Peak oxygen uptake cut-points to identify children at increased cardiometabolic risk - The PANIC Study
Agbaje, Andrew O; Haapala, Eero A; Lintu, Niina; Viitasalo, Anna; Barker, Alan R; Takken, Tim; Tompuri, Tuomo; Lindi, Virpi; Lakka, Timo A
(2019) Scandinavian Journal of Medicine & Science in Sports, volume 29, issue 1, pp. 16 - 24
(Article)
Abstract
We aimed to develop cut-points for directly measured peak oxygen uptake (VO 2peak) to identify boys and girls at increased cardiometabolic risk using different scaling methods to control for body size and composition. Altogether 352 children (186 boys, 166 girls) aged 9-11 years were included in the analyses. We measured V̇O
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2peak directly during a maximal cycle ergometer exercise test and lean body mass (LM) by bioelectrical impedance. We computed a sex- and age-specific cardiometabolic risk score (CRS) by summing important cardiometabolic risk factors and defined increased cardiometabolic risk as >1 standard deviation above the mean of CRS. Receiver operating characteristics curves were used to detect V̇O 2peak cut-points for increased cardiometabolic risk. Boys with V̇O 2peak <45.8 mL kg body mass (BM) −1 min −1 (95% confidence interval [CI] = 45.1 to 54.6, area under the curve [AUC] = 0.86, P < 0.001) and <63.2 mL kg LM −1 min −1 (95% CI =52.4 to 67.5, AUC = 0.65, P = 0.006) had an increased CRS. Girls with V̇O 2peak <44.1 mL kg BM −1 min −1 (95% CI = 44.0 to 58.6, AUC = 0.67, P = 0.013) had an increased CRS. V̇O 2peak scaled by BM −0.49 and LM −0.77 derived from log-linear allometric modeling poorly predicted increased cardiometabolic risk in boys and girls. In conclusion, directly measured VO 2peak <45.8 mL kg BM −1 min −1 among boys and <44.1 mL kg BM −1 min −1 among girls were cut-points to identify those at increased cardiometabolic risk. Appropriately controlling for body size and composition reduced the ability of cardiorespiratory fitness to identify children at increased cardiometabolic risk.
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Keywords: Journal Article, allometric scaling, adiposity, metabolic health, children, aerobic fitness, maximal exercise, Predictive Value of Tests, Cardiorespiratory Fitness, Humans, Risk Factors, Oxygen Consumption, Male, Exercise Test, Female, ROC Curve, Cardiovascular Diseases/diagnosis, Child, Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine, Journal Article
ISSN: 0905-7188
Publisher: Blackwell Munksgaard
Note: Funding Information: The PANIC Study has been financially supported by grants from the Ministry of Education and Culture of Finland, Ministry of Social Affairs and Health of Finland, Research Committee of the Kuopio University Hospital Catchment Area (State Research Funding), Finnish Innovation Fund Sitra, Social Insurance Institution of Finland, Finnish Cultural Foundation, Foundation for Paediatric Research, Diabetes Research Foundation in Finland, Finnish Foundation for Cardiovascular Research, Juho Vainio Foundation, Paavo Nurmi Foundation, Yrjö Jahnsson Foundation. Dr Agbaje has been financially supported by grants from Olvi Foundation and Urho Känkanen Foundation. Funding Information: Funding information The PANIC Study has been financially supported by grants from the Ministry of Education and Culture of Finland, Ministry of Social Affairs and Health of Finland, Research Committee of the Kuopio University Hospital Catchment Area (State Research Funding), Finnish Innovation Fund Sitra, Social Insurance Institution of Finland, Finnish Cultural Foundation, Foundation for Paediatric Research, Diabetes Research Foundation in Finland, Finnish Foundation for Cardiovascular Research, Juho Vainio Foundation, Paavo Nurmi Foundation, Yrj? Jahnsson Foundation. Dr Agbaje has been financially supported by grants from Olvi Foundation and Urho K?nkanen Foundation. The authors would like to thank all children and their families who participated in the PANIC study for the motivation to continue in the prospective study. We also appreciate Merja Atalay, Panu Karjalainen, Tuula-Riitta Mutanen, Juuso V?ist?, and Kirsi Saastamoinen for their contribution to data collection and management. Part of the results has been presented in the bi-annual Pediatric Work Physiology meeting, Greece, October 2017. Publisher Copyright: © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
(Peer reviewed)