Table 1 shows the general characteristics of the study population. Of 13,971 participants in total, 49.2% were men (average age, 48.2 years). When divided into four groups according to their PA status prior to matching, most participants were in the NE group (n = 6,854, 49.06%), followed by the AE (n = 3928, 28.12%), TE (n = 1980,14.17 8.65%), and RE (n = 1,209, 8.65%) groups. All socio-economic and lifestyle variables differed significantly between the four groups, which were matched for the study analysis.
Table 1
Clinical characteristics according to exercise type pre- and post-PSM
Variable | Pre-PSM | Post-PSM |
Overall | TE group | AE group | RE group | Non-AE and RE group | p-value | Overall | TE group | AE group | RE group | Non-AE and RE group | p-value |
Unweighted N | 13,971 | 1,980 | 3,928 | 1,209 | 6,854 | | 4,340 | 1,085 | 1,085 | 1,085 | 1,085 | |
Age (years) | 48.20 ± 16.43 | 42.81 ± 16.33 | 46.14 ± 15.68 | 51.61 ± 16.31 | 50.72 ± 16.30 | < 0.001 | 53.72 ± 15.84 | 53.72 ± 15.84 | 53.72 ± 15.84 | 53.72 ± 15.84 | 53.72 ± 15.84 | > 0.999 |
Sex | | | | | | < 0.001 | | | | | | > 0.999 |
Male | 49.2 | 66.3 | 45.5 | 64.6 | 42.9 | | 60.4 | 60.4 | 60.4 | 60.4 | 60.4 | |
Female | 50.8 | 33.7 | 54.5 | 35.4 | 57.1 | | 39.6 | 39.6 | 39.6 | 39.6 | 39.6 | |
Educational status | | | | | | < 0.001 | | | | | | < 0.001 |
Elementary school | 12 | 4.1 | 8.8 | 11.2 | 17 | | 13.3 | 8.6 | 12.8 | 13.5 | 18.4 | |
Middle school | 7.8 | 5.3 | 6.9 | 8.9 | 9.1 | | 11.1 | 10.4 | 10.8 | 11.2 | 12 | |
High school | 36.9 | 38.1 | 37.9 | 38.8 | 35.5 | | 36.6 | 36.3 | 37.8 | 37 | 35.4 | |
College or University | 43.3 | 52.5 | 46.4 | 41 | 38.5 | | 39 | 44.7 | 38.6 | 38.4 | 34.2 | |
Alcohol consumption (yes) | 55.4 | 63.9 | 56.5 | 60.7 | 50.8 | < 0.001 | 57.6 | 60.1 | 57.1 | 57.2 | 55.9 | 0.244 |
Smoking history | | | | | | < 0.001 | | | | | | < 0.001 |
No | 57.8 | 51.5 | 60.3 | 46.7 | 60.4 | | 49.6 | 51.2 | 50 | 48.9 | 48 | |
Current | 18.2 | 18.7 | 17.4 | 17 | 18.8 | | 17.9 | 14.2 | 18.1 | 16.2 | 23.3 | |
Former | 23.9 | 29.8 | 22.3 | 36.3 | 20.8 | | 32.5 | 34.6 | 31.9 | 34.8 | 28.7 | |
Household income status | | | | | | < 0.001 | | | | | | 0.008 |
Low | 14.1 | 8.1 | 11.9 | 15.7 | 17.4 | | 15.6 | 12.7 | 15.9 | 16.7 | 17.1 | |
Mid-low | 23.1 | 20.3 | 23 | 22.2 | 24.3 | | 24.6 | 23.1 | 26.2 | 23.4 | 25.6 | |
Mid-high | 29.3 | 29.7 | 30.3 | 27.6 | 28.9 | | 28.6 | 28.6 | 29.3 | 28.5 | 28.1 | |
High | 33.4 | 41.9 | 34.7 | 34.5 | 29.5 | | 31.2 | 35.6 | 28.6 | 31.4 | 29.1 | |
Body mass index | | | | | | < 0.001 | | | | | | 0.002 |
Underweight (< 18.5) | 4 | 2.4 | 4.7 | 3.3 | 4.3 | | 3.4 | 2.3 | 3.6 | 3.5 | 4.2 | |
Normal (≥ 18.5 and < 25) | 58.8 | 61.6 | 56.9 | 61.7 | 58.4 | | 60.6 | 64.2 | 57 | 62.9 | 58.2 | |
Obese (≥ 25) | 37.2 | 36 | 38.4 | 35 | 37.3 | | 36 | 33.5 | 39.4 | 33.5 | 37.5 | |
WC (cm) | 84.19 ± 10.86 | 83.36 ± 10.40 | 83.82 ± 11.02 | 84.56 ± 10.00 | 84.65 ± 11.03 | < 0.001 | 84.89 ± 10.21 | 83.82 ± 9.62 | 85.91 ± 10.38 | 84.38 ± 10.19 | 85.45 ± 10.51 | < 0.001 |
