Chen Yanchun, Yang Hongxi, Li Dun, Zhou Lihui, Lin Jing, Yin Xin, Yang Weiling, Gao Ying, Zhang Qing, Leng Sean X, Wang Yaogang
School of Public Health, Tianjin Medical University, Tianjin, China.
School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
Br J Sports Med. 2025 Feb 20;59(5):306-315. doi: 10.1136/bjsports-2024-108955.
This study examined the relationship of cardiorespiratory fitness (CRF) in the transition from healthy status to first cardiometabolic disease, subsequent cardiometabolic multimorbidity and further to death.
We used data from the UK Biobank of 47 484 participants without cardiometabolic diseases at baseline. CRF was assessed via a 6 min incremental ramp cycle ergometer test and expressed in metabolic equivalent of tasks (METs, 1 MET=3.5 mL/kg/min). Cardiometabolic multimorbidity was defined as at least two diseases among diabetes, hypertension, coronary heart disease and stroke.
Over 12.5 years median follow-up, 8123 participants developed first cardiometabolic disease, 1958 developed cardiometabolic multimorbidity and 2177 died. CRF was associated with different transition stages in cardiometabolic multimorbidity development. The HRs (95% CIs) per MET increase in CRF were 0.94 (0.93 to 0.95) and 0.97 (0.96 to 0.99) for transitions from healthy baseline to first cardiometabolic disease and subsequent cardiometabolic multimorbidity. Per MET increase in CRF was associated with reduced risk of transition from healthy baseline to death (HR: 0.97, 95% CI 0.95 to 0.99), but not for the transition from first cardiometabolic disease and cardiometabolic multimorbidity to death. When first cardiometabolic disease was divided into specific cardiometabolic diseases, there were comparable trends of CRF on the disease-specific transitions from healthy baseline to first cardiometabolic disease and subsequent cardiometabolic multimorbidity.
Higher CRF was associated with a lower risk of progression from a healthy state to first cardiometabolic disease and subsequently to cardiometabolic multimorbidity. These findings suggest that improving CRF is a potential strategy for preventing cardiometabolic multimorbidity development.
本研究探讨了心肺适能（CRF）在从健康状态转变为首次发生心脏代谢疾病、随后发生心脏代谢多重疾病并进一步发展至死亡过程中的关系。
我们使用了英国生物银行中47484名基线时无心脏代谢疾病参与者的数据。通过6分钟递增斜坡式自行车测力计测试评估CRF，并以代谢当量（METs，1 MET = 3.5 mL/kg/min）表示。心脏代谢多重疾病定义为糖尿病、高血压、冠心病和中风中的至少两种疾病。
在12.5年的中位随访期内，8123名参与者发生了首次心脏代谢疾病，1958名参与者发生了心脏代谢多重疾病，2177名参与者死亡。CRF与心脏代谢多重疾病发展的不同转变阶段相关。从健康基线转变为首次心脏代谢疾病以及随后转变为心脏代谢多重疾病时，CRF每增加1 MET，风险比（HRs，95%置信区间）分别为0.94（0.93至0.95）和0.97（0.96至0.99）。CRF每增加1 MET与从健康基线转变为死亡的风险降低相关（HR：0.97，95%置信区间0.95至0.99），但从首次心脏代谢疾病和心脏代谢多重疾病转变为死亡则不然。当将首次心脏代谢疾病分为特定的心脏代谢疾病时，CRF在从健康基线到首次心脏代谢疾病以及随后到心脏代谢多重疾病的疾病特异性转变上具有相似的趋势。
较高的CRF与从健康状态发展为首次心脏代谢疾病并随后发展为心脏代谢多重疾病的较低风险相关。这些发现表明，改善CRF是预防心脏代谢多重疾病发展的潜在策略。
