Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.

<h4>Background</h4>Obesity, particularly visceral adiposity, is associated with metabolic disorders and musculoskeletal deterioration. While physical activity (PA) benefits metabolic health, its dose-response effects on bone mineral density (BMD) and muscle mass in visceral obesity remai...

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Main Authors: Hongxin Zhuo, Xintao Zhang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0327987
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author Hongxin Zhuo
Xintao Zhang
author_facet Hongxin Zhuo
Xintao Zhang
author_sort Hongxin Zhuo
collection DOAJ
description <h4>Background</h4>Obesity, particularly visceral adiposity, is associated with metabolic disorders and musculoskeletal deterioration. While physical activity (PA) benefits metabolic health, its dose-response effects on bone mineral density (BMD) and muscle mass in visceral obesity remain unclear.<h4>Objective</h4>This study investigated associations between PA levels and musculoskeletal outcomes in visceral obesity, considering metabolic heterogeneity.<h4>Methods</h4>Utilizing data from 3,077 visceral obesity participants (NHANES 2011-2018), PA levels were categorized as inactive (0 min/week), low- (1-150), moderate- (150-300), and high-active (>300). Weighted linear regression and restricted cubic splines analyzed associations, adjusted for demographic, socioeconomic, and health-related covariates. Subgroup analyses were conducted based on metabolic clusters, which were defined using k-means clustering according to blood pressure, visceral adiposity index, and HbA1c levels.<h4>Results</h4>High-active PA correlated with increased lumbar BMD (β = 0.239, 95%CI:0.055-0.424, P = 0.012), showing nonlinear saturation effects. Muscle mass improved dose-dependently with moderate-active (β: 0.021; 95%CI: 0.007-0.035; P = 0.005) and high-active (β:0.032; 95%CI: 0.018-0.046; P < 0.001). Subgroups with favorable metabolic profiles exhibited stronger PA-musculoskeletal benefits, while metabolic dysfunction attenuated these associations.<h4>Conclusions</h4>Bone adaptations require high-intensity PA thresholds, whereas muscle mass responds linearly to PA dose. Metabolic status modulates both relationships. Integrating metabolic optimization into exercise strategies is critical for improving musculoskeletal health in visceral obesity.
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spelling doaj-art-726ed4830971465b8259a25aeb03e49d2025-08-20T03:13:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032798710.1371/journal.pone.0327987Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.Hongxin ZhuoXintao Zhang<h4>Background</h4>Obesity, particularly visceral adiposity, is associated with metabolic disorders and musculoskeletal deterioration. While physical activity (PA) benefits metabolic health, its dose-response effects on bone mineral density (BMD) and muscle mass in visceral obesity remain unclear.<h4>Objective</h4>This study investigated associations between PA levels and musculoskeletal outcomes in visceral obesity, considering metabolic heterogeneity.<h4>Methods</h4>Utilizing data from 3,077 visceral obesity participants (NHANES 2011-2018), PA levels were categorized as inactive (0 min/week), low- (1-150), moderate- (150-300), and high-active (>300). Weighted linear regression and restricted cubic splines analyzed associations, adjusted for demographic, socioeconomic, and health-related covariates. Subgroup analyses were conducted based on metabolic clusters, which were defined using k-means clustering according to blood pressure, visceral adiposity index, and HbA1c levels.<h4>Results</h4>High-active PA correlated with increased lumbar BMD (β = 0.239, 95%CI:0.055-0.424, P = 0.012), showing nonlinear saturation effects. Muscle mass improved dose-dependently with moderate-active (β: 0.021; 95%CI: 0.007-0.035; P = 0.005) and high-active (β:0.032; 95%CI: 0.018-0.046; P < 0.001). Subgroups with favorable metabolic profiles exhibited stronger PA-musculoskeletal benefits, while metabolic dysfunction attenuated these associations.<h4>Conclusions</h4>Bone adaptations require high-intensity PA thresholds, whereas muscle mass responds linearly to PA dose. Metabolic status modulates both relationships. Integrating metabolic optimization into exercise strategies is critical for improving musculoskeletal health in visceral obesity.https://doi.org/10.1371/journal.pone.0327987
spellingShingle Hongxin Zhuo
Xintao Zhang
Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.
PLoS ONE
title Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.
title_full Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.
title_fullStr Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.
title_full_unstemmed Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.
title_short Dose-response relationships of physical activity with bone mineral density and muscle mass in visceral obesity: A metabolic heterogeneity perspective.
title_sort dose response relationships of physical activity with bone mineral density and muscle mass in visceral obesity a metabolic heterogeneity perspective
url https://doi.org/10.1371/journal.pone.0327987
work_keys_str_mv AT hongxinzhuo doseresponserelationshipsofphysicalactivitywithbonemineraldensityandmusclemassinvisceralobesityametabolicheterogeneityperspective
AT xintaozhang doseresponserelationshipsofphysicalactivitywithbonemineraldensityandmusclemassinvisceralobesityametabolicheterogeneityperspective