| Title: | Effects of moderate-to-vigorous physical activity on the associations between an insulin resistance surrogate and incident cardiovascular disease and all-cause mortality: a UK Biobank cohort study |
| Journal: | Frontiers in Endocrinology |
| Published: | 5 Nov 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41268171/ |
| DOI: | https://doi.org/10.3389/fendo.2025.1709135 |
| URL: | https://public-pages-files-2025.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1709135/pdf |
Publication 19027
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Abstract
Background: Moderate-to-vigorous physical activity (MVPA) and insulin resistance (IR) are associated with cardiovascular disease (CVD). It remains unclear whether different durations of MVPA can modify the associations of the triglyceride glucose-waist height ratio (TyG-WHtR) index, a surrogate for IR, with incident CVD and all-cause mortality, and whether MVPA levels beyond guideline recommendations provide additional benefit.</p>
Methods: This cohort study included 299,928 adults from the UK Biobank study who were free of prevalent CVD at baseline and had complete data on MVPA, the TyG-WHtR index, and relevant covariates. The Cox proportional hazards model was used to assess the independent and joint associations of MVPA and TyG-WHtR with incident CVD and all-cause mortality. A product term of MVPA (< 150, 150-299, 300-599, and ≥ 600 min/week) and TyG-WHtR (tertiles) was included in the model to assess multiplicative interaction.</p>
Results: During a median follow-up of 13.8 and 13.6 years, 27,342 CVD cases and 21,258 deaths were observed. MVPA demonstrated a reverse J-shaped association with incident CVD, with a cutoff point at 261.71 min/week, whereas an L-shaped association was observed for all-cause mortality, with risk reduction plateauing at 217.00 min/week. Elevated TyG-WHtR was positively associated with increased risks of incident CVD and all-cause mortality. No significant interaction was found for incident CVD, whereas an interaction effect was observed between 150-299 min/week MVPA and TyG-WHtR tertile 2 on all-cause mortality (HR for interaction, 0.89; 95% CI, 0.81-0.97; p for interaction = 0.012). Compared with the reference group (< 150 min/week MVPA and TyG-WHtR tertile 3), all other combined groups were associated with lower risks. Among participants with MVPA levels of 150-299, 300-599, and ≥ 600 min/week, the extent of risk reduction for these outcomes was similar.</p>
Conclusions: Our findings highlight the importance of engaging in guideline-recommended MVPA (150-299 min/week) to reduce all-cause mortality risk, particularly among individuals with moderate IR (TyG-WHtR, 7.01-8.03), who are more likely to benefit. Furthermore, the protective effects of higher levels of MVPA against IR-related risks were consistent with those of guideline-recommended MVPA.</p>
17 Keywords
- Adult
- Aged
- Biological Specimen Banks
- Biomarkers
- Cardiovascular Diseases
- Cause of Death
- Cohort Studies
- Exercise
- Female
- Follow-Up Studies
- Humans
- Incidence
- Insulin Resistance
- Male
- Middle Aged
- UK Biobank
- United Kingdom
4 Authors
- Ying Zhu
- Tianci Yao
- Hongyu Yan
- Qinmei Ke
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