Can Aerobic Exercise Buffer the Smoking-Induced Risk of Metabolic Syndrome? A Precision Analysis by Gender and Age Based on the 2022-2024 KNHANES

PURPOSE This study investigated the “metabolic shield” effect of aerobic exercise on smokers, focusing on gender- and age-specific variations in metabolic syndrome (MetS) risk using recent national representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2022-2024.METHODS Data from 12,056 adults (KNHANES 2022-2024) were analyzed. Complex sample logistic regression was used to calculate adjusted odds ratios (α OR) and 95% confidence intervals (CI) for metabolic syndrome components in smokers, adjusting for age, socioeconomic status, and lifestyle factors.RESULTS Aerobic exercise significantly buffered overall MetS risk in smokers(αOR = 0.795, 95% CI: 0.665-0.949, <i>p</i> < 0.05). Analysis of individual components revealed significant risk reductions for abdominal obesity(αOR = 0.791, 95% CI: 0.669-0.934, <i>p</i> < 0.01) and impaired fasting glucose(IFG) or diabetes mellitus(DM)(αOR = 0.778, 95% CI: 0.650-0.932, <i>p</i> < 0.01); however, no statistical significance was observed for high triglycerides, low HDL-C, or hypertension at the total group level. Gender-stratified analysis showed that males had a significantly reduced risk for low HDL-C(α OR = 0.752, 95% CI: 0.584-0.968, <i>p</i> < 0.05), while females showed a prominent reduction in abdominal obesity risk(αOR = 0.742, 95% CI: 0.582-0.945, <i>p</i> < 0.01). In the elderly population (60+), the strongest buffering effect was observed for IFG or DM(αOR = 0.792, 95% CI: 0.665-0.942, <i>p</i> < 0.01).CONCLUSIONS Aerobic exercise serves as a critical physiological buffer against smoking-induced metabolic deterioration. These findings highlight the necessity of precision exercise prescriptions tailored to gender and life stages. Implementing professional kinesiologist-led interventions is essential to reduce social healthcare costs and enhance public health.