LaMonte Michael J, Barlow Carolyn E, Jurca Radim, Kampert James B, Church Timothy S, Blair Steven N
Cooper Institute, 12330 Preston Rd, Dallas, TX 75230, USA.
Circulation. 2005 Jul 26;112(4):505-12. doi: 10.1161/CIRCULATIONAHA.104.503805. Epub 2005 Jul 11.
Few studies have reported the relationship between cardiorespiratory fitness and metabolic syndrome incidence, particularly in women.
We prospectively studied 9007 men (mean+/-SD age, 44+/-9 years; body mass index, 25+/-3 kg/m2) and 1491 women (age, 44+/-9 years; body mass index, 22+/-2 kg/m2) who were free of metabolic syndrome and for whom measures of waist girth, resting blood pressure, fasting lipids, and glucose were taken during baseline and follow-up examinations. Baseline cardiorespiratory fitness was quantified as duration of a maximal treadmill test. Metabolic syndrome was defined with NCEP ATP-III criteria. During a mean follow-up of 5.7 years, 1346 men and 56 women developed metabolic syndrome. Age-adjusted incidence rates were significantly lower (linear trend, P<0.001) across incremental thirds of fitness in men and women. After further adjustment for potential confounders, multivariable hazard ratios for incident metabolic syndrome among men in the low, middle, and upper thirds of fitness, were 1.0 (referent), 0.74 (95% CI, 0.65 to 0.84), and 0.47 (95% CI, 0.40 to 0.54) (linear trend P<0.001); in women, they were 1.0 (referent), 0.80 (95% CI, 0.44 to 1.46), and 0.37 (95% CI, 0.18 to 0.80) (linear trend P=0.01), respectively. Similar patterns of significant inverse associations between fitness and metabolic syndrome incidence were seen when men were stratified on categories of body mass index, age, and number of baseline metabolic risk factors, but patterns were variable in women.
Low cardiorespiratory fitness is a strong and independent predictor of incident metabolic syndrome in women and men. Clinicians should consider the potential benefits of greater cardiorespiratory fitness in the primary prevention of metabolic syndrome, particularly among patients who have already begun to cluster metabolic syndrome components.
很少有研究报道心肺适能与代谢综合征发病率之间的关系，尤其是在女性中。
我们对9007名男性（平均±标准差年龄，44±9岁；体重指数，25±3kg/m²）和1491名女性（年龄，44±9岁；体重指数，22±2kg/m²）进行了前瞻性研究，这些人无代谢综合征，在基线和随访检查期间测量了腰围、静息血压、空腹血脂和血糖。基线心肺适能通过最大跑步机测试的持续时间进行量化。代谢综合征根据美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP-III）标准进行定义。在平均5.7年的随访期间，1346名男性和56名女性发生了代谢综合征。男性和女性中，随着适能水平递增的三分位数，年龄调整后的发病率显著降低（线性趋势，P<0.001）。在进一步调整潜在混杂因素后，适能水平处于低、中、高三分位数的男性发生代谢综合征的多变量风险比分别为1.0（参照）、0.74（95%CI，0.65至0.84）和0.47（95%CI，0.40至0.54）（线性趋势P<0.001）；在女性中，分别为1.0（参照）、0.80（95%CI，0.44至1.46）和0.37（95%CI，0.18至0.80）（线性趋势P=0.01）。当根据体重指数类别、年龄和基线代谢风险因素数量对男性进行分层时，也观察到了适能与代谢综合征发病率之间显著的负相关关系，但女性中的模式存在差异。
低心肺适能是男性和女性发生代谢综合征的一个强有力的独立预测因素。临床医生在代谢综合征的一级预防中应考虑提高心肺适能的潜在益处，尤其是在已经开始出现代谢综合征组分聚集的患者中。
