ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health and Nutrition
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1652015
This article is part of the Research TopicSports, Nutrition and Public Health: Analyzing their Interconnected ImpactsView all 27 articles
Moderating effects of a healthy lifestyle on the association of premetabolic syndrome with multiple chronic disease comorbidities
Provisionally accepted
Youqiong Xu1*
Xinchao Zhang2Jinxi Fang2Wenchu Xu2Qihui Chen2Yitao Zhu2
Haiping Hu2Xiangyu Cao1
Xiaoyang Zhang1*- 1The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
- 2Fujian Medical University, Fuzhou, China
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Studies have shown that healthy lifestyles reduce the risk of metabolic syndrome (MetS), but their impact on pre-metabolic syndrome (PreMetS) with multiple comorbidities remains unclear. To explore the association of PreMetS and MetS with multiple comorbidities and to assess whether a healthy lifestyle influences these associations. Associations between PreMetS and MetS, lifestyle behaviours and multiple comorbidities were analysed by univariate and multivariate logistic regression.The moderating effect of healthy lifestyle was assessed by stratified analyses. Integrate healthy lifestyles and explore their association with multiple comorbidities using normal metabolism and healthy lifestyles as reference groups. PreMetS [OR=1.38, 95%CI:1.16-1.64] and MetS [OR=1.61, 95%CI:1.32-1.97] were associated with a significantly higher risk of multiple comorbidities compared with the normal population, and the risk of multiple comorbidities tended to increase as the number of metabolic disorder components increased (P<0.001). Adherence to a healthy lifestyle (favourable [OR=0.69, 95%CI:0.59-0.82] and extremely favourable [OR=0.54, 95%CI:0.43-0.68]) was associated with a reduced risk of multiple comorbidities, with a trend towards a decreased risk of multiple comorbidities as the number of healthy lifestyles increased (P<0.001). PreMetS was not associated with multiple comorbidities in healthy lifestyles (moderate and above) (P>0.05), whereas MetS remained an associated risk factor for multiple comorbidities (P<0.05). Compared to healthy lifestyle normometabolic subjects, unfavourable lifestyle PreMetS subjects were associated with increased risk of multiple comorbidities [OR=2.05, 95%CI:1.30-3.23], whereas healthy lifestyle PreMetS subjects were not associated with increased risk of multiple comorbidities [OR=1.52, 95%CI:0.93-2.50]. Metabolic profiles and lifestyle factors were independently associated with multiple comorbidities, and a healthy lifestyle counteracted the deleterious effects of PreMetS on the risk of multiple comorbidities in adults in Fuzhou.However, population homogeneity and recall bias resulting from the study design may lead to reverse causality and residual or unknown confounding factors.
Keywords: Healthy lifestyle, pre-metabolic syndrome, comorbidities, Risk factors, chronic disease healthy lifestyle
Received: 23 Jun 2025; Accepted: 24 Jul 2025.
Copyright: © 2025 Xu, Zhang, Fang, Xu, Chen, Zhu, Hu, Cao and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Youqiong Xu, The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
Xiaoyang Zhang, The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, China
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