Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China.
School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia.
Front Endocrinol (Lausanne). 2020 Jun 12;11:342. doi: 10.3389/fendo.2020.00342. eCollection 2020.
Findings for associations between cardiorespiratory fitness (CRF) and cardiometabolic risk (CMR) factors are inconsistent, and the interactive association between CRF and fatness with CMR factors is unclear in children. Our study aimed to examine whether CRF and fatness are independently and interactively associated with CMR factors. We included 5,869 children aged 6-13 years in the analysis. Physical examinations, blood tests, and CRF were measured at baseline and 1 year later. Cardiometabolic risk score (CMRS) was computed by summing scores of waist circumference (WC), averaged systolic and diastolic blood pressure, glucose, high-density lipoprotein cholesterol (HDL-C, multiplied by -1), and triglycerides. There was a high correlation between fatness and CRF in both boys and girls. High baseline CRF was independently associated with favorable changes in CMRS, BMI, WC, percent body fat (PBF), total cholesterol, LDL-C, and HDL-C (all < 0.025). Improved CRF was independently associated with favorable changes in CMRS, BMI, WC, PBF, total cholesterol, LDL-C, HDL-C, triglycerides, and fasting glucose (all < 0.0321). Baseline BMI was positively associated with changes in CMRS, WC, blood pressure, triglycerides, insulin, and HOMA-IR (all < 0.0462). Low PBF at baseline was associated with favorable changes in CMRS, BMI, WC, blood pressure, HDL-C, triglycerides, insulin, and HOMA-IR (all < 0.0423). The percentage of the total effect of baseline CRF on changes in CMRS, triglycerides, HDL-C, PBF, and WC mediated by baseline BMI was 66.0, 61.6, 40.3, 20.7, and 9.2%, respectively. Baseline CRF was a significant mediator for the association between baseline BMI and changes in CMRS (mediated by 4.3%), triglycerides (5.1%), and HDL-C (12.0%). An inverse association was found between baseline CRF and CMRS in children with high baseline BMI/PBF only. Improved CRF was associated with decreased BMI and WC in children with low baseline CRF. Fatness and CRF are each independently associated with changes in CMR factors. Fatness is a major mediator for the association between CRF and CMR factors, whereas the association between fatness and CMR factors is also mediated by CRF. The beneficial effect of high CRF on CMR factors was more evident in obese or unfit children.
研究目的在于检验心肺适能（CRF）和肥胖与心血管代谢风险（CMR）因素之间的交互关联是否具有独立性。我们分析了 5869 名 6-13 岁的儿童，在基线和 1 年后进行了体格检查、血液检查和 CRF 测量。通过将腰围（WC）、平均收缩压和舒张压、血糖、高密度脂蛋白胆固醇（HDL-C，乘以-1）和甘油三酯的得分相加来计算心血管代谢风险评分（CMRS）。在男孩和女孩中，肥胖和 CRF 之间存在高度相关性。较高的基线 CRF 与 CMRS、BMI、WC、体脂百分比（PBF）、总胆固醇、LDL-C 和 HDL-C 的有利变化独立相关（均<0.025）。CRF 的改善与 CMRS、BMI、WC、PBF、总胆固醇、LDL-C、HDL-C、甘油三酯和空腹血糖的有利变化独立相关（均<0.0321）。基线 BMI 与 CMRS、WC、血压、甘油三酯、胰岛素和 HOMA-IR 的变化呈正相关（均<0.0462）。基线时低 PBF 与 CMRS、BMI、WC、血压、HDL-C、甘油三酯、胰岛素和 HOMA-IR 的有利变化相关（均<0.0423）。基线 CRF 对 CMRS、甘油三酯、HDL-C、PBF 和 WC 变化的总效应的百分比分别为 66.0%、61.6%、40.3%、20.7%和 9.2%。基线 CRF 是基线 BMI 与 CMRS 变化之间关联的一个显著的中介因素（通过 4.3%介导），以及与甘油三酯（5.1%）和 HDL-C（12.0%）变化之间的关联。仅在基线 BMI/PBF 较高的儿童中发现基线 CRF 与 CMRS 呈负相关。在基线 CRF 较低的儿童中，CRF 的改善与 BMI 和 WC 的降低有关。脂肪量和 CRF 均与 CMR 因素的变化独立相关。肥胖是 CRF 与 CMR 因素之间关联的主要介导因素，而肥胖与 CMR 因素之间的关联也受 CRF 介导。高 CRF 对 CMR 因素的有益影响在肥胖或不适合运动的儿童中更为明显。
