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Publications

Journal Article Ahead of print

PubMed: 42755173 DOI: 10.1111/dom.71367

Higher Cardiorespiratory Fitness Is Associated With a Lower Burden of Metabolic Syndrome Traits: A Cross-Sectional Analysis of 39 197 UK Adults.

Diabetes Obes Metab

Authors: Scott A Willis, Annalena Phillipp, Kevin Deighton, Christopher Goodwin, Daniel J Cuthbertson, Shelley E Keating, Christopher J A Pugh, Jonathan G Stine, Gaël Ennequin, Alexis Couret, David J Stensel, Guruprasad P Aithal, Thomas Yates, James A King

Affiliations

  • National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
  • NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK.
  • Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK.
  • National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany.
  • National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. Nuffield Health Research Group, Nuffield Health, Epsom, UK.
  • Nuffield Health Research Group, Nuffield Health, Epsom, UK.
  • Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
  • Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
  • School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.
  • School of Life Course & Population Health Sciences, King's College London, London, UK.
  • Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
  • Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, France.
  • International Research Chair Health in Motion, Clermont Auvergne University Foundation, Clermont-Ferrand, France.
  • National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK. Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
  • Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
  • NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.
  • National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK.

Abstract

AIMS

To investigate associations of cardiorespiratory fitness (CRF) with metabolic syndrome (MetS) trait count, MetS prevalence and individual MetS traits in a large population-based cohort.

MATERIALS AND METHODS

This cross-sectional study analysed data for 39 197 adults from a UK-based independent healthcare charity (mean ± SD: age, 45.8 ± 9.0 years; BMI, 26.3 ± 4.1 kg⋅m -2; 31% female). CRF was estimated as peak oxygen uptake from submaximal treadmill or cycle ergometer protocols and analysed continuously and as sex- and mode-specific quintiles. MetS was defined using established criteria, with outcomes examined as trait count (0-5), presence (≥ 3 traits) and individual traits. Associations were assessed using negative binomial regression for trait count and Poisson regression for MetS presence. Models were sequentially adjusted for demographics (primary model), adiposity (BMI) and hepatic steatosis (fatty liver index [FLI]).

RESULTS

Each 1 mL⋅kg -1⋅min -1 higher CRF was associated with a 2.9% lower MetS trait count and 6.0% lower MetS prevalence (p < 0.001). Compared with the highest CRF quintile, the lowest quintile had a 2.4-fold higher MetS trait count and 5.4-fold higher MetS prevalence (p < 0.001). Associations persisted after BMI and FLI adjustment, although attenuated. Spline analyses demonstrated graded, non-linear inverse associations, steepest at lower CRF levels. Higher CRF was inversely associated with all individual MetS traits, strongest for central obesity.

CONCLUSIONS

Higher CRF was associated with lower metabolic risk burden and MetS prevalence, which remained after adjustment for adiposity-related measures. These findings support the potential public health relevance of modest fitness improvements, particularly among the least fit adults, as a strategy that may help reduce MetS burden even when adiposity changes are limited.

MeSH

Cross-Sectional Studies, Cardiorespiratory Fitness, Adiposity, Prevalence, Metabolic Syndrome