Associations of regular physical exercise and total physical activity volume with the prevalence of abnormal glucose and lipid metabolism among community-dwelling older adults: a cross-sectional study

Objective To investigate the association between regular physical exercise (RPE) and the prevalence of abnormal glucose and lipid metabolism (AGLM, an observational window defined by the presence of any single abnormality across fasting glucose, insulin, and lipid components) among community-dwelling older adults.Methods This cross-sectional study included 499 older adults, comprising 378 individuals with RPE habit (defined as ≥3 sessions/week, ≥30 min/session, for ≥3 years) and 121 irregular exercise controls. Data on domain-specific physical activity volumes, sociodemographic characteristics, and clinical biochemical parameters were evaluated using multivariable logistic regression.Results The overall prevalence of AGLM was 60.5%. Residents engaging in RPE exhibited a significantly lower unadjusted prevalence of AGLM compared to those without RPE (57.9% vs. 68.6%, P = 0.037). The RPE group also showed a lower proportion of abnormal fasting glucose (13.8% vs. 28.1%, P < 0.001). Multivariable regression analysis demonstrated that RPE was independently associated with a lower odds of AGLM (adjusted OR = 0.63, 95% CI: 0.40–0.99). Categorical analysis indicated that physical activity exceeding 5500 MET-min/w was associated with lower odds of presenting with AGLM. Besides, interaction analyses revealed that this inverse association was most pronounced among BMI 24.0–27.9 subgroup, (P for interaction = 0.004).Conclusion Both RPE status and higher total physical activity volumes (particularly >5500 MET-min/w) are independently associated with lower odds of the composite AGLM phenotype among community-dwelling older adults. These cross-sectional findings highlight that long-term structured exercise habits, alongside overall physical activity, represent crucial lifestyle factors associated with favorable metabolic homeostasis in aging populations.