UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
BMC Pediatr. 2023 Jul 8;23(1):345. doi: 10.1186/s12887-023-04157-0.
Cardiovascular fitness is strongly linked with metabolic risk; however, research is limited in preschool children. Although there is currently no simple validated measure of fitness in preschool children, heart rate recovery has been highlighted as an easily accessible and non-invasive predictor of cardiovascular risk in school-aged children and adolescents. We aimed to investigate whether heart rate recovery was associated with adiposity and blood pressure in 5-year-olds.
This is a secondary analysis of 272 5-year-olds from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet in pregnancy to prevent recurrence of macrosomia) Kids study. Three-minute step tests were completed by 272 participants to determine heart rate recovery duration. Body mass index (BMI), circumferences, skinfold thickness, heart rate, and blood pressure were collected. Independent t-tests, Mann-Whitney U, and Chi-square tests were used to compare participants. Linear regression models examined associations between heart rate recovery and child adiposity. Confounders included child sex, age at study visit, breastfeeding, and perceived effort in the step test.
The median (IQR) age at the study visit was 5.13 (0.16) years. 16.2% (n = 44) had overweight and 4.4% (n = 12) had obesity based on their BMI centile. Boys had a quicker mean (SD) heart rate recovery after the step test than girls (112.5 (47.7) seconds vs. 128.8 (62.5) seconds, p = 0.02). Participants with a slower recovery time (> 105 s) had higher median (IQR) sum of skinfolds (35.5 (11.8) mm vs. 34.0 (10.0) mm, p = 0.02) and median (IQR) sum of subscapular and triceps skinfold (15.6 (4.4) mm vs. 14.4 (4.0) mm, p = 0.02) compared to participants with a quicker recovery time. After adjusting for confounders (child sex, age at study visit, breastfeeding, effort in the step test), linear regression analyses revealed heart rate recovery time after stepping was positively associated with sum of skinfolds (B = 0.034, 95% CI: 0.01, 0.06, p = 0.007).
Child adiposity was positively associated with heart rate recovery time after the step test. A simple stepping test could be used as a non-invasive and inexpensive fitness tool in 5-year-olds. Additional research is needed to validate the ROLO Kids step test in preschool children.
心血管健康与代谢风险密切相关；然而，针对学龄前儿童的研究有限。虽然目前还没有简单有效的适用于学龄前儿童的体能测试方法，但心率恢复已被证明是一种可用于评估儿童心血管风险的简单、无创的预测指标。本研究旨在探讨 5 岁儿童的心率恢复与肥胖和血压之间的关系。
这是 ROLO（孕期低血糖指数饮食控制试验以预防巨大儿复发）儿童研究的二次分析，共有 272 名 5 岁儿童参与。通过 272 名参与者进行 3 分钟踏步测试，以确定心率恢复持续时间。收集了儿童的体重指数（BMI）、周长、皮褶厚度、心率和血压。采用独立 t 检验、Mann-Whitney U 检验和卡方检验比较参与者的各项数据。线性回归模型用于分析心率恢复与儿童肥胖之间的关系。混杂因素包括儿童的性别、研究时的年龄、母乳喂养和踏步测试中的感知努力程度。
研究时的中位（IQR）年龄为 5.13（0.16）岁。根据 BMI 百分位数，16.2%（n=44）的儿童超重，4.4%（n=12）的儿童肥胖。男孩在踏步测试后的心率恢复时间比女孩更快（112.5（47.7）秒比 128.8（62.5）秒，p=0.02）。恢复时间较长（>105 秒）的参与者的皮褶厚度总和中位数（IQR）更高（35.5（11.8）mm 比 34.0（10.0）mm，p=0.02），肩胛下和肱三头肌皮褶厚度总和中位数（IQR）也更高（15.6（4.4）mm 比 14.4（4.0）mm，p=0.02）。调整混杂因素（儿童性别、研究时的年龄、母乳喂养、踏步测试中的努力程度）后，线性回归分析显示，踏步后心率恢复时间与皮褶厚度总和呈正相关（B=0.034，95%CI：0.01，0.06，p=0.007）。
儿童肥胖与踏步后心率恢复时间呈正相关。简单的踏步测试可以作为 5 岁儿童非侵入性、经济实惠的体能测试工具。需要进一步的研究来验证 ROLO 儿童踏步测试在学龄前儿童中的有效性。
