or indirect estimations, potentially introducing misclassification bias.
Age restriction to ≥45 years limits generalizability to younger populations.
Diagnostic criteria for dyslipidemia specific to middle-aged and older Chinese adults limit extrapolation to other ethnicities or regions.

Implication

May support recommending higher-intensity activity to lower arterial stiffness risk; leaves open causal confirmation in trials.

Abstract

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.

Discussion

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Cite This Study

Jiang et al. (2026) conducted a cross-sectional in Arterial stiffness (n=6,356). High-intensity physical activity vs. Low-intensity physical activity was evaluated on Arterial stiffness (estimated pulse wave velocity ≥10 m/s) (OR 0.57, 95% CI 0.48-0.68, p=<0.001). High-intensity physical activity was associated with a 43% lower risk of arterial stiffness compared to low-intensity physical activity in middle-aged and older Chinese adults.

synapsesocial.com/papers/6ad0fcb515427f6a84040250 https://doi.org/10.20945/2359-4292-2026-0094

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

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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