Abstract
The association between physical activity and lipid profiles in youth remains inconsistent. We aimed to evaluate the age- and sex-specific, non-linear dose-response associations between total physical activity (TPA) and traditional/novel lipid biomarkers in Chinese children and adolescents. This cross-sectional study included 581 participants aged 6-17 years whose TPA was assessed via validated questionnaires. Multiple linear regression and restricted cubic spline (RCS) models were utilized to analyze associations with ApoA-1, ApoB, HDL-C, LDL-C, and related risk ratios. Overall, higher TPA was positively associated with the potentially cardioprotective ApoA-1 and inversely associated with the atherogenic ApoB/ApoA-1 ratio. Age- and sex-stratified analyses revealed that these associations appeared more pronounced among adolescent girls (12-17 years), where every 100 min/week increase in TPA was associated with a 0.0179 g/L increase in ApoA-1 (P = 0.047). Additionally, RCS models identified a significant non-linear dose-response relationship (P for non-linearity = 0.029) in the adolescent subgroup, demonstrating an apparent plateau in ApoA-1 concentrations at approximately 400-500 min/week. Traditional cholesterol metrics (LDL-C, HDL-C) showed no significant linear associations. In conclusion, higher TPA is associated with a favorable apolipoprotein profile in youth, particularly among adolescent girls. Although the observed non-linear plateau aligns with current WHO physical activity volume guidelines, such comparisons should be interpreted with caution due to the lack of intensity-specific data, highlighting adolescent girls as a priority population for targeted physical activity interventions.Supplementary information
The online version contains supplementary material available at https://doi.org/10.1007/s13205-026-05089-z.