Mean BP (mmHg) | 89.79 ± 10.77 | 88.83 ± 10.11 | 89.63 ± 11.01 | 89.80 ± 10.06 | 90.22 ± 10.93 | < 0.001 | 90.64 ± 10.43 | 89.93 ± 10.13 | 91.56 ± 10.51 | 89.94 ± 10.15 | 91.14 ± 10.84 | < 0.001 |
Total cholesterol (mg/dL) | 193.05 ± 38.66 | 192.57 ± 37.19 | 194.58 ± 38.50 | 191.39 ± 37.47 | 192.55 ± 39.43 | 0.08 | 191.99 ± 39.87 | 192.85 ± 39.47 | 193.74 ± 39.61 | 190.97 ± 39.08 | 190.41 ± 41.24 | 0.171 |
TG (mg/dL) | 131.10 ± 106.97 | 120.18 ± 108.96 | 128.83 ± 106.48 | 131.59 ± 117.16 | 136.18 ± 104.35 | < 0.001 | 132.25 ± 104.96 | 121.12 ± 94.15 | 134.03 ± 86.50 | 132.86 ± 125.69 | 140.97 ± 108.40 | < 0.001 |
HDL-cholesterol (mg/dL) | 52.25 ± 12.83 | 53.47 ± 12.99 | 53.08 ± 12.99 | 51.71 ± 13.07 | 51.41 ± 12.56 | < 0.001 | 51.74 ± 13.17 | 53.33 ± 13.66 | 51.54 ± 12.88 | 51.93 ± 13.28 | 50.17 ± 12.66 | < 0.001 |
LDL-cholesterol (mg/dL) | 116.14 ± 34.55 | 116.41 ± 32.83 | 117.19 ± 34.40 | 115.07 ± 33.68 | 115.58 ± 35.35 | 0.185 | 115.27 ± 35.59 | 116.21 ± 35.72 | 116.52 ± 35.30 | 114.15 ± 34.52 | 114.20 ± 36.76 | 0.248 |
Glucose (mg/dL) | 100.79 ± 22.35 | 97.46 ± 18.02 | 100.19 ± 22.25 | 100.81 ± 20.68 | 102.31 ± 23.85 | < 0.001 | 102.85 ± 24.16 | 101.06 ± 20.86 | 104.11 ± 27.17 | 101.61 ± 21.52 | 104.63 ± 26.26 | < 0.001 |
Insulin (IU/L) | 9.07 ± 6.97 | 8.19 ± 6.12 | 9.02 ± 6.56 | 8.54 ± 6.01 | 9.50 ± 7.58 | < 0.001 | 8.49 ± 6.29 | 7.72 ± 6.22 | 9.07 ± 7.17 | 8.28 ± 5.56 | 8.88 ± 6.04 | < 0.001 |
HOMR-IR | 2.34 ± 2.20 | 2.03 ± 1.85 | 2.30 ± 2.01 | 2.20 ± 1.89 | 2.49 ± 2.44 | < 0.001 | 2.22 ± 1.92 | 1.98 ± 1.68 | 2.40 ± 2.30 | 2.15 ± 1.71 | 2.36 ± 1.91 | < 0.001 |
HbA1c (%) | 5.77 ± 0.82 | 5.63 ± 0.67 | 5.74 ± 0.82 | 5.75 ± 0.72 | 5.83 ± 0.88 | < 0.001 | 5.85 ± 0.86 | 5.78 ± 0.74 | 5.90 ± 0.93 | 5.80 ± 0.75 | 5.91 ± 0.99 | < 0.001 |
TyG Index | 8.59 ± 0.66 | 8.46 ± 0.66 | 8.57 ± 0.65 | 8.59 ± 0.65 | 8.64 ± 0.66 | < 0.001 | 8.62 ± 0.65 | 8.53 ± 0.64 | 8.67 ± 0.62 | 8.60 ± 0.65 | 8.70 ± 0.66 | < 0.001 |
AST (IU/L) | 24.82 ± 14.36 | 25.78 ± 16.02 | 24.39 ± 12.85 | 26.21 ± 24.03 | 24.50 ± 12.14 | 0.006 | 25.83 ± 16.72 | 26.08 ± 16.52 | 26.04 ± 14.20 | 25.99 ± 21.36 | 25.19 ± 13.68 | 0.551 |
ALT (IU/L) | 24.53 ± 20.39 | 25.51 ± 21.65 | 24.07 ± 18.71 | 24.71 ± 21.59 | 24.45 ± 20.72 | 0.172 | 24.52 ± 19.85 | 23.74 ± 17.72 | 25.36 ± 18.83 | 23.96 ± 19.68 | 25.04 ± 22.77 | 0.154 |
WBC (× 103/µL) | 6.17 ± 1.68 | 6.06 ± 1.62 | 6.16 ± 1.68 | 6.06 ± 1.66 | 6.23 ± 1.70 | 0.001 | 6.12 ± 1.67 | 5.85 ± 1.53 | 6.22 ± 1.68 | 6.02 ± 1.62 | 6.37 ± 1.79 | < 0.001 |
MetS (yes) | 27.8 | 19.3 | 26.5 | 26.2 | 31.8 | < 0.001 | 29.5 | 24.8 | 33.4 | 26.9 | 33 | < 0.001 |
NAFLD (yes) | 45.5 | 38.8 | 46.5 | 41.2 | 48 | < 0.001 | 44.4 | 43.9 | 45.2 | 42.7 | 45.7 | 0.485 |
HIS | 36.03 ± 4.80 | 35.30 ± 4.73 | 36.07 ± 4.62 | 35.62 ± 4.78 | 36.33 ± 4.90 | < 0.001 | 35.95 ± 4.93 | 35.99 ± 5.63 | 36.09 ± 4.52 | 35.82 ± 4.67 | 35.92 ± 4.84 | 0.627 |
HTN (yes) | 54.4 | 49.5 | 50.6 | 57.9 | 57.8 | < 0.001 | 60.6 | 57.3 | 63.5 | 58.5 | 63.2 | 0.003 |
DM (yes) | 53.4 | 42.5 | 51.4 | 56.1 | 58 | < 0.001 | 61 | 58.4 | 62.8 | 60 | 62.8 | 0.098 |
