Maximal Estimated Cardiorespiratory Fitness, Cardiometabolic Risk Factors, and Metabolic Syndrome in the Aerobics Center Longitudinal Study

doi:10.1016/j.mayocp.2012.11.006

Mayo Clinic Proceedings

Volume 88, Issue 3, March 2013, Pages 259-270

https://doi.org/10.1016/j.mayocp.2012.11.006 Get rights and content

Abstract

Objective

To examine the relationship between estimated maximal cardiorespiratory fitness (CRF) and metabolic syndrome (MetSyn).

Patients and Methods

We performed a cross-sectional analysis of 38,659 Aerobics Center Longitudinal Study participants seen between January 1, 1979, and December 31, 2006, to examine CRF levels defined as low (lower 20%), moderate (middle 40%), and high (upper 40%) of age- and sex-specific distributions vs National Cholesterol Education Program–derived MetSyn expressed as a summed z-score continuous variable. We used a general linear model for continuous variables, the χ² test for distribution of categorical variables, and multiple linear regression for single and cumulative MetSyn scores adjusted for body mass index, smoking status, alcohol intake, and family history of cardiovascular disease.

Results

We observed significant inverse trends for MetSyn vs CRF in both sexes (P for trend <.001). The CRF associations vs individual components were as follows: waist circumference–men: β=−.14, r²=0.78; women: β=−.04, r²=0.71; triglycerides–men: β=−.29, r²=0.18; women: β=−.17, r²=0.18; high-density lipoprotein cholesterol–men: β=.25, r²=0.17; women: β=.08, r²=0.19; fasting glucose–men: β=−.09, r²=0.09; women: β=.09, r²=0.01; systolic blood pressure–men: β=−.09, r²=0.09; women: β=−.01, r²=0.21; and diastolic blood pressure–men: β=−.07, r²=0.12; women: β=−.05, r²=0.14. All associations except for systolic blood pressure (both sexes) and glucose (women) are significant (P<.001).

Conclusion

Cardiorespiratory fitness demonstrated a strong inverse relationship with MetSyn in both sexes, with the strongest single associative component being waist circumference.

Section snippets

Study Population

We performed a cross-sectional analysis of participants from the ACLS by examining the association between MetSyn and estimated maximal CRF. Study participants came to the Cooper Clinic (Dallas, Texas) for periodic preventive health examinations. We initially considered 47,398 participants with complete data and having medical examinations from January 1, 1979, to December 31, 2006. We excluded participants with a history of CVD (myocardial infarction or stroke; n=740), cancer (n=2294),

Results

Demographic characteristics (Table 1), independent MetSyn composite scores for men (Table 2) and women (Table 3), and composite MetSyn scores (Figure 2) are presented.

Discussion

The primary finding from our current study is the observation of a significant inverse relationship between fitness and MetSyn for both men and women regardless of the analytical model we used (Figure 1). For men, each model demonstrated significant group differences among each fitness category. In women, models 1 and 2 demonstrated the same pattern as men; however, model 3 did not reveal a significant difference between the moderate and high fitness groups. This latter finding may be in part

Acknowledgments

We thank Cooper Clinic physicians and technicians and staff at the Cooper Institute.

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: Grant Support: This study was supported by National Institutes of Health grants AG06945, HL62508, and R21DK088195 and the Spanish Ministry of Education grant EX-2010-1008.

: Potential Competing Interests: Dr Blair receives book royalties (<$5000 per year) from Human Kinetics; honoraria for service on the scientific/medical advisory boards for Alere, Technogym, Santech, Clarity, and Jenny Craig; and honoraria for lectures and consultations from scientific, corporate, educational, and lay groups. He has received research grants from the National Institutes of Health, The Coca-Cola Company, Department of Defense, and Body Media. Dr Church receives honoraria for lectures from scientific, educational, and lay groups. Dr Church has a book entitled Move Yourself: The Cooper Clinic Medical Director’s Guide to All the Healing Benefits of Exercise. Dr Church has received research funding from the American Heart Association and the National Institutes of Health as well as unrestricted research funding from Coca-Cola. Dr Church has overseen study sites for large pharmaceutical trials funded by Sanofi Aventis, Orexigen, Arena, and Amylin. Dr Church is a member of the Jenny Craig Medical Advisory Board and has served as a consultant to Technogym, Trestle Tree, Vivus, Lockton-Dunning, and Neuliven Health. In addition, he serves as the senior medical adviser for Catapult Health.

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Original articleMaximal Estimated Cardiorespiratory Fitness, Cardiometabolic Risk Factors, and Metabolic Syndrome in the Aerobics Center Longitudinal Study

Abstract

Objective

Patients and Methods

Results

Conclusion

Section snippets

Study Population

Results

Discussion

Acknowledgments

Am Heart J

Am Heart J

J Am Coll Cardiol

Am J Prev Med

Am J Cardiol

Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement

Circulation

Banting lecture 1988. Role of insulin resistance in human disease

Diabetes

Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women

Br J Sports Med

Recommendations for blood pressure measurement in humans and experimental animals, part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research

Circulation

Physical fitness and all-cause mortality: a prospective study of healthy men and women

JAMA

ACSM's Guidelines For Exercise Testing And Prescription

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report

Circulation

Insulin sensitivity index, acute insulin response, and glucose effectiveness in a population-based sample of 380 young healthy Caucasians: analysis of the impact of gender, body fat, physical fitness, and life-style factors

J Clin Invest

What is the relationship between exercise and metabolic abnormalities? a review of the metabolic syndrome

Sports Med

Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women

Circulation

A quantitative analysis of the relationship between habitual energy expenditure, fitness and the metabolic cardiovascular syndrome

Br J Nutr

Original article
Maximal Estimated Cardiorespiratory Fitness, Cardiometabolic Risk Factors, and Metabolic Syndrome in the Aerobics Center Longitudinal Study