The current standard measure of cardiorespiratory fitness introduces confounding by body mass: the DR's EXTRA study

被引:37
|
作者
Savonen, K. [1 ,2 ]
Krachler, B. [1 ,3 ]
Hassinen, M. [1 ]
Komulainen, P. [1 ]
Kiviniemi, V. [4 ]
Lakka, T. A. [1 ,5 ]
Rauramaa, R. [1 ,2 ]
机构
[1] Kuopio Res Inst Exercise Med, Kuopio 70100, Finland
[2] Kuopio Univ Hosp, Dept Clin Physiol & Nucl Med, SF-70210 Kuopio, Finland
[3] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden
[4] Univ Eastern Finland, Informat Technol Ctr, Kuopio, Finland
[5] Univ Eastern Finland, Inst Biomed Physiol, Kuopio, Finland
基金
芬兰科学院;
关键词
abnormal glucose metabolism; body mass; cardiorespiratory fitness; maximal oxygen uptake; ACTIVITY ENERGY-EXPENDITURE; METABOLIC SYNDROME; PHYSICAL-ACTIVITY; OXYGEN-UPTAKE; EXERCISE; SIZE; ASSOCIATION; CAPACITY; WEIGHT; ADULTS;
D O I
10.1038/ijo.2011.212
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE: Cardiorespiratory fitness is currently estimated by dividing maximal oxygen consumption (VO2max) by body weight (per-weight standard). However, the statistically correct way to neutralize the effect of weight on VO2max in a given population is adjustment for body weight by regression techniques (adjusted standard). Our objective is to quantify the bias introduced by the per-weight standard in a population distributed across different categories of body mass. DESIGN: This is a cross-sectional study. SUBJECTS AND METHODS: Baseline measures from participants of the Dose-Responses to Exercise Training Study (DR's EXTRA), 635 men (body mass index (BMI): 19-47 kgm(-2)) and 638 women (BMI: 16-49 kgm(-2)) aged 57-78 years who performed oral glucose tolerance tests and maximal exercise stress tests with direct measurement of VO2max. We compare the increase in VO2max implied by the per-weight standard with the real increase of VO2max per kg body weight. A linear logistic regression model estimates odds for abnormal glucose metabolism (either impaired fasting glycemia or impaired glucose tolerance or Type 2 diabetes) of the least-fit versus most-fit quartile according to both per-weight standard and adjusted standard. RESULTS: The per-weight standard implies an increase of VO2max with 20.9 ml min(-1) in women and 26.4 ml min(-1) in men per additional kg body weight. The true increase per kg is only 7.0 ml min(-1) (95% confidence interval: 5.3-8.8) and 8.0 ml min(-1) (95% confidence interval: 5.3-10.7), respectively. Risk for abnormal glucose metabolism in the least-fit quartile of the population is overestimated by 52% if the per-weight standard is used. CONCLUSIONS: In comparisons across different categories of body mass, the per-weight standard systematically underestimates cardiorespiratory fitness in obese subjects. Use of the per-weight standard markedly inflates associations between poor fitness and co-morbidities of obesity.
引用
收藏
页码:1135 / 1140
页数:6
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