Dyslipidemia (yes) | 34.9 | 28.9 | 33.9 | 33.5 | 37.8 | < 0.001 | 38.2 | 36.3 | 40.9 | 35.9 | 39.4 | 0.044 |
Abbreviations: AE, aerobic exercise; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; CE, complex exercise; DM, diabetes mellitus; HDL, high density lipoprotein; HSI, hepatic steatosis index; HOMA-IR, homeostasis model assessment-estimated insulin resistance; HTN, hypertension; LDL, low-density lipoprotein; MetS, metabolic syndrome; NAFLD, non-alcoholic fatty liver disease; PSM, propensity score matching; RE, resistance exercise; TG, triglyceride; TyG index, triglyceride and glucose index; TE, total exercise; WBC, white blood cell; WC, waist circumference |
After matching, each group consisted of 1,085 participants (males, 60.4%; average age, 53.72 years). The prevalence of obesity according to BMI and WC was lowest in the TE and RE groups, as was the mean BP. Fasting glucose, HbA1c, serum insulin, and the HOMA-IR and TyG indices uniformly showed that the TE group had the lowest mean values, followed by the RE group, with both sets of values being lower than those in the AE and NE groups. The WBC count also followed this trend. Total cholesterol and LDL-C levels did not differ significantly between the four groups; however, TG was significantly lower, and HDL-C was significantly higher in the TE group compared with the other PA groups.
Table 2 shows the regression coefficients between the four PA groups after PSM. WC, mean BP, all glucose, and insulin-related indices (glucose, HbA1c, insulin, HOMA-IR, and TyG) and the WBC count uniformly showed decreased values in the TE and RE groups only, with the TE group showing larger differences. Total cholesterol and LDL-C showed no significant differences between the four groups; however, HDL-C levels were higher in all exercise groups compared with the NE group and highest in the TE group. TG levels were significantly lower (–17.29 mg/dL) in the TE group compared with the NE group; however, one type of PA showed no significant difference.
Table 2
Comparison of clinical characteristics between the AE, RE, non-AE and RE, and TE groups post-PSM
Variable | TE group | AE only group | RE only group | Non-AE and RE group | p-value |
Coefficient (95% CI) | p-value | Coefficient (95% CI) | p-value | Coefficient (95% CI) | p-value | Coefficient (95% CI) | p-value |
BMI (kg/m2) | Ref | Ref | 0.453 (0.167–0.738) | 0.002 | -0.013 (-0.298–0.273) | 0.931 | 0.132 (-0.156–0.420) | 0.368 | 0.004 |
| -0.453 (-0.738–-0.167) | 0.002 | Ref | Ref | -0.465 (-0.750–-0.181) | 0.001 | -0.321 (-0.606– -0.035) | 0.028 | |
| 0.013 (-0.273–0.298) | 0.931 | 0.465 (0.181–0.750) | 0.001 | Ref | Ref | 0.145 (-0.141–0.430) | 0.32 | |
| -0.132 (-0.420–0.156) | 0.368 | 0.321 (0.035–0.606) | 0.028 | -0.145 (-0.430–0.141) | 0.32 | Ref | Ref | |
WC (cm) | Ref | Ref | 1.992 (1.221–2.762) | < 0.001 | 0.449 (-0.321–1.219) | 0.253 | 1.441 (0.664–2.218) | < 0.001 | < 0.001 |
