PURPOSE This study aimed to analyze the moderating effect of physical fitness on the relationship between abdominal obesity and metabolic syndrome (MetS) in older women.METHODS A total of 190 participants were categorized based on waisthip ratio (WHR) into high (50%) and low (50%) groups, as well as based on Z-score of fitness into high (25%; high fit), moderate (50%; moderate fit), and low (25%; low fit) groups. Logistic regression was used to assess the relative risk of MetS based on abdominal obesity and fitness levels, and moderation analysis using the Process macro was conducted to explore the moderating effect of fitness on the relationship between abdominal obesity and MetS risk factors.RESULTS After adjusting forcovariates, logistic regression showed that high WHR (odds ratio (OR)=2.721, <i>p</i>=0.004) led to a significantly higher risk of MetS compared with low WHR; the high fit group (OR=0.360, <i>p</i>=0.044) had a significantly lower risk of MetS compared wih the low fit group. Moderation analysis revealed that the impact of abdominal obesity on MetS risk factors varied depending on the level of fitness (<i>β</i>=-0.495, <i>p</i>=0.037), and the results remained significant after covariate adjustment (<i>β</i>=-0.458, <i>p</i>=0.049).CONCLUSIONS This study suggests that the risk of MetS from abdominal obesity can be mitigated by higher levels of physical fitness. These findings highlight the need for participation in regular physical activity to maintain a high level of fitness, along with proper nutritional intake, to prevent MetS in older women.
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