Department of Human Performance and Sport Sciences, Winston-Salem State University, Winston-Salem, NC, USA.
Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Prog Cardiovasc Dis. 2014 Jan-Feb;56(4):434-40. doi: 10.1016/j.pcad.2013.09.006. Epub 2013 Oct 11.
Until recently, cardiorespiratory fitness (CRF) has been overlooked as a potential modifier of the inverse association between obesity and mortality (the so-called obesity paradox), observed in patients with known or suspected cardiovascular (CV) disease. Evidence from five observational cohort studies of 30,104 patients (87% male) with CV disease indicates that CRF significantly alters the obesity paradox. There is general agreement across studies that the obesity paradox persists among patients with low CRF, regardless of whether adiposity is assessed by body mass index, waist circumference, or percentage body fat. However, among patients with high CRF, risk of all-cause mortality is lowest for the overweight category in some, but not all, studies, suggesting that higher levels of fitness may modify the relationship between body fatness and survival in patients manifesting an obesity paradox. Further study is needed to better characterize the joint contribution of CRF and obesity on mortality in diverse populations.
直到最近，心肺适能（CRF）一直被忽视，作为肥胖与死亡率之间负相关（所谓的肥胖悖论）的潜在调节剂，在患有已知或疑似心血管（CV）疾病的患者中观察到。来自五项针对 30104 名患有 CV 疾病的患者（87%为男性）的观察性队列研究的证据表明，CRF 显著改变了肥胖悖论。无论通过体重指数、腰围还是体脂百分比来评估肥胖程度，所有研究都普遍认为，低 CRF 的患者中肥胖悖论仍然存在。然而，在高 CRF 的患者中，超重组的全因死亡率风险在一些但不是所有研究中最低，这表明更高水平的体能可能会改变在表现出肥胖悖论的患者中体脂与生存之间的关系。需要进一步研究以更好地描述在不同人群中 CRF 和肥胖对死亡率的联合贡献。