| -1.992 (-2.762–-1.221) | < 0.001 | Ref | Ref | -1.542 (-2.311–-0.774) | < 0.001 | -0.551 (-1.321–0.220) | 0.161 | |
| -0.449 (-1.219–0.321) | 0.253 | 1.542 (0.774–2.311) | < 0.001 | Ref | Ref | 0.992 (0.220–1.763) | 0.012 | |
| -1.441 (-2.218–-0.664) | < 0.001 | 0.551 (-0.220–1.321) | 0.161 | -0.992 (-1.763–-0.220) | 0.012 | Ref | Ref | |
Mean BP (mmHg) | Ref | Ref | 1.612 (0.759–2.465) | < 0.001 | 0.035 (-0.818–0.887) | 0.936 | 1.161 (0.300–2.021) | 0.008 | < 0.001 |
| -1.612 (-2.465–-0.759) | < 0.001 | Ref | Ref | -1.577 (-2.428–-0.727) | < 0.001 | -0.451 (-1.305–0.402) | 0.3 | |
| -0.035 (-0.887–0.818) | 0.936 | 1.577 (0.727–2.428) | < 0.001 | Ref | Ref | 1.126 (0.272–1.980) | 0.01 | |
| -1.161 (-2.021–-0.300) | 0.008 | 0.451 (-0.402–1.305) | 0.3 | -1.126 (-1.980–-0.272) | 0.01 | Ref | Ref | |
Total cholesterol (mg/dL) | Ref | Ref | 1.555 (-1.751–4.861) | 0.357 | -1.040 (-4.345–2.265) | 0.537 | -1.122 (-4.458–2.213) | 0.51 | 0.349 |
| -1.555 (-4.861–1.751) | 0.357 | Ref | Ref | -2.595 (-5.892–0.702) | 0.123 | -2.677 (-5.985–0.631) | 0.113 | |
| 1.040 (-2.265–4.345) | 0.537 | 2.595 (-0.702–5.892) | 0.123 | Ref | Ref | -0.082 (-3.391–3.227) | 0.961 | |
| 1.122 (-2.213–4.458) | 0.51 | 2.677 (-0.631–5.985) | 0.113 | 0.082 (-3.227–3.391) | 0.961 | Ref | Ref | |
TG (mg/dL) | Ref | Ref | 12.136 (3.474–20.797) | 0.006 | 11.210 (2.552–19.867) | 0.011 | 17.293 (8.554–26.032) | < 0.001 | 0.001 |
| -12.136 (-20.797–-3.474) | 0.006 | Ref | Ref | -0.926 (-9.564–7.711) | 0.834 | 5.157 (-3.508–13.823) | 0.243 | |
| -11.210 (-19.867–-2.552) | 0.011 | 0.926 (-7.711–9.564) | 0.834 | Ref | Ref | 6.083 (-2.586–14.753) | 0.169 | |
| -17.293 (-26.032–-8.554) | < 0.001 | -5.157 (-13.823–3.508) | 0.243 | -6.083 (-14.753–2.586) | 0.169 | Ref | Ref | |
HDL-cholesterol (mg/dL) | Ref | Ref | -1.511 (-2.539–-0.484) | 0.004 | -1.116 (-2.142–-0.089) | 0.033 | -2.661 (-3.697–-1.625) | < 0.001 | < 0.001 |
| 1.511 (0.484–2.539) | 0.004 | Ref | Ref | 0.396 (-0.629–1.420) | 0.449 | -1.149 (-2.177–-0.122) | 0.028 | |
| 1.116 (0.089–2.142) | 0.033 | -0.396 (-1.420–0.629) | 0.449 | Ref | Ref | -1.545 (-2.573–-0.517) | 0.003 | |
| 2.661 (1.625–3.697) | < 0.001 | 1.149 (0.122–2.177) | 0.028 | 1.545 (0.517–2.573) | 0.003 | Ref | Ref | |
LDL-cholesterol (mg/dL) | Ref | Ref | 0.806 (-2.157–3.768) | 0.594 | -1.417 (-4.378-1.544) | 0.348 | -0.827 (-3.816–2.162) | 0.587 | 0.479 |
| -0.806 (-3.768–2.157) | 0.594 | Ref | Ref | -2.222 (-5.177–0.732) | 0.14 | -1.633 (-4.597–1.331) | 0.28 | |
| 1.417 (-1.544–4.378) | 0.348 | 2.222 (-0.732–5.177) | 0.14 | Ref | Ref | 0.589 (-2.376–3.555) | 0.697 | |
| 0.827 (-2.162–3.816) | 0.587 | 1.633 (-1.331–4.597) | 0.28 | -0.589 (-3.555–2.376) | 0.697 | Ref | Ref | |
Glucose (mg/dL) | Ref | Ref | 2.828 (0.856–4.800) | 0.005 | 0.348 (-1.623–2.319) | 0.729 | 3.063 (1.074–5.053) | 0.003 | 0.002 |
| -2.828 (-4.800–-0.856) | 0.005 | Ref | Ref | -2.480 (-4.446–-0.513) | 0.013 | 0.235 (-1.738–2.208) | 0.815 | |
| -0.348 (-2.319–1.623) | 0.729 | 2.480 (0.513–4.446) | 0.013 | Ref | Ref | 2.715 (0.741–4.689) | 0.007 | |
