Kullo IJ, Khaleghi M, Hensrud DD. Markers of inflammation are inversely associated with V O2 max in asymptomatic men. J Appl Physiol 102: 1374 -1379, 2007. First published December 14, 2006; doi:10.1152/japplphysiol.01028.2006.-We investigated whether markers of inflammation, including a cytokine (IL-6), acute-phase reactants [C-reactive protein (CRP) and fibrinogen], and white blood cell (WBC) count are associated with maximal O 2 consumption (V O2 max) in men without coronary heart disease (CHD). In asymptomatic men (n ϭ 172, 51 Ϯ 9.3 yr old), V O2 max was measured during a symptom-limited graded treadmill exercise test. Physical activity level was assessed by a standardized questionnaire. IL-6 and CRP were measured by immunoassays, fibrinogen by the Clauss method, and WBC count with a Coulter counter. IL-6 and CRP were logarithmically transformed to reduce skewness. Multivariable regression was used to assess whether markers of inflammation were associated with V O2 max after adjustment for age, body mass index, CHD risk factors, and lifestyle variables (physical activity level, percent body fat, and alcohol intake). V O2 max was 34.5 ml ⅐ kg Ϫ1 ⅐ min Ϫ1 (SD 6.1). Log IL-6 (r ϭ Ϫ0.38, P Ͻ 0.001), log CRP (r ϭ Ϫ0.40, P Ͻ 0.001), fibrinogen (r ϭ Ϫ0.42, P Ͻ 0.001), and WBC count (r ϭ Ϫ0.22, P ϭ 0.004) were each correlated with V O2 max. In separate multivariable linear regression models that adjusted for age, body mass index, CHD risk factors, and lifestyle variables, log IL-6 [-coeff ϭ Ϫ1.66 Ϯ 0.63 (SE), P ϭ 0.010], log CRP [-coeff ϭ Ϫ0.99 Ϯ 0.33 (SE), P ϭ 0.003], fibrinogen [-coeff ϭ Ϫ1.51 Ϯ 0.44 (SE), P ϭ 0.001], and WBC count [-coeff ϭ Ϫ0.52 Ϯ 0.30 (SE), P ϭ 0.088] were each inversely associated with V O2 max. In conclusion, higher circulating levels of IL-6, CRP, and fibrinogen are independently associated with lower V O2 max in asymptomatic men.fitness; interleukin-6; C-reactive protein; fibrinogen SEVERAL PROSPECTIVE STUDIES have shown greater cardiorespiratory fitness to be associated with a lower risk of coronary heart disease (CHD) in asymptomatic individuals (3,4,13,19,31,33). The association is independent of measures of adiposity, and a potential underlying mechanism may be that greater cardiorespiratory fitness reduces systemic inflammation (51). Atherosclerosis is recognized as a chronic inflammatory disorder, and activation of inflammatory pathways is a key event in the initiation as well as progression of atherosclerotic vascular disease (42).Prior studies have shown acute-phase reactants, such as C-reactive protein (CRP) and fibrinogen, and white blood cell (WBC) count to be inversely related to cardiorespiratory fitness (6,7,21,22,38,54). Whether more "proximal" mediators in the inflammatory cascade, such as the cytokines, are similarly associated with cardiorespiratory fitness is not known. Furthermore, previous studies of inflammation and cardiorespiratory fitness used treadmill time, rather than a direct measure of cardiorespiratory fitness, i.e., maximal O 2 consumption (V O 2 max ). ...