Cardiorespiratory Fitness and Carotid Intima–Media Thickness in Physically Active Young Adults: CHIEF Atherosclerosis Study

Abstract

Background: The relationship of cardiorespiratory fitness (CRF) with subclinical atherosclerosis affected by the body adiposity has been observed in children, whereas this relationship remains unclear in young adults. Methods and Results: A total of 1520 military recruits, aged 18–40 years, were included in Taiwan in 2018–2020. All subjects underwent detailed physical and blood laboratory examinations. CRF was evaluated by time for a 3000 m run, and subclinical atherosclerosis was evaluated by intima–media thickness of the bulb of the left common carotid artery (cIMT) utilizing high-resolution ultrasonography. Multivariable linear regression analysis with adjustments for age, sex, cigarette smoking, alcohol intake, systolic and diastolic blood pressure, high- and low-density lipoprotein cholesterols, fasting glucose, waist circumference, serum uric acid and serum triglycerides were utilized to determine the correlation between CRF and cIMT. CRF was independently correlated with cIMT (standardized β: 0.11, p < 0.001). Of the cardiometabolic risk markers, serum triglycerides were the only independent risk marker of cIMT (standardized β: 0.063, p = 0.03). In addition, the association of CRF with cIMT did not differ between those with a body mass index (BMI) ≥ 25 kg/m2 and those with BMI < 25 kg/m2 (standardized β: 0.103 and 0.117; p = 0.01 and 0.005, respectively). Conclusions: In physically active young men and women, there was an inverse association of cIMT with CRF, which was observed in both overweight/mild obesity and normal-weight individuals, highlighting the importance of endurance capacity on reducing risk of early atherosclerosis and implying that the moderation effect of body adiposity might not be present in this population.

Electrocardiographic and echocardiographic predictors of greater carotid intima‐media thickness in tactical athletes: The CHIEF atherosclerosis study

“…Moreover, most of the increased LV diastolic functions related to exercise training directed from reduced heart rate (Lin, Liu, Tsai, et al, 2022;Lin, Lloyd-Jones, Colangelo, et al, 2022;Lin, Tsai, Chang, et al, 2022;Lin, Tsai, Han, et al, 2022), which revealed an association with significant cIMT in this study, reconfirming the physical effects on both LVM and cIMT.…”

“…Among patients with hypertension, higher BP level is a crucial shared risk factor and plays a major role in the positive relationship between LVM and cIMT (Meijs et al, 2009). In tactical athletes, such as our military personnel, prior studies have revealed that physical fitness could increase LV muscle hypertrophy and diastolic function (Lin, Liu, Tsai, et al, 2022;Lin, Lloyd-Jones, Colangelo, et al, 2022;Lin, Tsai, Chang, et al, 2022;Lin, Tsai, Han, et al, 2022;Liu et al, 2022). Greater cardiorespiratory fitness TA B L E 2 Echocardiographic findings of participants with ultrasonography for carotid intima-media thickness and muscular strength levels have revealed an inverse association with lower cIMT levels (Lin, Liu, Tsai, et al, 2022;Lin, Lloyd-Jones, Colangelo, et al, 2022;Lin, Tsai, Chang, et al, 2022;Lin, Tsai, Han, et al, 2022).…”

“…In tactical athletes, such as our military personnel, prior studies have revealed that physical fitness could increase LV muscle hypertrophy and diastolic function (Lin, Liu, Tsai, et al, 2022;Lin, Lloyd-Jones, Colangelo, et al, 2022;Lin, Tsai, Chang, et al, 2022;Lin, Tsai, Han, et al, 2022;Liu et al, 2022). Greater cardiorespiratory fitness TA B L E 2 Echocardiographic findings of participants with ultrasonography for carotid intima-media thickness and muscular strength levels have revealed an inverse association with lower cIMT levels (Lin, Liu, Tsai, et al, 2022;Lin, Lloyd-Jones, Colangelo, et al, 2022;Lin, Tsai, Chang, et al, 2022;Lin, Tsai, Han, et al, 2022). It is reasonable that greater LVM related to more intensive physical training was inversely associated with lower cIMT, which highlights that echocardiographic LVH may be a protective marker for atherosclerosis in physically fit individuals in this study.…”

“…In addition, exercises can reduce the prevalence and severity of vascular risk factors, for example, obesity, dyslipidemia, and hypertension, which are related to the atherosclerosis progression (Lavie et al, 2019;Lin, Li, et al, 2016;Lin, Liu, et al, 2016). Several prior studies have shown that both aerobic and resistant exercises were associated with reduced burden of atherosclerosis assessed by cIMT in children and young adults (Lin, Liu, Tsai, et al, 2022;Lin, Lloyd-Jones, Colangelo, et al, 2022;Lin, Tsai, Chang, et al, 2022;Lin, Tsai, Han, et al, 2022;Melo et al, 2015). However, the impacts of echocardiography and ECG-based-LVH on atherosclerosis were rarely investigated in physically active individuals, such as military personnel.…”

Estimated power output for a distance run and maximal oxygen uptake in young adults

“…Cardiorespiratory fitness (CRF) is inversely associated with the risk of metabolic syndrome, diabetes mellitus, cardiovascular diseases (CVD), and mortality in the general population ( Carnethon et al, 2009 ; Mehta et al, 2020 ; Wang et al, 2021 ; Lin et al, 2022 ; Sui et al, 2022 ). Obtaining greater CRF levels for sedentary individuals has been proposed as one of the major preventive measures to reduce the severity and burden of atherosclerosis in developed countries ( Lavie et al, 2019 ; Sanchis-Gomar et al, 2022 ).…”