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The current standard measure of cardiorespiratory fitness introduces confounding by body mass : the DR's EXTRA study
- Savonen, K (author)
-
- Krachler, Benno (author)
- Umeå universitet,Yrkes- och miljömedicin
- Hassinen, M (author)
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- Komulainen, P (author)
- Kiviniemi, V (author)
- Lakka, T A (author)
- Rauramaa, R (author)
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- (creator_code:org_t)
- 2011-11-22
- 2012
- English.
- In: International Journal of Obesity. - London : Nature Publishing Group. - 0307-0565 .- 1476-5497. ; 36:8, s. 1135-1140
- Journal article (peer-reviewed)
Abstract
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- OBJECTIVE:Cardiorespiratory fitness is currently estimated by dividing maximal oxygen consumption (VO(2max)) by body weight (per-weight standard). However, the statistically correct way to neutralize the effect of weight on VO(2max) 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 kg m(-2)) and 638 women (BMI: 16-49 kg m(-2)) aged 57-78 years who performed oral glucose tolerance tests and maximal exercise stress tests with direct measurement of VO(2max). We compare the increase in VO(2max) implied by the per-weight standard with the real increase of VO(2max) 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 VO(2max) 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.International Journal of Obesity advance online publication, 22 November 2011; doi:10.1038/ijo.2011.212.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)
Keyword
- abnormal glucose metabolism
- body mass
- cardiorespiratory fitness
- maximal oxygen uptake
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- ref (subject category)
- art (subject category)
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- Savonen, K
- Krachler, Benno
- Hassinen, M
- Komulainen, P
- Kiviniemi, V
- Lakka, T A
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- Rauramaa, R
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