Department of Paediatric and Congenital Cardiology, M3C Regional Reference CHD Centre, Montpellier University Hospital, 371 Avenue du Doyen Giraud, 34295, Montpellier, France.
PhyMedExp, CNRS, INSERM, University of Montpellier, 371 Avenue du Doyen Giraud, 34295, Montpellier, France.
Eur J Prev Cardiol. 2023 Jul 12;30(9):820-829. doi: 10.1093/eurjpc/zwad054.
There has been a growing interest in the use of markers of aerobic physical fitness (VO2max assessed by cardiopulmonary exercise test (CPET)) in the follow-up of paediatric chronic diseases. The dissemination of CPET in paediatrics requires valid paediatric VO2max reference values to define the upper and lower normal limits. This study aimed to establish VO2max reference Z-score values, from a large cohort of children representative of the contemporary paediatric population, including those with extreme weights.
In this cross-sectional study, 909 children aged 5 to 18 years old from the general French population (development cohort) and 232 children from the general German and US populations (validation cohort) underwent a CPET, following the guidelines on high-quality CPET assessment. Linear, quadratic, and polynomial mathematical regression equations were applied to identify the best VO2max Z-score model. Predicted and observed VO2max values using the VO2max Z-score model, and the existing linear equations were compared, in both development and validation cohorts. For both sexes, the mathematical model using natural logarithms of VO2max, height, and BMI was the best fit for the data. This Z-score model could be applied to normal and extreme weights and was more reliable than the existing linear equations, in both internal and external validity analyses (https://play.google.com/store/apps/details?id=com.d2l.zscore).
This study established reference Z-score values for paediatric cycloergometer VO2max using a logarithmic function of VO2max, height, and BMI, applicable to normal and extreme weights. Providing Z-scores to assess aerobic fitness in the paediatric population should be useful in the follow-up of children with chronic diseases.
ClinicalTrials.gov NCT04876209.
人们对使用有氧体力活动（通过心肺运动试验评估的最大摄氧量 [VO2max]）标志物来监测儿科慢性疾病越来越感兴趣。心肺运动试验在儿科中的普及需要有效的儿科 VO2max 参考值来确定上下正常范围。本研究旨在建立一个基于大样本量儿童队列（包括体重极端值儿童）的 VO2max 参考 Z 评分值，该队列代表了当代儿科人群。
在这项横断面研究中，来自法国普通人群的 909 名 5 至 18 岁儿童（发展队列）和来自德国和美国普通人群的 232 名儿童（验证队列）按照高质量心肺运动试验评估指南进行了心肺运动试验。应用线性、二次和多项式数学回归方程来确定最佳 VO2max Z 评分模型。在发展和验证队列中，使用 VO2max Z 评分模型预测的和观察到的 VO2max 值与现有的线性方程进行了比较。对于两性，使用 VO2max、身高和 BMI 的自然对数的数学模型最适合数据。该 Z 评分模型可应用于正常和极端体重，在内部和外部有效性分析中比现有的线性方程更可靠（https://play.google.com/store/apps/details?id=com.d2l.zscore）。
本研究使用 VO2max、身高和 BMI 的对数函数建立了儿科踏车式 VO2max 的参考 Z 评分值，适用于正常和极端体重。提供 Z 评分来评估儿科人群的有氧健身能力应该有助于慢性疾病儿童的随访。
ClinicalTrials.gov NCT04876209。
