The Cooper Institute, Dallas, TX 75230, USA.
Med Sci Sports Exerc. 2012 Nov;44(11):2132-7. doi: 10.1249/MSS.0b013e31826524be.
There are no published data regarding the joint association of cardiorespiratory fitness (CRF) and LDL cholesterol concentration with subsequent CHD mortality in men.
A total of 40,718 healthy men received a comprehensive baseline clinical examination between 1971 and 2006. CRF was determined from a maximal treadmill exercise test. Participants were divided into categories of low (quintile 1), moderate (quintiles 2-3), and high (quintiles 4-5) CRF by age group, as well as by Adult Treatment Panel III-defined LDL categories. HRs for CHD mortality were computed with Cox regression analysis.
A total of 557 deaths due to CHD occurred during 16.7 ± 9.0 yr (681,731 man-years) of follow-up. After adjustment for age, examination year, smoking status, family history, and body mass index, a significant positive trend in CHD mortality was shown across decreasing categories of CRF. HRs with 95% confidence interval were 1.0 (referent), 1.18 (0.94-1.47), and 2.10 (1.65-2.67) for high, moderate, and low fit groups, P trend <0.0001. Adjusted HRs were significantly higher across increasing LDL categories: 1.0 (referent), 1.30 (0.87-1.95), 1.54 (1.04-2.28), 2.16 (1.45-3.21), and 2.02 (1.31-3.13), P trend <0.0001. When grouped by CRF category as well as by LDL category, there was a significant positive trend (P < 0.02) in adjusted mortality across decreasing categories of CRF within each LDL category.
CRF is strongly and inversely associated with CHD mortality in men. Compared with men with low CRF, at a moderate to high level of CRF, the risk of mortality within each LDL category is significantly attenuated. This study suggests that measurement of CRF should be considered for routine cardiovascular risk assessment and risk management.
目前尚无文献报道心肺适能（CRF）与 LDL 胆固醇浓度联合与男性随后发生 CHD 死亡率之间的关系。
共有 40718 名健康男性于 1971 年至 2006 年间接受了全面的基线临床检查。CRF 通过最大跑步机运动试验确定。根据年龄组以及成人治疗小组 III 定义的 LDL 类别，将参与者分为低（五分位 1）、中（五分位 2-3）和高（五分位 4-5）CRF 类别。使用 Cox 回归分析计算 CHD 死亡率的 HR。
在 16.7±9.0 年（681731 人年）的随访期间，共有 557 例 CHD 死亡。在调整年龄、检查年份、吸烟状况、家族史和体重指数后，CRF 逐渐降低的类别与 CHD 死亡率呈显著正相关趋势。HRs（95%CI）分别为 1.0（参照组）、1.18（0.94-1.47）和 2.10（1.65-2.67），适能高、中、低组，P<0.0001。随着 LDL 分类的增加，调整后的 HRs 显著升高：1.0（参照组）、1.30（0.87-1.95）、1.54（1.04-2.28）、2.16（1.45-3.21）和 2.02（1.31-3.13），P<0.0001。当按 CRF 类别和 LDL 类别分组时，在每个 LDL 类别中，CRF 逐渐降低的类别中，死亡率呈显著正相关趋势（P<0.02）。
CRF 与男性 CHD 死亡率呈强烈的负相关。与低 CRF 相比，在中到高 CRF 水平，每个 LDL 类别内的死亡率风险显著降低。本研究表明，CRF 的测量应考虑用于常规心血管风险评估和风险管理。
