Does Cardiorespiratory Fitness Attenuate the Adverse Effects of Severe/Morbid Obesity on Cardiometabolic Risk and Insulin Resistance in Children? A Pooled Analysis

Background:The influence of higher physical activity on the relationship between adiposity and cardiometabolic risk is not completely understood.Methods:Between 2000–2002, data were collected on 6795 Multi-Ethnic Study of Atherosclerosis (MESA) participants. Self-reported intentional physical activity in the lowest quartile (0–105 MET-minutes/week) was categorized as inactive and the upper three quartiles (123–37,260 MET-minutes/week) as active. Associations of body mass index (BMI) and waist circumference categories, stratified by physical activity status (inactive or active) with cardiometabolic risk factors (dyslipidemia, hypertension, upper quartile of homeostasis model assessment of insulin resistance [HOMA-IR] for population, and impaired fasting glucose or diabetes) were assessed using logistic regression analysis adjusting for age, gender, race/ethnicity, and current smoking.Results:Among obese participants, those who were physically active had reduced odds of insulin resistance (47% lower; P < .001) and impaired fasting glucose/diabetes (23% lower; P = .04). These associations were weaker for central obesity. However, among participants with a normal waist circumference, those who were inactive were 63% more likely to have insulin resistance (OR [95% CI] 1.63 [1.24–2.15]) compared with the active reference group.Conclusions:Physical activity was inversely related to the cardiometabolic risk associated with obesity and central obesity.

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Functional high-intensity exercise training ameliorates insulin resistance and cardiometabolic risk factors in type 2 diabetes

Experimental Physiology ◽

10.1113/ep086844 ◽

2018 ◽

Vol 103 (7) ◽

pp. 985-994 ◽

Cited By ~ 14

Author(s):

Ciarán E. Fealy ◽

Stephan Nieuwoudt ◽

Julie A. Foucher ◽

Amanda R. Scelsi ◽

Steven K. Malin ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Exercise Training ◽

High Intensity ◽

Cardiometabolic Risk ◽

High Intensity Exercise ◽

Cardiometabolic Risk Factors

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Abstract P115: Cardiorespiratory Fitness Level is Associated with Metabolic Risk in an Asymptomatic Population

Circulation ◽

10.1161/circ.133.suppl_1.p115 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Ebenezer T Oni ◽

Michael J Blaha ◽

Seth S Martin ◽

Arthur S Agatston ◽

Roger S Blumenthal ◽

...

Keyword(s):

Cardiorespiratory Fitness ◽

Cardiometabolic Risk ◽

Activity Level ◽

Metabolic Risk ◽

Metabolic Equivalent ◽

Fitness Level ◽

Fatty Liver Index ◽

Asymptomatic Individuals ◽

Health Screen ◽

Improve Health

Background: Cardiorespiratory fitness (CRF) is a measure of habitual physical activity level of an individual. We evaluate the association between CRF and measures of metabolic risk: Fatty Liver Index (FLI) and Lipid Accumulation Product (LAP). Methods: This study evaluated 3,154 asymptomatic Brazilian subjects (43±10 years, 80% males) who had metabolic equivalent (METS) measured during routine health screen between November 2008 and July 2010. Both FLI and LAP were calculated from standardized algorithms. Results: The prevalence of METS attained were classified into 3; category 1: METS ≤ 12 (44%, n=1,377), category 2 METS >12 & <14 (33%, n=1050) and category 3: METS ≥ 14 (23%, n=727). There was a steady decrease in both median FLI and LAP with higher CRF categories, Figure 1. A logistic regression analysis showed that higher fitness level was associated with lower LAP and FLI levels, see table 1. Conclusions: Higher CRF level is associated with reduced cardiometabolic risk among asymptomatic individuals. This re-emphasis the importance of promoting increasing fitness level to improve health.

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Abstract P148: Neck Circumference as an Independent Contributor to Cardio Metabolic Risk Factors - ELSA BRASIL

Circulation ◽

10.1161/circ.131.suppl_1.p148 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Cristina P Baena ◽

