Collective exerkines mediate physical activity mitigating new-onset heart failure risk in older adults with prediabetes or diabetes: a community-based longitudinal cohort study
Authors' conclusion
Collective exerkine activity plays a crucial mediating role in the relationship between PA and HF risk among older adults managing prediabetes or diabetes.
Study context
- Population
- Older adults with prediabetes or DM from community dwellings in Shandong, China, enrolled 2008–2011
- Participants
- 5,886 adults
- Exposure
- Moderate and vigorous physical activity (PA) vs light PA
- Outcome
- New-onset HF
- Follow-up
- Median 11.1 years
Methodological detailscommunity-based, longitudinal
- Community-based
- Longitudinal
Main finding
As reported in the abstract
Each group vs light PAHazard ratio (95% CI)
Moderate PAHF risk reduced by 57.0%
0.43(0.33–0.56)
Vigorous PAHF risk reduced by 36.0%
0.64(0.49–0.83)
- Participants who developed heart failure (HF)
- 615
- HF incidence rate
- 9.59 per 1000 person-years
Observational data: associations, not effects.
Further findings
HF risk per quartile increase across all exerkines
- HR
- 0.68 (95% CI: 0.63-0.73)
- Decreased HF risk
- 32%
- Brain-derived neurotrophic factor (BDNF) most significant negative contributor; IL-6 predominant positive contributor to HF risk
Principal component analysis
- IL-6 and BDNF primary contributors to component 1; variance explained
- 42.87%
Population attributable risk
- Low BDNF
- 18.6%
- Elevated IL-6
- 12.6%
Correlation of PA metabolic equivalent task (MET) scores with exerkines
- Recreational-leisure PA: significant positive correlation with BDNF, negative with IL-6
- Occupational PA: correlations with BDNF and IL-6 not statistically significant
Mediation by collective exerkines
- Proportion of PA MET score–HF association mediated
- 67.83%
- Proportion of hyperglycemic status–HF association mediated
- 20.48%
- Padjustment
- <0.001
Original publication
Collective exerkines mediate physical activity mitigating new-onset heart failure risk in older adults with prediabetes or diabetes: a community-based longitudinal cohort study. Cardiovasc Diabetol. Published 3 April 2026. doi:10.
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