Role of remnant cholesterol in the relationship between physical activity and diabetes mellitus: an intermediary analysis

Front Public Health. 2024 Mar 12:12:1322244. doi: 10.3389/fpubh.2024.1322244. eCollection 2024.

Abstract

Objective: The purpose of this investigation was to evaluate the potential link between physical activity (PA) and the heightened susceptibility to diabetes mellitus (DM), by examining whether remnant cholesterol (RC) might act as a mediator in this correlation.

Methods: The research utilized data from the National Health and Nutrition Examination Survey, spanning from 2005 to 2018. Various statistical analyses were conducted for continuous and categorical variables, including the t-test, ANOVA, and χ2 test. Logistic regression was employed to analyze the association between PA and DM across three distinct models. Mediation analysis was also conducted to assess the potential mediation effects of RC.

Results: The study encompassed a total of 9,149 participants, and it was observed that individuals with DM exhibited lower levels of PA. Furthermore, PA levels were found to be associated with all participant characteristics except poverty income ratio, fasting blood glucose, and HOMA-IR (p < 0.05). After adjusting for covariates (Model 3), individuals with high PA levels demonstrated a decreased likelihood of developing DM compared to those in the low PA group (OR: 0.73, 95%CI: 0.54-0.99). A significant dose-response relationship was identified (p < 0.05). No interaction between PA and RC in relation to DM risk was detected, and RC was found to serve as a mediator in the connection between PA and DM. After considering covariates, the mediating effect of RC between PA and DM weakens.

Discussion: Our findings suggest that higher levels of PA are linked to a reduced risk of DM in U.S. adults, with RC likely playing a mediating role.

Keywords: National Health and Nutrition Examination Survey; diabetes mellitus; intermediary analysis; physical activity; remnant cholesterol.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cholesterol
  • Diabetes Mellitus* / diagnosis
  • Exercise
  • Humans
  • Nutrition Surveys

Substances

  • Cholesterol

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Discipline Construction Project of Guangdong Medical University (nos. 4SG21276P and 1003K20220004), Guangdong Province Foundation and Applied Basic Re-search Foundation Regional Joint Fund (The Key Project) (no. 2020B1515120021), Guangdong Basic and Applied Basic Research Fund Enterprise Joint Fund (no. 2022A1515220196), Guangdong Province General University Characteristic Innovation Project (nos. 2020KTSCX042 and 2019KTSCX046), 2022 Undergraduate Teaching Quality and Teaching Reform Project (Special Talent Training Plan) (no. 1JG22125).