{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T02:24:41Z","timestamp":1773714281953,"version":"3.50.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the relationship between physical activity (PA) patterns and infertility among women in the United States and to ascertain whether glycated hemoglobin (HbA1c) influences this association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross-sectional study of PA patterns and infertility was conducted. The PA classification was based on two categories: recreational PA and work-related PA. The subgroups were classified as inactive, less active, or active. We conducted data analysis via both multiple logistic regression analysis and mediation analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National Health and Nutrition Examination Survey (NHANES, 2013\u20132018).<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Women aged 18\u201349 years (n, 3,948).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no statistically significant link demonstrated between infertility and work-related PA patterns. The recreational PA group may decrease the prevalence of infertility, with its occurrence being merely 0.79 times that of inactive group. (95% CI: 0.62, 1.0; <jats:italic>p<\/jats:italic> = 0.045). The consistency of this discrepancy was not preserved in Model III after the mixed effect was incorporated into the recreational PA group. The stratified research findings revealed that the association between recreational PA patterns and infertility was influenced by variables such as age, BMI, and history of diabetes. Furthermore, the mediation analysis revealed that recreational PA did not have a statistically significant direct effect on infertility (<jats:italic>p<\/jats:italic> = 0.098). HbA1c serves as a mediator in this interaction (95% CI: -0.06, -0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recreational PA patterns were associated with infertility among women aged 18\u201349 years in the United States, which was likely due to the effects of HbA1c.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1495470","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T18:12:07Z","timestamp":1743012727000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The association between glycated hemoglobin, physical activity and infertility: a multiple logistic regression and mediation analysis based on the NHANES database"],"prefix":"10.3389","volume":"16","author":[{"given":"Panpan","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leilei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanli","family":"Mou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuyun","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanyou","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1001\/jama.2021.4788","article-title":"Diagnosis and management of infertility: A review","volume":"326","author":"Carson","year":"2021","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex234","article-title":"The international glossary on infertility and fertility care, 2017","volume":"32","author":"Zegers-Hochschild","year":"2017","journal-title":"Hum Reprod"},{"key":"B3","doi-asserted-by":"publisher","first-page":"R19","DOI":"10.1530\/REP-21-0022","article-title":"Mechanisms of ovarian aging","volume":"162","author":"Park","year":"2021","journal-title":"Reproduction"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2023.02.036","article-title":"Does maternal age affect assisted reproduction technology success rates after euploid embryo transfer? A systematic review and meta-analysis","volume":"120","author":"Vitagliano","year":"2023","journal-title":"Fertil Steril"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/sms.12581","article-title":"Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases","author":"Pedersen","year":"2015","journal-title":"Scand J Med Sci Sports"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2021.1958310","article-title":"Polycystic ovarian syndrome and infertility: overview and insights of the putative treatments","volume":"37","author":"Collee","year":"2021","journal-title":"Gynecol Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1186\/s12967-022-03426-3","article-title":"Association between physical activity and infertility: a comprehensive systematic review and meta-analysis","volume":"20","author":"Xie","year":"2022","journal-title":"J Transl Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead234","article-title":"Impaired glucose tolerance and cardiovascular risk factors in relation to infertility: a Mendelian randomization analysis in the Norwegian Mother, Father, and Child Cohort Study","volume":"39","author":"Hernaez","year":"2024","journal-title":"Hum Reprod"},{"key":"B9","doi-asserted-by":"publisher","first-page":"9668","DOI":"10.3390\/ijms25179668","article-title":"Association between serum glycated hemoglobin levels and female infertility: A cross-sectional survey and genetic approach","volume":"25","author":"Liao","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2019.1708893","article-title":"Evaluation of relationship between HbA1c levels and ovarian reserve in patients with type 1 diabetes mellitus","volume":"36","author":"Kadiro\u011fullar\u0131","year":"2020","journal-title":"Gynecol Endocrinol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"3280","DOI":"10.3390\/ijerph19063280","article-title":"Association between physical exercise and glycated hemoglobin levels in Korean patients diagnosed with diabetes","volume":"19","author":"Yun","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc","article-title":"Activation, physical activity, and outcomes among individuals with T2D","volume":"28","author":"Nair","year":"2022","journal-title":"Am J Manag Care"},{"key":"B13","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12902-022-01208-y","article-title":"Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity","volume":"23","author":"Cowan","year":"2023","journal-title":"BMC Endocr Disord"},{"key":"B14","volume-title":"Global Recommendations on Physical Activity for Health","year":"2010"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jshs.2021.02.004","article-title":"What\u2019s new in the 2020 world health organization guidelines on physical activity and sedentary behavior","volume":"10","author":"Pratt","year":"2021","journal-title":"J Sport Health Sci"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.51.6.1173","article-title":"The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations","volume":"51","author":"Baron","year":"1986","journal-title":"J Pers Soc Psychol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcps.2012.03.009","article-title":"Commentary on \u201cMediation analysis and categorical variables: the final frontier\u201d by dawn iacobucci","volume":"22","author":"Mackinnon","year":"2012","journal-title":"J Consum Psychol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1080\/01942638.2022.2060058","article-title":"Mental health benefits of physical activity in youth with cerebral palsy: A scoping review","volume":"42","author":"Starowicz","year":"2022","journal-title":"Phys Occup Ther