Abstract
BACKGROUND: With the shift in modern lifestyles, the relationship between physical activity (PA) and health has emerged as a significant concern in global public health. A sedentary lifestyle poses a substantial threat to cardiovascular health, particularly through the development of atherosclerosis, the primary pathological basis of cardiovascular disease (CVD) and a condition influenced by various lifestyle factors. The atherogenic index of plasma (AIP), a critical indicator for predicting cardiovascular disease risk, assesses an individual's risk of atherosclerosis by reflecting the ratio of high-density lipoprotein cholesterol (HDL-C) to triglycerides (TG). Despite the recognized importance of PA, the impact of various physical activity patterns on AIP remains unclear. METHODS: This study utilized the National Health and Nutrition Examination Survey (NHANES) database from the United States. PA was assessed via a questionnaire, and participants were categorized into four groups: inactive, insufficiently active, weekend warriors (WW), and regularly active (RA). The AIP was calculated via the ratio of HDL-C to TG, with covariates such as age, sex, race, and body mass index controlled. Multivariate regression analysis served as the primary analytical method. RESULTS: This study included a total of 24,504 participants. After adjusting for all potential covariates, RA (β=-0.044, P<0.0001) was associated with a significant reduction in AIP compared with WWs (β=0.01, P=0.65). Additionally, subgroup analysis and interaction tests showed that the PA-AIP association varied slightly among individuals with different education levels (P for interaction = 0.07) and marital statuses (P for interaction = 0.09), although these differences were small and did not reach statistical significance. Furthermore, restricted cubic splines (RCS) analysis revealed a significant, nonlinear, and negative correlation between total weekly PA and AIP among inactive individuals (P<0.001, nonlinearity P<0.001). The study found that 510 minutes of total physical activity per week is a threshold, beyond which the rate of decrease in AIP tends to slow down. CONCLUSION: RA is more effective in reducing AIP than WWs are. For inactive adults, engaging in more than 510 minutes of PA per week significantly reduces the AIP.