Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, CLINTEC, Blickagången 6A, Novum, S-141 57, Huddinge, Sweden.
Health Professionals Function, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
Sci Rep. 2023 May 5;13(1):7289. doi: 10.1038/s41598-023-34374-7.
It is unclear if associations between cardiorespiratory fitness (CRF) and cardiometabolic risk factors are independent of degree of obesity, in children with obesity. The aim of this cross-sectional study on 151 children (36.4% girls), 9-17 years, from a Swedish obesity clinic, was to investigate associations between CRF and cardiometabolic risk factors, adjusted for body mass index standard deviation score (BMI SDS), in children with obesity. CRF was objectively assessed with the Åstrand-Rhyming submaximal cycle ergometer test, and blood samples (n = 96) and blood pressure (BP) (n = 84) according to clinical routine. Obesity specific reference values for CRF were used to create CRF levels. CRF was inversely associated with high-sensitivity C-reactive protein (hs-CRP), independent of BMI SDS, age, sex, and height. The inverse associations between CRF and diastolic BP did not remain significant when adjusted for BMI SDS. CRF and high-density lipoprotein cholesterol became inversely associated when adjusted for BMI SDS. Independent of degree of obesity, lower CRF is associated with higher levels of hs-CRP, as a biomarker of inflammation, in children with obesity and regular assessment of CRF should be encouraged. Future research in children with obesity should investigate if low-grade inflammation decreases when CRF is improved.
在肥胖儿童中，心肺适能（CRF）与心血管代谢风险因素之间的关联是否独立于肥胖程度尚不清楚。本研究对瑞典肥胖诊所的 151 名 9-17 岁儿童（36.4%为女孩）进行了横断面研究，旨在调查肥胖儿童中 CRF 与心血管代谢风险因素之间的关联，这些因素经过了体重指数标准差评分（BMI SDS）的调整。CRF 通过 Åstrand-Rhyming 亚最大循环测力计测试进行客观评估，根据临床常规采集了血液样本（n=96）和血压（BP）样本（n=84）。使用肥胖特异性 CRF 参考值来创建 CRF 水平。CRF 与高敏 C 反应蛋白（hs-CRP）呈负相关，独立于 BMI SDS、年龄、性别和身高。当调整 BMI SDS 时，CRF 与舒张压之间的负相关不再显著。当调整 BMI SDS 时，CRF 与高密度脂蛋白胆固醇呈负相关。独立于肥胖程度，较低的 CRF 与肥胖儿童的 hs-CRP 水平较高有关，hs-CRP 是炎症的生物标志物，应鼓励定期评估 CRF。在肥胖儿童中，未来的研究应调查当 CRF 改善时，低度炎症是否会减少。
