Mediation factors of the association between coronary heart disease and physical activity among rural residents: a cross-sectional study

There is evidence that physical and chemical factors and risky lifestyle behaviours are significantly correlated with elevated susceptibility to coronary heart disease (CHD). Nevertheless, the mediation factors of this relationship are little investigated. This article attempts to assess the mediating factors between CHD and physical activity (PA) in rural residents. We conducted a cross-sectional study of 9,004 permanent residents in rural regions of Xinxiang County, Henan Province. The correlation between CHD and PA was evaluated using a logistic regression model, as well as the association between CHD and its associated risk factors. The robustness of the outcomes was evaluated through sensitivity analysis. The mediating factors of the correlation between CHD and PA in rural residents were explored through mediation analysis. The results showed that CHD was associated with PA (0.72, 95%CI:0.56-0.95), and the levels of fasting insulin (FINS), total cholesterol (TC), and blood glucose (GLU) were associated with PA (-0.92, 95%CI: (-1.48, -0.37), 0.08, 95%CI: (0.01, 0.15), -0.17, 95%CI: (-0.28, -0.06)). The levels of FINS, TC and GLU had significant mediating effects on the association of PA with CHD (1.00, 95%CI: (-0.0028, 0.0000), 1.00, 95%CI: (-0.0016, 0.0000), 1.00, 95%CI: (-0.0014, 0.0000)). In rural populations, PA is associated with CHD, possibly mediated by FINS, TC and GLU, rather than relying solely on the direct effects of PA.