Laitinen Emilia, Soininen Sonja, Leppänen Marja H, Waller Katja, Bond Bert, Lintu Niina, Faigenbaum Avery D, Laitinen Tomi, Haapala Eero A, Lakka Timo A
Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
Sports Med Open. 2025 May 3;11(1):48. doi: 10.1186/s40798-025-00841-w.
Cardiovascular diseases (CVDs) are the leading cause of morbidity and premature mortality globally. While the relationship between indicators of physical fitness and arterial structure and stiffness are reasonably well-studied in adults, these associations in children and adolescents remain less understood. The aim of this study was to investigate longitudinal associations of cardiorespiratory fitness, muscular fitness and motor fitness with arterial structure and stiffness from childhood to adolescence.
Higher mean value of VO/LM from childhood to adolescence was associated with higher carotid intima-media thickness (cIMT) at 8-year follow-up (β = 0.184, 95% confidence interval [CI] = 0.019 to 0.350). Better performance in sit-up test at baseline was associated with lower cardio-ankle vascular index (CAVI) (β = - 0.219, 95% CI = - 0.387 to - 0.051) at 8-year follow-up, and higher mean sit-up performance from baseline to 8-year follow-up was associated with lower carotid-femoral pulse-wave velocity (cfPWV) (β = - 0.178, 95% CI = - 0.353 to - 0.003) and CAVI (β = - 0.190, 95% CI = - 0.365 to - 0.016) at 8-year follow-up. Also cross-sectionally, better sit-up performance at 8-year follow-up was associated with lower cfPWV (β = - 0.232, 95% CI = - 0.411 to - 0.054) and CAVI (β = - 0.185, 95% CI = - 0.365 to - 0.005) and higher carotid artery distensibility (β = 0.165, 95% CI = 0.004 to 0.327) at 8-year follow-up. Most of the associations were explained by body fat percentage (BF%).
Physical fitness had a weak if any association with indicators of arterial structure and arterial stiffness in adolescence. BF% largely explained the associations of higher VO/LM with higher cIMT and better sit-up performance with lower arterial stiffness in adolescents. Therefore, preventing adiposity rather than improving CRF should be addressed in public health strategies to prevent CVDs in general paediatric populations.
Better sit-up performance was associated with lower arterial stiffness, but the association was largely explained by body fat percentage. Lower body muscular strength, handgrip strength, or motor fitness was not associated with arterial stiffness or carotid artery intima-media thickness. Measures other than cardiorespiratory fitness, muscular fitness, or motor fitness, such as adiposity, should be used to screen children and adolescents at increased risk of cardiovascular diseases.
心血管疾病(CVDs)是全球发病和过早死亡的主要原因。虽然成年人体适能指标与动脉结构和僵硬度之间的关系已得到较为充分的研究,但儿童和青少年中的这些关联仍了解较少。本研究的目的是调查从儿童期到青少年期心肺适能、肌肉适能和运动适能与动脉结构和僵硬度的纵向关联。
从儿童期到青少年期较高的VO/LM平均值与8年随访时较高的颈动脉内膜中层厚度(cIMT)相关(β = 0.184,95%置信区间[CI] = 0.019至0.350)。基线时仰卧起坐测试表现较好与8年随访时较低的心踝血管指数(CAVI)相关(β = -0.219,95% CI = -0.387至-0.051),从基线到8年随访期间较高的平均仰卧起坐表现与8年随访时较低的颈动脉-股动脉脉搏波速度(cfPWV)(β = -0.178,95% CI = -0.353至-0.003)和CAVI(β = -0.190,95% CI = -0.365至-0.016)相关。同样在横断面分析中,8年随访时较好的仰卧起坐表现与较低的cfPWV(β = -0.232,95% CI = -0.411至-0.054)和CAVI(β = -0.185,95% CI = -0.365至-0.005)以及较高的颈动脉扩张性(β = 0.165,95% CI = 0.004至0.327)相关。大多数关联可由体脂百分比(BF%)解释。
在青少年中,体适能与动脉结构和动脉僵硬度指标之间即便存在关联也很微弱。BF%在很大程度上解释了较高的VO/LM与较高的cIMT以及较好的仰卧起坐表现与较低的动脉僵硬度在青少年中的关联。因此,在预防一般儿科人群的心血管疾病的公共卫生策略中,应着重预防肥胖而非改善心肺适能。
较好的仰卧起坐表现与较低的动脉僵硬度相关,但这种关联在很大程度上可由体脂百分比解释。较低的下肢肌肉力量、握力或运动适能与动脉僵硬度或颈动脉内膜中层厚度无关。应使用除心肺适能、肌肉适能或运动适能之外的其他指标,如肥胖程度,来筛查心血管疾病风险增加的儿童和青少年。