Sex differences in the change of exercise behavior leading to incident metabolic syndrome reduction: A community-based prospective study

Hsiu-Fan Hsu; Yen-Po Yeh; Tony Hsiu-Hsi Chen; Dih-Ling Luh

doi:10.1016/j.pmedr.2022.102076

Sex differences in the change of exercise behavior leading to incident metabolic syndrome reduction: A community-based prospective study

Prev Med Rep. 2022 Dec 2:31:102076. doi: 10.1016/j.pmedr.2022.102076. eCollection 2023 Feb.

Authors

Hsiu-Fan Hsu¹, Yen-Po Yeh², Tony Hsiu-Hsi Chen³, Dih-Ling Luh^{1

4}

Affiliations

¹ Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan, ROC.
² Changhua County Public Health Bureau, Changhua 500, Taiwan, ROC.
³ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 533, Taipei 100, Taiwan, ROC.
⁴ Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan, ROC.

Abstract

This study was undertaken to assess the role of sex differences in the effects of exercise behavior change on incident metabolic syndrome (MetS) in Changhua County, Taiwan. Using data derived from the Changhua Community-based Integrated Screening (CHCIS), 22,594 eligible residents aged 40 years or older had the screening at least twice from 2005 to 2018. A prospective cohort study was designed to follow up the normal cohort without MetS at baseline to ascertain incident MetS in the light of the criteria of the Epidemiology Task Force Consensus Group. We then evaluated whether there was a sex difference in the outcome of incident MetS attributed to the change in exercise behavior from three (no, irregular, and regular exercise) maintained patterns already defined at baseline to either the enhanced pattern or the reduced pattern by the end of follow-up. We applied Cox proportional hazards regression model stratified by sex for estimating the hazard ratio of any two-group comparison. After adjustment for sociodemographic factors, the number of screenings attended, personal disease history, and other health behaviors, the influence of change in exercise behavior on incident MetS was statistically significant only in men. Specifically, maintaining no exercise showed a lower risk of MetS than maintaining regular exercise 21 % in men. Regarding the change in exercise behavior, men with the enhanced pattern reduced the risk of MetS by 15 % compared with those maintaining regular exercise. The findings suggest that positive changes in exercise behavior reduce the incidence of MetS in men but not in women.

Keywords: Change in exercise behavior; Incidence of metabolic syndrome (MetS); Sex difference.