Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Med Sci Sports Exerc. 2009 Jun;41(6):1222-9. doi: 10.1249/MSS.0b013e318195d491.
The clinical utility of cardiorespiratory fitness (CRF) criterion-referenced standards (FITNESSGRAM) has not been tested in adolescents. We aimed to determine the ability of the FITNESSGRAM standards to discriminate between low and high cardiovascular disease (CVD) risk in a population-based sample of US adolescents.
Participants included 1247 adolescents (45.7% females) aged 12-19 yr. A submaximal walking treadmill test was used to estimate peak oxygen consumption as a measure of CRF. Participants were dichotomized based on meeting or failing the sex- and age-specific FITNESSGRAM standards. CVD risk factors included systolic blood pressure, sum of triceps and subscapular skinfolds, homeostatic model assessment (HOMA) of insulin resistance, triglycerides, and total cholesterol/high-density lipoprotein ratio. A sex- and age-specific CVD risk score was computed as the mean of these five standardized risk factors. A risk score >1 SD was considered to indicate a high CVD risk.
One third of the adolescents fail to meet the FITNESSGRAM standards. Body fat and CVD risk score were significantly lower in adolescents meeting versus failing the FITNESSGRAM standards (all P < 0.003). Receiver operating characteristics curve analyses revealed that the CRF thresholds that best discriminated between low and high CVD risk were very similar to those established by FITNESSGRAM: 44.1 and 40.3 mL x kg(-1) x min(-1) among 12- to 15- and 16- to 19-yr-old boys and 36.0 and 35.5 mL x kg(-1) x min(-1) among 12- to 15- and 16- to 19-yr-old girls, respectively.
The CRF criterion-referenced standards established by FITNESSGRAM discriminate adolescents with a more favorable cardiovascular profile from those with a less favorable profile. Identification of children who fail to meet these standards can help detect the target population for pediatric CVD prevention strategies.
心肺适能（CRF）标准参考标准（FITNESSGRAM）的临床实用性尚未在青少年中进行测试。我们旨在确定 FITNESSGRAM 标准在基于人群的美国青少年样本中区分低和高心血管疾病（CVD）风险的能力。
参与者包括 1247 名年龄在 12-19 岁的青少年（45.7%为女性）。使用亚最大步行跑步机测试来估计峰值耗氧量作为 CRF 的衡量标准。参与者根据是否符合或不符合性别和年龄特定的 FITNESSGRAM 标准进行二分法。心血管疾病危险因素包括收缩压、三头肌和肩胛下皮褶总和、胰岛素抵抗的稳态模型评估（HOMA）、甘油三酯和总胆固醇/高密度脂蛋白比值。这些五个标准化危险因素的平均值被计算为心血管疾病风险评分。风险评分>1 SD 被认为表示高心血管疾病风险。
三分之一的青少年不符合 FITNESSGRAM 标准。在符合与不符合 FITNESSGRAM 标准的青少年中，体脂肪和 CVD 风险评分显着降低（均 P <0.003）。接收器操作特征曲线分析显示，最佳区分低和高 CVD 风险的 CRF 阈值与 FITNESSGRAM 建立的阈值非常相似：12-15 岁和 16-19 岁男孩分别为 44.1 和 40.3 mL x kg(-1) x min(-1)，12-15 岁和 16-19 岁女孩分别为 36.0 和 35.5 mL x kg(-1) x min(-1)。
FITNESSGRAM 建立的 CRF 标准参考标准可区分心血管状况较好的青少年和心血管状况较差的青少年。识别不符合这些标准的儿童可以帮助发现儿科 CVD 预防策略的目标人群。
