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Silveira JFDC, Brand C, Welser L, Gaya AR, Burns RD, Pfeiffer KA, Lima RA, Andersen LB, Reuter CP, Pohl HH. The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis. Pediatr Exerc Sci 2024; 36:75-82. [PMID: 37591502 DOI: 10.1123/pes.2022-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. METHOD Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. RESULTS BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (-0.036; 95% confidence interval, -0.070 to -0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. CONCLUSIONS BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI.
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Affiliation(s)
- João Francisco de Castro Silveira
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
- Graduate Program in Human Movement Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS,Brazil
| | - Caroline Brand
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso,Chile
| | - Letícia Welser
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
| | - Anelise Reis Gaya
- Graduate Program in Human Movement Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS,Brazil
| | - Ryan Donald Burns
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT,USA
| | - Karin Allor Pfeiffer
- Department of Kinesiology, Michigan State University (MSU), East Lansing, MI,USA
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona,Spain
- Research Group on Lifestyles and Health, University of Pernambuco, Recife, PE,Brazil
| | - Lars Bo Andersen
- Faculty of Education, Arts and Sport, Western Norway University of Applied Sciences, Songdal,Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo,Norway
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
- Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
| | - Hildegard Hedwig Pohl
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
- Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS,Brazil
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Rodríguez-Gutiérrez E, Torres-Costoso A, Lucas-de la Cruz L, Mesas AE, Martínez-Vizcaíno V, Díez-Fernández A. The impact of reduced muscular fitness on cardiometabolic risk factors in children aged 9-11 years. Acta Paediatr 2024. [PMID: 38403778 DOI: 10.1111/apa.17178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 02/27/2024]
Abstract
AIM To analyse the relationships between muscular fitness (MF), fat mass (FM), fat-free mass (FFM) and its combined ratio with cardiometabolic risk (CMR) and whether the relationship between MF and CMR is mediated by body composition in schoolchildren. METHODS A cross-sectional study was conducted on schoolchildren from Cuenca, Spain, between September and November 2017. FM and FFM were estimated using bioimpedance analysis. The CMR index was calculated from triglycerides-HDL-c ratio, arterial pressure and fasting insulin. The MF index was assessed using handgrip and standing long jump tests. Analysis of covariance models assessed CMR index differences across the MF index and the FM/FFM ratio categories. Mediation analysis examined whether the MF index and the CMR index association were mediated by FM, FFM or FM/FFM ratio. RESULTS The analyses involved 485 schoolchildren aged 9-11 years (55.4% girls). Children with a higher MF index had a lower CMR index (p < 0.05). This association did not persist after controlling for FM/FFM. FM, FFM and FM/FFM ratio mediated the relationship between the MF index and the CMR index. CONCLUSION Better levels of MF are associated with better cardiometabolic profile, but a healthy body composition is determinant to improve future health.
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Affiliation(s)
- Eva Rodríguez-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Lidia Lucas-de la Cruz
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Arthur E Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| | - Ana Díez-Fernández
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
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Glucose Levels as a Mediator of the Detrimental Effect of Abdominal Obesity on Relative Handgrip Strength in Older Adults. J Clin Med 2020; 9:jcm9082323. [PMID: 32707776 PMCID: PMC7464715 DOI: 10.3390/jcm9082323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022] Open
Abstract
Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (β = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (β = −0.003, 95%CI = −0.005 to −0.001), p < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (β = −0.069, 95%CI = −0.082 to −0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect β = −0.002, 95%CI = −0.004 to −0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass.
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Brand C, Sehn AP, Gaya AR, Mota J, Brazo-Sayavera J, Renner JD, Reuter CP. Physical fitness as a moderator in the relationship between adiposity and cardiometabolic risk factors in children and adolescents. J Sports Med Phys Fitness 2020; 60:1567-1575. [PMID: 32614155 DOI: 10.23736/s0022-4707.20.11130-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The aim of this study was to verify the moderator role of physical fitness in the relationship between adiposity and cardiometabolic risk factors in normal weight and overweight/obese children and adolescents. METHODS Cross-sectional study comprising 2482 children and adolescents, aged 7-17 years. Physical fitness was evaluated according the procedures of Projeto Esporte Brazil, and waist circumference (WC) with an inelastic tape. Cardiometabolic risk score was defined by the z-score sum of glucose, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. Moderation analysis was done through linear regression models. RESULTS Significant interaction term for cardiorespiratory fitness (CRF)×WC with cardiometabolic risk factors (P<0.001), as well as for lower limbs strength (LLS)×WC (P<0.001) and agility × WC (P=0.01) in normal weight girls. For normal weight boys it was found a significant interaction term for CRF×WC with cardiometabolic risk factor (P=0.007), and also for agility × WC (P=0.003), while overweight/obese boys showed a significant interaction term only for agility × WC with cardiometabolic risk factor (P=0.001). CONCLUSIONS CRF, LLS and agility are moderators in the relationship between WC and cardiometabolic risk factors in normal weight girls, while CRF and agility were moderators for normal weight boys and only agility for overweight/obese boys.
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Affiliation(s)
- Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil -
| | - Ana P Sehn
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
| | - Anelise R Gaya
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jorge Mota
- Faculty of Sport, University of Porto, Porto, Portugal
| | - Javier Brazo-Sayavera
- Polo de Desarrollo Universitario EFISAL, Centro Universitario Regional Noreste, University of the Republic, Rivera, Uruguay
| | - Jane D Renner
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
| | - Cézane P Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
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