| -3.063 (-5.053–-1.074) | 0.003 | -0.235 (-2.208–1.738) | 0.815 | -2.715 (-4.689–-0.741) | 0.007 | Ref | Ref | |
Insulin (IU/L) | Ref | Ref | 1.271 (0.744–1.798) | < 0.001 | 0.489 (-0.037–1.015) | 0.069 | 1.053 (0.522–1.585) | < 0.001 | < 0.001 |
| -1.271 (-1.798–-0.744) | < 0.001 | Ref | Ref | -0.782 (-1.307–-0.257) | 0.004 | -0.218 (-0.745–0.309) | 0.418 | |
| -0.489 (-1.015–0.037) | 0.069 | 0.782 (0.257–1.307) | 0.004 | Ref | Ref | 0.564 (0.037–1.091) | 0.036 | |
| -1.053 (-1.585–-0.522) | < 0.001 | 0.218 (-0.309–0.745) | 0.418 | -0.564 (-1.091–-0.037) | 0.036 | Ref | Ref | |
HOMA-IR | Ref | Ref | 0.396 (0.236–0.557) | < 0.001 | 0.147 (-0.014–0.308) | 0.073 | 0.343 (0.181–0.506) | < 0.001 | < 0.001 |
| -0.396 (-0.557–-0.236) | < 0.001 | Ref | Ref | -0.249 (-0.410–-0.089) | 0.002 | -0.053 (-0.214–0.108) | 0.517 | |
| -0.147 (-0.308–0.014) | 0.073 | 0.249 (0.089–0.410) | 0.002 | Ref | Ref | 0.196 (0.035–0.357) | 0.017 | |
| -0.343 (-0.506– -0.181) | < 0.001 | 0.053 (-0.108–0.214) | 0.517 | -0.196 (-0.357–-0.035) | 0.017 | Ref | Ref | |
HbA1c (%) | Ref | Ref | 0.106 (0.037–0.175) | 0.003 | 0.012 (-0.057–0.080) | 0.743 | 0.096 (0.026–0.165) | 0.007 | 0.002 |
| -0.106 (-0.175–-0.037) | 0.003 | Ref | Ref | -0.094 (-0.163–-0.026) | 0.007 | -0.010 (-0.079–0.059) | 0.773 | |
| -0.012 (-0.080–0.057) | 0.743 | 0.094 (0.026–0.163) | 0.007 | Ref | Ref | 0.084 (0.015–0.153) | 0.017 | |
| -0.096 (-0.165–-0.026) | 0.007 | 0.010 (-0.059–0.079) | 0.773 | -0.084 (-0.153–-0.015) | 0.017 | Ref | Ref | |
TyG index | Ref | Ref | 0.138 (0.086–0.189) | < 0.001 | 0.060 (0.008–0.112) | 0.023 | 0.147 (0.095–0.199) | < 0.001 | < 0.001 |
| -0.138 (-0.189–-0.086) | < 0.001 | Ref | Ref | -0.078 (-0.129–-0.026) | 0.003 | 0.010 (-0.042–0.061) | 0.708 | |
| -0.060 (-0.112–-0.008) | 0.023 | 0.078 (0.026–0.129) | 0.003 | Ref | Ref | 0.087 (0.036–0.139) | < 0.001 | |
| -0.147 (-0.199–-0.095) | < 0.001 | -0.010 (-0.061–0.042) | 0.708 | -0.087 (-0.139–-0.036) | < 0.001 | Ref | Ref | |
AST (IU/L) | Ref | Ref | -0.171 (-1.574–1.232) | 0.811 | -0.231 (-1.633–1.172) | 0.747 | -1.215 (-2.631–0.200) | 0.092 | 0.323 |
| 0.171 (-1.232–1.574) | 0.811 | Ref | Ref | -0.059 (-1.459–1.340) | 0.934 | -1.044 (-2.448–0.360) | 0.145 | |
| 0.231 (-1.172–1.633) | 0.747 | 0.059 (-1.340–1.459) | 0.934 | Ref | Ref | -0.985 (-2.389–0.420) | 0.169 | |
| 1.215 (-0.200–2.631) | 0.092 | 1.044 (-0.360–2.448) | 0.145 | 0.985 (-0.420–2.389) | 0.169 | Ref | Ref | |
ALT (IU/L) | Ref | Ref | 1.505 (-0.140–3.149) | 0.073 | 0.101 (-1.543–1.744) | 0.905 | 1.031 (-0.629–2.690) | 0.223 | 0.209 |
| -1.505 (-3.149–0.140) | 0.073 | Ref | Ref | -1.404 (-3.044–0.236) | 0.093 | -0.474 (-2.119–1.171) | 0.572 | |
| -0.101 (-1.744–1.543) | 0.905 | 1.404 (-0.236–3.044) | 0.093 | Ref | Ref | 0.930 (-0.716–2.576) | 0.268 | |
| -1.031 (-2.690–0.629) | 0.223 | 0.474 (-1.171–2.119) | 0.572 | -0.930 (-2.576–0.716) | 0.268 | Ref | Ref | |
WBC (× 103/µL) | Ref | Ref | 0.297 (0.165–0.430) | < 0.001 | 0.109 (-0.024–0.241) | 0.107 | 0.357 (0.223–0.490) | < 0.001 | < 0.001 |
