Cardiorespiratory fitness and metabolic risk in Chinese population: evidence from a prospective cohort study

Abstract

Background Studies on the association between estimated cardiorespiratory fitness (CRF) and changes in metabolic risk in the Chinese population are limited. This study aims to examine the associations between CRF and changes in metabolic risk. Subjects and methods We included 4,862 and 2,700 participants recruited from 28 provinces in the China Health and Retirement Longitudinal Study (CHARLS) in the baseline (Wave 1) and follow-up (Wave 4) analyses, respectively. CRF was calculated using sex-specific longitudinal non-exercise equations. Metabolic indicators included systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and fasting plasma glucose (FPG) levels. The metabolic score was calculated as the number of changes in the above metabolic indicators above the 75th percentile of the distribution of changes (equal to or below the 25th percentile for HDL-C). Results In the baseline analysis, CRF was negatively associated with SBP, DBP, TG, and FPG, and positively correlated with HDL-C after adjusting for age, smoking status, and drinking status (all P < 0.0001) in both males and females. In the follow-up analysis, higher baseline CRF was significantly related to a decrease in SBP, DBP, TG, FPG, and metabolic score (all P < 0.0005), and increased HDL-C (P < 0.0001) after further adjustment for corresponding baseline metabolic indicators. The associations remained significant after stratification by sex, except for the changes in HDL-C levels in females. Furthermore, improved CRF was associated with favorable changes in DBP, TG, HDL-C, FPG, and metabolic scores in all populations and males. Significant associations between changes in CRF and DBP, TG, and FPG levels were found in females. Conclusion Higher baseline CRF and improved CRF were associated with favorable changes in metabolic indicators.

Estimated Cardiorespiratory Fitness and Metabolic Risks

“…The four-year CHARLS results supported these inverse associations in the oldest Chinese populations studied. Using the Jackson eCRF as the exposure variable, findings indicate that in the total population, older adults with higher baseline eCRF tend to have significantly (p < 0.0001 ) lower (β, 95%CI; -0.037, -0.05--0.03) fasting blood glucose per year [28]. This association was consistent with changes in eCRF over time and in men and women, respectively.…”

“…Their results indicate that in the total population, those with higher baseline eCRF tend to have better arterial pressure, characterized by lower SBP and DBP per year. Those with higher baseline eCRF had significantly (p < 0.0001 ) lower SBP (β, 95%CI; -0.39, -0.52--0.25) and lower DBP (β, 95%CI; -0.19, -0.28--0.10) per year [28]. The annual change in eCFR per year was similar for DBP but not SBP.…”

“…Rather than focusing on incidence, Liu et al conducted a 4-year investigation utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) to examine eCRF and its impact on change in an array of metabolic risk factors, including blood pressure. The population included 4862 (52.6% female) older Chinese adults aged 58.6 (9.4) [28]. Their results indicate that in the total population, those with higher baseline eCRF tend to have better arterial pressure, characterized by lower SBP and DBP per year.…”

“…According to the WHO, elevated blood pressure is the primary metabolic risk factor responsible for the highest number of deaths worldwide, accounting for 19% of global mortality [24]. Since 2020, four epidemiological eCRF studies have examined the association of eCRF with the incidence of hypertension [25][26][27][28]. Cabanas-Sanchez et al conducted a large cohort study to examine the longterm relationship (5.7 ± 4.4 years) between eCRF and key metabolic risk factors for adult cardiovascular disease.…”

“…A dearth of research has been conducted on the association between eCRF and dyslipidemia incidence. From the CHARLS cohort, Liu et al investigated the annual changes in dyslipidemia with eCRF [28]. Their results indicate that older Chinese adults with higher baseline eCRF tend to have better lipid profiles over time.…”