Obesity Severity Differentially Shapes Diabetes-Related Impairment in Cardiorespiratory Fitness: A Cross-Sectional Propensity Score-Weighted Analysis of Middle-Aged Adults.

Yan Jin, Ke Liu, Yang Yang, Lu Lu Wang, Zhi Yuan Zhang, Xin Yan Li, Ning Zhang

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Article in Journal of clinical medicine research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Yan JinDepartment of Rehabilitation Medicine, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China.

Ke LiuDepartment of Rehabilitation, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

Yang YangDepartment of Rehabilitation Medicine, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing 210008, China.

Lu Lu WangDepartment of Cardiology, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

Zhi Yuan ZhangDepartment of Rehabilitation, College of Acupuncture and Moxibustion and Massage Health, Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing 210023, China.

Xin Yan LiNHC Contraceptives Adverse Reaction Surveillance Center, Jiangsu Health Development Research Center, Nanjing 210008, China.

Ning ZhangDepartment of Ultrasound, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Obesity and type 2 diabetes mellitus (T2DM) are each linked to reduced cardiorespiratory fitness (CRF), but it remains unclear whether diabetes-related impairment in exercise capacity depends on obesity severity. This question has been rarely addressed in adults aged 20-50 years, a group in whom obesity and T2DM frequently coexist while advanced cardiovascular complications may still be subclinical. Methods: In this cross-sectional study, we performed a propensity score-weighted analysis of 823 adults aged 20-50 years who underwent cardiopulmonary exercise testing (CPX). Participants were classified by obesity severity (body mass index (BMI) 24 to < 35 vs. ≥ 35 kg/m Results: After weighting, obesity severity accounted for the largest differences across most CPX indices. Peak VO Conclusions: In middle-aged adults, obesity severity modifies the association between T2DM and CRF. Body composition and postprandial glycemia, rather than diabetes status alone, appear to be central determinants of aerobic capacity. Together, these results support phenotype-informed interpretation of CPX and motivate stratified approaches to cardiopulmonary assessment and intervention in obesity and T2DM.

Indexed as

Cardiopulmonary exercise testingCardiorespiratory fitnessObesityPropensity score weightingType 2 diabetes mellitus

Identifiers

PMID42327971

DOI10.14740/jocmr6519

PMCPMC13278680

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LicenceCC BY

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.