| -0.297 (-0.430–-0.165) | < 0.001 | Ref | Ref | -0.189 (-0.321–-0.057) | 0.005 | 0.059 (-0.073–0.192) | 0.38 | |
| -0.109 (-0.241–0.024) | 0.107 | 0.189 (0.057–0.321) | 0.005 | Ref | Ref | 0.248 (0.115–0.380) | < 0.001 | |
| -0.357 (-0.490–-0.223) | < 0.001 | -0.059 (-0.192–0.073) | 0.38 | -0.248 (-0.380–-0.115) | < 0.001 | Ref | Ref | |
HSI | Ref | Ref | 0.021 (-0.378–0.420) | 0.918 | -0.250 (-0.649–0.148) | 0.218 | -0.209 (-0.612–0.193) | 0.307 | < 0.001 |
| -0.021 (-0.420–0.378) | 0.918 | Ref | Ref | -0.271 (-0.669–0.126) | 0.181 | -0.230 (-0.629–0.168) | 0.257 | |
| 0.250 (-0.148–0.649) | 0.218 | 0.271 (-0.126–0.669) | 0.181 | Ref | Ref | 0.041 (-0.358–0.440) | 0.841 | |
| 0.209 (-0.193–0.612) | 0.307 | 0.230 (-0.168–0.629) | 0.257 | -0.041 (-0.440–0.358) | 0.841 | Ref | Ref | |
Abbreviations: AE, aerobic exercise; Alt, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; CI, confidence interval; HbA1c, glycated hemoglobin; HDL, high-density lipoprotein; HOMA-IR, homeostasis model assessment-estimated insulin resistance; HSI, hepatic steatosis index; LDL, low-density lipoprotein; RE, resistance exercise; TE, total exercise; TG, triglyceride; TyG index, triglyceride and glucose index; WBC, white blood cell; WC, waist circumference |
Table 3 presents the characteristics of the AE and RE groups. After PSM, the AE group exhibited a lower average age, a higher proportion of females, and lower rates of smoking than the RE group. Conversely, in contrast to the AE group, the RE group showed a reduced prevalence of BMI-defined obesity and smaller WC values. Furthermore, the average mean BP, total cholesterol, fasting glucose, insulin, HbA1c, the TyG index, and WBC count were also statistically lower in the RE group.
Table 3
Clinical characteristics in the AE and RE groups pre- and post-PSM
Variable | Pre-PSM | Post-PSM |
Overall | AE group | RE group | p-value | Overall | AE group | RE group | p-value |
Unweighted N | 5,137 | 3,928 | 1,209 | | 3,328 | 2,128 | 1,200 | |
Age (years) | 47.35 ± 15.98 | 46.14 ± 15.68 | 51.61 ± 16.31 | < 0.001 | 54.58 ± 16.32 | 54.04 ± 16.29 | 55.53 ± 16.32 | 0.012 |
Sex | | | | < 0.001 | | | | 0.016 |
Male | 49.7 | 45.5 | 64.6 | | 56.9 | 55.3 | 59.7 | |
Female | 50.3 | 54.5 | 35.4 | | 43.1 | 44.7 | 40.3 | |
Educational status | | | | 0.004 | | | | 0.471 |
Elementary school | 9.3 | 8.8 | 11.2 | | 16.3 | 16.5 | 15.8 | |
Middle school | 7.4 | 6.9 | 8.9 | | 11.1 | 10.6 | 12.1 | |
High school | 38.1 | 37.9 | 38.8 | | 34.7 | 34.4 | 35.3 | |
College or University | 45.2 | 46.4 | 41 | | 37.9 | 38.5 | 36.8 | |
Alcohol consumption (yes) | 57.4 | 56.5 | 60.7 | 0.029 | 55 | 54.8 | 55.4 | 0.776 |
Smoking history | | | | < 0.001 | | | | 0.002 |
No | 57.3 | 60.3 | 46.7 | | 52.3 | 53.8 | 49.6 | |
Current | 17.3 | 17.4 | 17 | | 16.5 | 17.1 | 15.4 | |
Former | 25.4 | 22.3 | 36.3 | | 31.2 | 29.1 | 35 | |
Household income status | | | | 0.02 | | | | 0.455 |
Low | 12.7 | 11.9 | 15.7 | | 18.4 | 17.9 | 19.3 | |