Pediatr"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1186\/s12889-020-09522-7","article-title":"Multicausal analysis on psychosocial and lifestyle factors among patients undergoing assisted reproductive therapy - with special regard to self-reported and objective measures of pre-treatment habitual physical activity","volume":"21","author":"Premusz","year":"2021","journal-title":"BMC Public Health"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2015.1022901","article-title":"A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations","volume":"9","author":"Rebar","year":"2015","journal-title":"Health Psychol Rev"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-016-0669-8","article-title":"Effect of exercise on ovulation: A systematic review","volume":"47","author":"Hakimi","year":"2017","journal-title":"Sports Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s12958-024-01234-6","article-title":"Effects of physical activity on infertility in reproductive females","volume":"22","author":"Zhang","year":"2024","journal-title":"Reprod Biol Endocrinol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1186\/s13075-018-1624-x","article-title":"Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study","volume":"20","author":"Bartlett","year":"2018","journal-title":"Arthritis Res Ther"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep337","article-title":"Physical activity and fertility in women: the North-Tr\u00f8ndelag Health Study","volume":"24","author":"Gudmundsdottir","year":"2009","journal-title":"Hum Reprod"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241043","article-title":"The association of types, intensities and frequencies of physical activity with primary infertility among females in Gaza Strip, Palestine: A case-control study","volume":"15","author":"Dhair","year":"2020","journal-title":"PLoS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"13735","DOI":"10.1038\/s41598-017-13872-5","article-title":"Relationships between different types of physical activity and metabolic syndrome among Taiwanese workers","volume":"7","author":"Huang","year":"2017","journal-title":"Sci Rep"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1186\/s12889-019-7944-1","article-title":"Association of work-related and leisure-time physical activity with workplace food purchases, dietary quality, and health of hospital employees","volume":"19","author":"Feig","year":"2019","journal-title":"BMC Public Health"},{"key":"B29","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1186\/s12889-023-15730-8","article-title":"Benefits of physical activity on reproductive health functions among polycystic ovarian syndrome women: a systematic review","volume":"23","author":"Butt","year":"2023","journal-title":"BMC Public Health"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1080\/15402002.2019.1614927","article-title":"Work-related mental fatigue, physical activity and risk of insomnia symptoms: longitudinal data from the norwegian HUNT study","volume":"18","author":"Skarpsno","year":"2020","journal-title":"Behav Sleep Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15170","article-title":"The diagnostic value of glycosylated hemoglobin for gestational diabetes mellitus in Asian populations: A systematic review and meta-analysis","volume":"48","author":"Zhang","year":"2022","journal-title":"J Obstet Gynaecol Res"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.2196\/46986","article-title":"Association between serum glycated hemoglobin levels at early gestation and the risk of subsequent pregnancy loss in pregnant women without diabetes mellitus: prospective cohort study","volume":"9","author":"Chen","year":"2023","journal-title":"JMIR Public Health Surveill"},{"key":"B33","doi-asserted-by":"publisher","first-page":"27122","DOI":"10.1038\/s41598-024-78679-7","article-title":"Association between glycated hemoglobin and the risk of neonatal respiratory distress syndrome in preterm premature rupture of membranes pregnancies","volume":"14","author":"Chen","year":"2024","journal-title":"Sci Rep"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002595","article-title":"Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: a systematic review and meta-analysis","volume":"10","author":"Jansson","year":"2022","journal-title":"BMJ Open Diabetes Res Care"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.xfre.2023.04.005","article-title":"The effect of physical activity on fertility: a mini-review","volume":"4","author":"Mussawar","year":"2023","journal-title":"F S Rep"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.2019.51.issue-3","article-title":"A systematic review of physical activity and exercise on physiological and biochemical outcomes in children and adolescents with type 1 diabetes","volume":"51","author":"Aljawarneh","year":"2019","journal-title":"J Nurs Scholarsh"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0179429","article-title":"Accelerometer measured levels of moderate-to-vigorous intensity physical activity and sedentary time in children and adolescents with chronic disease: A systematic review and meta-analysis","volume":"12","author":"Elmesmari","year":"2017","journal-title":"PLoS One"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2014.01.029","article-title":"Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS)","volume":"105","author":"Beraki","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2023.230725","article-title":"Elevated hbA1c level has a linear association with infertility in women","volume":"70","author":"Yu","year":"2024","journal-title":"Clin Lab"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.5152\/jtgga.2015.15232","article-title":"Impact of obesity on infertility in women","volume":"16","author":"Da\u011f","year":"2015","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"B41","doi-asserted-by":"publisher","first-page":"6153","DOI":"10.1038\/s41598-024-56818-4","article-title":"Effect of weight loss before in vitro fertilization in women with obesity or overweight and infertility: a systematic review and meta-analysis","volume":"14","author":"Jeong","year":"2024","journal-title":"Sci Rep"},{"key":"B42","doi-asserted-by":"publisher","first-page":"2285025","DOI":"10.1080\/01443615.2023.2285025","article-title":"Association between nutrient intake and female infertility: a study based on NHANES database","volume":"43","author":"Ji","year":"2023","journal-title":"J Obstet Gynaecol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1175394","article-title":"Association between weight-adjusted-waist index and female infertility: a population-based study","volume":"14","author":"Wen","year":"2023","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1495470\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T18:12:26Z","timestamp":1743012746000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1495470\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,26]]},"references-count":43,"alternative-id":["10.3389\/fendo.2025.1495470"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1495470","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,26]]},"article-number":"1495470"}}