Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos 11015-020, SP, Brazil.
Department of Cardiovascular Medicine, Angiocorpore Institute of Cardiovascular Medicine, Santos 11075-350, SP, Brazil.
Int J Environ Res Public Health. 2022 Jul 31;19(15):9377. doi: 10.3390/ijerph19159377.
We investigated whether cardiorespiratory fitness (CRF) mediates the association between moderate-to-vigorous physical activity (MVPA) and lung function in asymptomatic adults. We examined the cross-sectional results of 1362 adults aged 18-80 years from the Epidemiology and Human Movement Study. Participants were submitted to spirometry to obtain forced vital capacity (FVC) and forced expiratory volume in 1s (FEV1). Additionally, we used cardiopulmonary exercise testing to obtain peak oxygen uptake (V˙O) as a measure of CRF. Participants used a triaxial accelerometer for 4-7 days to obtain MVPA. Mediation analyses were performed considering the CRF as a mediator, MVPA as an independent variable, and FVC and FEV1 as dependent variables with adjustment for age, sex, and cardiovascular risk score. We aimed to investigate the total (path c) and direct (paths a, b, c') effects through the regression coefficients. We also examined the indirect effect, which was obtained from the product of the coefficients (path ab). Our sample was composed mainly of overweight and middle-aged women. MVPA was positively related to CRF (path a), as well as CRF and lung function (path b). MVPA also presented a significant positive total effect (path c) in the lung function. However, this relationship became non-significant when CRF was included in the model for both FVC and FEV1 (path c'). We did not observe a direct effect of MVPA on the lung function. In contrast, the indirect effect was significant (path ab). Lastly, CRF mediated 60% of the total effect of MVPA on FVC and 61.9% on FEV1. CRF mediates the relationship between lung function and MVPA in asymptomatic adults. Therefore, our results reinforce the need to include CRF assessment in practice clinical routine and suggest that strategies focusing on CRF might be more promising to prevent respiratory diseases in adults.
我们研究了心肺适能（CRF）是否在无症状成年人中调节了中等到剧烈体力活动（MVPA）与肺功能之间的关系。我们检查了来自流行病学和人类运动研究的 1362 名 18-80 岁成年人的横断面结果。参与者接受了肺活量测定法以获得用力肺活量（FVC）和 1 秒用力呼气量（FEV1）。此外，我们使用心肺运动测试获得峰值摄氧量（V˙O）作为 CRF 的衡量标准。参与者使用三轴加速度计进行 4-7 天的 MVPA 测量。在调整年龄、性别和心血管风险评分后，我们进行了中介分析，将 CRF 视为中介，MVPA 视为自变量，FVC 和 FEV1 视为因变量。我们旨在通过回归系数来研究总（路径 c）和直接（路径 a、b、c'）效应。我们还检查了间接效应，该效应是通过系数乘积（路径 ab）获得的。我们的样本主要由超重和中年女性组成。MVPA 与 CRF（路径 a）以及 CRF 和肺功能（路径 b）呈正相关。MVPA 对肺功能也具有显著的正向总效应（路径 c）。然而，当 CRF 包含在 FVC 和 FEV1 的模型中时，这种关系变得没有统计学意义（路径 c'）。我们没有观察到 MVPA 对肺功能的直接影响。相反，间接效应是显著的（路径 ab）。最后，CRF 介导了 MVPA 对 FVC 的总效应的 60%和对 FEV1 的 61.9%。CRF 调节了无症状成年人中肺功能与 MVPA 之间的关系。因此，我们的结果加强了在临床实践常规中包括 CRF 评估的必要性，并表明专注于 CRF 的策略可能更有希望预防成年人的呼吸疾病。