Mid low | 22.9 | 23 | 22.2 | | 24.6 | 25.3 | 23.5 | |
Mid-high | 29.7 | 30.3 | 27.6 | | 27.9 | 28.2 | 27.3 | |
High | 34.7 | 34.7 | 34.5 | | 29.1 | 28.6 | 29.9 | |
BMI | | | | 0.02 | | | | 0.012 |
Underweight (< 18.5) | 4.4 | 4.7 | 3.3 | | 3.3 | 3.2 | 3.3 | |
Normal (≥ 18.5–<25) | 58 | 56.9 | 61.7 | | 59.5 | 57.7 | 62.8 | |
Obese (≥ 25) | 37.6 | 38.4 | 35 | | 37.2 | 39.1 | 33.9 | |
WC (cm) | 83.99 ± 10.80 | 83.82 ± 11.02 | 84.56 ± 10.00 | 0.068 | 85.26 ± 10.30 | 85.60 ± 10.40 | 84.67 ± 10.10 | 0.011 |
Mean BP (mmHg) | 89.67 ± 10.81 | 89.63 ± 11.01 | 89.80 ± 10.06 | 0.669 | 90.85 ± 10.64 | 91.29 ± 10.85 | 90.08 ± 10.21 | 0.001 |
Cholesterol (mg/dL) | 193.87 ± 38.29 | 194.58 ± 38.50 | 191.39 ± 37.47 | 0.028 | 191.34 ± 40.03 | 192.56 ± 40.54 | 189.19 ± 39.04 | 0.019 |
TG (mg/dL) | 129.44 ± 108.93 | 128.83 ± 106.48 | 131.59 ± 117.16 | 0.499 | 132.12 ± 114.82 | 132.49 ± 110.85 | 131.48 ± 121.57 | 0.812 |
HDL-cholesterol (mg/dL) | 52.78 ± 13.02 | 53.08 ± 12.99 | 51.71 ± 13.07 | 0.008 | 51.89 ± 13.08 | 52.07 ± 13.08 | 51.58 ± 13.06 | 0.3 |
LDL-cholesterol (mg/dL) | 116.72 ± 34.25 | 117.19 ± 34.40 | 115.07 ± 33.68 | 0.111 | 114.43 ± 35.40 | 115.25 ± 35.85 | 112.98 ± 34.56 | 0.072 |
Glucose (mg/dL) | 100.33 ± 21.91 | 100.19 ± 22.25 | 100.81 ± 20.68 | 0.396 | 103.18 ± 24.21 | 103.69 ± 25.11 | 102.27 ± 22.51 | 0.095 |
Insulin (IU/L) | 8.91 ± 6.44 | 9.02 ± 6.56 | 8.54 ± 6.01 | 0.043 | 8.78 ± 6.65 | 8.95 ± 6.92 | 8.49 ± 6.14 | 0.047 |
HOMA-IR | 2.28 ± 1.99 | 2.30 ± 2.01 | 2.20 ± 1.89 | 0.185 | 2.31 ± 2.14 | 2.36 ± 2.18 | 2.24 ± 2.07 | 0.12 |
HbA1c (%) | 5.75 ± 0.80 | 5.74 ± 0.82 | 5.75 ± 0.72 | 0.782 | 5.87 ± 0.85 | 5.90 ± 0.90 | 5.83 ± 0.76 | 0.013 |
TyG Index | 8.57 ± 0.65 | 8.57 ± 0.65 | 8.59 ± 0.65 | 0.518 | 8.63 ± 0.63 | 8.65 ± 0.62 | 8.60 ± 0.65 | 0.03 |
AST (IU/L) | 24.79 ± 16.04 | 24.39 ± 12.85 | 26.21 ± 24.03 | 0.055 | 25.67 ± 15.91 | 25.57 ± 12.86 | 25.85 ± 20.22 | 0.668 |
ALT (IU/L) | 24.21 ± 19.38 | 24.07 ± 18.71 | 24.71 ± 21.59 | 0.478 | 24.16 ± 18.11 | 24.42 ± 17.62 | 23.70 ± 18.95 | 0.281 |
WBC (× 103/µL) | 6.13 ± 1.67 | 6.16 ± 1.68 | 6.06 ± 1.66 | 0.148 | 6.13 ± 1.67 | 6.18 ± 1.68 | 6.04 ± 1.65 | 0.014 |
MetS (yes) | 26.4 | 26.5 | 26.2 | 0.833 | 31 | 32.8 | 27.8 | 0.003 |
NAFLD (yes) | 45.4 | 46.5 | 41.2 | 0.012 | 46.7 | 48.1 | 44.3 | 0.037 |
HSI | 35.97 ± 4.66 | 36.07 ± 4.62 | 35.62 ± 4.78 | 0.018 | 36.14 ± 4.56 | 36.25 ± 4.52 | 35.93 ± 4.64 | 0.05 |
HTN (yes) | 52.2 | 50.6 | 57.9 | < 0.001 | 62.5 | 63.1 | 61.5 | 0.376 |
DM (yes) | 52.4 | 51.4 | 56.1 | 0.016 | 62.3 | 62.6 | 61.7 | 0.622 |
Dyslipidemia (yes) | 33.8 | 33.9 | 33.5 | 0.837 | 38.5 | 39.8 | 36.2 | 0.039 |
Abbreviations: AE, aerobic exercise; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; DM, diabetes mellitus; HDL, high-density lipoprotein; HIS, hepatic steatosis index; HOMA-IR, homeostasis model assessment-estimated insulin resistance; HTN, hypertension; LDL, low-density lipoprotein; MetS, metabolic syndrome; NAFLD, non-alcoholic fatty liver disease; PSM, propensity score matching; RE, resistance exercise; TG, triglyceride; TyG index, triglyceride and glucose index; TE, total exercise; WC, waist circumference |
