Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL.
Department of Biostatistics and Data Science, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC.
Med Sci Sports Exerc. 2022 Jul 1;54(7):1147-1154. doi: 10.1249/MSS.0000000000002893. Epub 2022 Feb 8.
This study aimed to describe maximal and submaximal cardiorespiratory fitness from early adulthood to midlife and examine differences in maximal fitness at age 20 yr and changes in fitness overtime by subcategories of sociodemographic, behavioral, and health-related factors.
Data include 5018 Coronary Artery Risk Development in Young Adults participants (mean (SD) age, 24.8 (3.7) yr; 53.3% female; and 51.4% Black participants) who completed at least one maximal graded exercise test at baseline and/or the year 7 and 20 exams. Maximal and submaximal fitness were estimated by exercise duration and heart rate at the end of stage 2. Multivariable adjusted linear-mixed models were used to estimate fitness trajectories using age as the mechanism for time after adjustment for covariates. Fitness trajectories from ages 20 to 50 yr in 5-yr increments were estimated overall and by subgroups determined by each factor after adjustment for duration within the less favorable category.
Mean (95% confidence interval) maximal fitness at age 20 and 50 yr was 613 (607-616) and 357 (350-362) s; submaximal heart rate during this period also reflected age-related fitness declines (126 (125-127) and 138 (137-138) bpm). Compared with men, women had lower maximal fitness at age 20 yr (P < 0.001), which persisted over follow-up (P < 0.001); differences were also found by race within sex strata (all P < 0.001). Differences in maximal fitness at age 20 yr were noted by socioeconomic, behavioral, and health-related status in young adulthood (all P < 0.05), which persisted over follow-up (all P < 0.001) and were generally consistent in sex-stratified analyses.
Targeting individuals experiencing accelerated fitness declines with tailored intervention strategies may provide an opportunity to preserve fitness throughout midlife to reduce lifetime cardiovascular disease risk.
本研究旨在描述从青年早期到中年的最大和亚最大心肺功能适应性，并通过社会人口统计学、行为和健康相关因素的亚分类检查 20 岁时最大适应性的差异以及随时间的适应性变化。
数据包括 5018 名冠状动脉风险发展中的年轻人参与者（平均（SD）年龄 24.8（3.7）岁；53.3%为女性；51.4%为黑人参与者），他们至少在基线和/或第 7 年和 20 年检查时完成了一次最大分级运动测试。最大和亚最大适应性通过第 2 阶段结束时的运动持续时间和心率来估计。多变量调整线性混合模型用于使用年龄作为调整协变量后的时间机制来估计适应性轨迹。根据每个因素调整不利类别内的持续时间后，以每 5 年为增量，从 20 岁到 50 岁的适应性轨迹进行了总体估计和亚组估计。
20 岁和 50 岁时的平均（95%置信区间）最大适应性分别为 613（607-616）和 357（350-362）秒；在此期间，亚最大心率也反映了与年龄相关的适应性下降（126（125-127）和 138（137-138）次/分钟）。与男性相比，女性在 20 岁时的最大适应性较低（P < 0.001），并且在随访期间持续存在（P < 0.001）；在性别分层内，种族之间也存在差异（均 P < 0.001）。在青年时期，社会经济、行为和健康相关状态的差异导致 20 岁时的最大适应性差异（均 P < 0.05），并且在随访期间持续存在（均 P < 0.001），并且在性别分层分析中基本一致。
针对具有特定干预策略的适应能力加速下降的个体，可能有机会在中年期间保持适应能力，从而降低终生心血管疾病风险。
