IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2530388, Chile.
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, Murcia 30071, Spain.
J Sport Health Sci. 2021 May;10(3):360-367. doi: 10.1016/j.jshs.2019.08.003. Epub 2019 Aug 16.
This study was aimed to analyze the mediation role of cardiorespiratory fitness (CRF) on the association between fatness and cardiometabolic risk scores (CMRs) in European adolescents.
A cross-sectional study was conducted in adolescents (n = 525; 46% boys; 14.1 ± 1.1 years old, mean ± SD) from 10 European cities involved in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. CRF was measured by means of the shuttle run test, while fatness measures included body mass index (BMI), waist to height ratio, and fat mass index estimated from skinfold thicknesses. A clustered CMRs was computed by summing the standardized values of homeostasis model assessment, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and leptin.
Linear regression models indicated that CRF acted as an important and partial mediator in the association between fatness and CMRs in 12-17-year-old adolescents (for BMI: coefficients of the indirect role β = 0.058 (95% confidence interval (95%CI): 0.023-0.101), Sobel test z = 3.11 (10.0% mediation); for waist to height ratio: β = 4.279 (95%CI: 2.242-7.059), z =3.86 (11.5% mediation); and for fat mass index: β = 0.060 (95%CI: 0.020-0.106), z = 2.85 (9.4% mediation); all p < 0.01).
In adolescents, the association between fatness and CMRs could be partially decreased with improvements to fitness levels; therefore, CRF contribution both in the clinical field and public health could be important to consider and promote in adolescents independently of their fatness levels.
本研究旨在分析心肺适能（CRF）在欧洲青少年体脂与心血管代谢风险评分（CMRs）之间的关联中的中介作用。
本横断面研究纳入了来自参与“青少年欧洲营养健康生活方式研究”的 10 个欧洲城市的 525 名青少年（46%为男性；14.1±1.1 岁，均值±标准差）。CRF 通过往返跑测试进行测量，而体脂测量指标包括体重指数（BMI）、腰高比和通过皮褶厚度估计的体脂指数。通过对稳态模型评估、收缩压、甘油三酯、总胆固醇/高密度脂蛋白胆固醇比值和瘦素的标准化值进行求和，计算出聚类 CMRs。
线性回归模型表明，CRF 在 12-17 岁青少年体脂与 CMRs 之间的关联中起着重要的部分中介作用（对于 BMI：间接作用的系数为β=0.058（95%置信区间（95%CI）：0.023-0.101），Sobel 检验 z=3.11（10.0%的中介作用）；对于腰高比：β=4.279（95%CI：2.242-7.059），z=3.86（11.5%的中介作用）；对于体脂指数：β=0.060（95%CI：0.020-0.106），z=2.85（9.4%的中介作用）；均 P<0.01）。
在青少年中，体脂与 CMRs 之间的关联可以通过提高健康水平而部分降低；因此，CRF 的贡献无论是在临床领域还是公共卫生领域，都可能是重要的，并且应该考虑并促进青少年的 CRF 水平的提高，而不论其体脂水平如何。