Table 4 shows the regression coefficients of the biochemical and metabolic indices of the RE group with the AE group set as a reference after PSM. Compared with the AE group, the RE group showed significantly lower BMI and WC, mean BP, glucose, HbA1c, TyG index, and WBC count. Insulin and HOMA-IR levels showed decreases that were nearly statistically significant (p = 0.055 and 0.079, respectively). No significant difference was observed between the groups in terms of total cholesterol levels.
Table 4
Comparison between AE and RE post-PSM
Variable | AE group | RE group |
Coefficient (95% CI) | p-value |
BMI (kg/m2) | Ref | -0.425 (-0.670–-0.180) | < 0.001 |
WC (cm) | Ref | -1.458 (-2.114–-0.803) | < 0.001 |
Mean BP (mmHg) | Ref | -1.517 (-2.249–-0.784) | < 0.001 |
Total cholesterol (mg/dL) | Ref | -2.451 (-5.233–-0.331) | 0.084 |
TG (mg/dL) | Ref | -2.355 (-10.361–5.652) | 0.564 |
HDL-cholesterol (mg/dL) | Ref | -0.037 (-0.896–0.823) | 0.933 |
LDL-cholesterol (mg/dL) | Ref | -1.545 (-4.017–0.927) | 0.22 |
Glucose (mg/dL) | Ref | -2.065 (-3.731–-0.398) | 0.015 |
Insulin (IU/L) | Ref | -0.459 (-0.928–0.010) | 0.055 |
HOMA-IR | Ref | -0.136 (-0.287–0.015) | 0.079 |
HbA1c (%) | Ref | -0.095 (-0.152–-0.037) | 0.001 |
TyG index | Ref | -0.068 (-0.111–-0.025) | 0.002 |
AST (IU/L) | Ref | 0.023 (-1.098–1.145) | 0.967 |
ALT (IU/L) | Ref | -0.938 (-2.194–0.318) | 0.143 |
WBC (× 103/µL) | Ref | -0.150 (-0.264–-0.037) | 0.009 |
HSI | Ref | -0.285 (-0.590–0.021) | 0.068 |
Abbreviations: AE, aerobic exercise; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; CI, confidence interval; HDL, high-density lipoprotein; HSI, hepatic steatosis index; HOMA-IR, homeostasis model assessment-estimated insulin resistance; HTN, hypertension; LDL, low-density lipoprotein; PSM, propensity score matching; RE, resistance exercise; TG, triglyceride; TyG index, triglyceride and glucose index; WBC, white blood cell; WC, waist circumference |
In Fig. 2a), the ORs for metabolic disorders are shown, with the NE group set as a reference following PSM. HTN risk was lowest in the TE group (OR 0.793, 95% CI 0.655–0.959), followed by the RE group (OR 0.815, 95% CI 0.674–0.985) when compared with the NE group. DM risk decreased in the TE group alone (OR 0.82, 95% CI 0.675–0994), and dyslipidemia risk did not differ significantly in the AE, RE, and TE groups compared with that in the NE group. MetS risk, such as HTN, was lowest in the TE group (OR 0.704, 95% CI 0.579–0.854), followed by the RE group (OR 0.77, 95% CI 0.633–0.925).
Figure 2b) shows the ORs of metabolic disorders in the RE group compared with that in the AE group. The risk of HTN was lower in RE group than AE group(OR 0.82, 95% CI 0.70–0.97; p = 0.019), as was the risk of dyslipidemia (OR 0.81, 95% CI 0.70–0.95; p = 0.007), NAFLD (OR 0.86, 95% CI 0.74–1.00; p = 0.048), and MetS (OR 0.74, 95% CI 0.63–0.87; p < 0.001) in the RE group.