Paulo A Lotufo ◽

Maria J Fonseca ◽

Isabela J Benseñor

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Blood Pressure ◽

Primary Care ◽

Cardiometabolic Risk ◽

Neck Circumference ◽

Cardiometabolic Risk Factors ◽

Metabolic Risk ◽

Men And Women ◽

Low Hdl

Background: Neck circumference is a proxy for upper body fat and it is a simple anthropometric measure. Therefore it could be a useful tool to identify individuals with cardiometabolic risk factors in the context of primary care. Hypothesis: Neck circumference is independently associated to cardiometabolic risk factors in an apparently healthy population. Methods: This is a cross-sectional analysis of baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort of 15105 civil servants aged 35-74 years. We excluded from this analysis those who fulfilled American Diabetes Association criteria for diabetes diagnosis, were taking antihypertensive and/or lipid-lowering drugs. A sex-specific analysis was conducted. Partial correlation (age-adjusted) was used. Risk factors were set as low HDL<50mg/dL for women and <40mg/dL for men, hypertriglyceridemia ≥ 150 mg/dl , hypertension as systolic blood pressure ≥130 mg/dl or diastolic blood pressure ≥85 mm Hg and insulin resistance(HOMA-IR ≥ 75th percentile). Logistic regression models were built to analyze the association between individual and clustered risk factors as dependent variables and 1-SD increase in neck circumference as independent variable. Multiple adjustments were subsequently performed for age, smoking, alcohol, body-mass index, waist and physical activity. Receiver Operating Curves were employed to find the best NC cut-off points for clustered risk factors. Results: We analyzed 3810 men (mean age= 49.0 ±8.3 yrs) and 4916 women (49.2 ±8.0 yrs). Mean NC was 38.9 (±2.6)cm for men and 33.4(±2.6)cm for women. NC positively correlated with systolic and diastolic blood pressure (r=0.21 and r=0.27), HOMA - IR (r=0.44), triglycerides (r=0.31) and negatively correlated with HDL (r= -0.21) in men (p<0.001 for all) with similar results in women. Fully adjusted Odds Ratio (OR) (95% CI) of risk factor per SD increase in neck circumference in men and women were 1.29(1.14;1.46) and 1.42(1.28;1.57) for insulin resistance; 1.24(1.11;1.39) and 1.25(1.11;1.40) for hypertension; 1.33(1.19;1.49) and 1.42(1.29;1.63) for hypertriglyceridemia; 1.07(0.92;1.23) and 1.32 (1.19;1.43) for low HDL. Fully adjusted OR (95% CI) of 2 clustered risk factor per SD increase in neck circumference in men and women were 1.29(1.14;1.48) and 1.37(1.21;1.54 ). Fully adjusted OR (95% CI) of 3 or more clustered risk factors per SD increase in neck circumference in men and women were 1.33 (1.02;1.74) and 1.62 (1.33;1.92). Values of neck circumference of >40 cm for men and >34.1 cm for women were the best cut-off points for 3 or more clustered risk factors. Conclusion: Neck circumference is significantly and independently associated to cardiometabolic risk factors in a well-defined non-treated population. It should be considered as a marker of cardio metabolic risk factors in primary care settings.

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CARDIORESPIRATORY FITNESS AND CARDIOMETABOLIC RISK FACTORS AMONG UNIVERSITY PROFESSORS

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220182402171631 ◽

2018 ◽

Vol 24 (2) ◽

pp. 102-106

Author(s):

Jaqueline de Oliveira Santana ◽

Juliana Vaz de Melo Mambrini ◽

Sérgio Viana Peixoto

Keyword(s):

Risk Factors ◽

Cardiorespiratory Fitness ◽

Cardiometabolic Risk ◽

Strong Association ◽

Protein Body ◽

Hdl Cholesterol ◽

Work Capacity ◽

Cardiometabolic Risk Factors ◽

Level Of Evidence ◽

Cross Sectional

ABSTRACT Introduction: Cardiorespiratory fitness (CF) is associated with mortality and the development of cardiovascular disease, in addition to being related to work capacity. Objectives: This study aimed to verify the demographic, cardiometabolic and behavioral factors associated with CF in a representative sample of professors from a public university in Minas Gerais, Brazil. Methods: This is a cross-sectional study which evaluated, in addition to the CF, age, sex, glycemia, triglycerides, LDL and HDL cholesterol, C-reactive protein, body mass index (BMI), waist circumference, and physical activity (PA). The association between CF and cardiometabolic risk factors was estimated by logistic regression to obtain the odds ratios and respective confidence intervals (95%). Results: After adjustment, it was observed that professors with lower levels of CF were older, female, had higher BMI and a greater chance of being physically inactive. Conclusion: In general, the results show that the probability of low CF increases with the increase in BMI, in addition to the strong association with PA practice, which is a major focus of intervention measures aimed at improving workers health and their work capacity. Level of Evidence III; Case control study.

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Cardiovascular events in patients with type 2 diabetes

The British Journal of Diabetes ◽

10.1177/1474651402002001s0201 ◽

2002 ◽

Vol 2 (1_suppl) ◽

pp. S4-S8

Author(s):

Erland Erdmann

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Risk Factor ◽

Adverse Effects ◽

Cardiovascular Events ◽

Left Ventricular ◽

Diabetic Patients ◽

Increased Risk

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

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