The association of cardiorespiratory fitness with cardiometabolic factors, markers of inflammation, and endothelial dysfunction in Latino youth: findings from the Hispanic Community Children's Health Study/Study of Latino Youth

Adiponectin concentration and cardiometabolic risk factors: the moderator role of cardiorespiratory fitness in adolescents

The aim of this study was to examine the moderating role of cardiorespiratory fitness (CRF) between the relationship of cardiometabolic risk factors and adiponectin in adolescents. This is a cross-sectional study conducted with 255 adolescents of both sexes, aged 11 to 17 years. Anthropometric and biochemical parameters such as body mass, height, fat mass (FM), fat-free mass, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, adiponectin, systolic blood pressure, diastolic blood pressure, and peak oxygen consumption (VO2peak) were measured. Body mass index z-score (BMI-z), tri-ponderal mass index (TMI), homeostasis model assessment insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and age peak height velocity were calculated. The moderation analyses were tested using linear regression models. Interaction was observed with low CRF, indicating that those who achieved more than 2.27 (BMI-z), 2.18 (TMI), 2.10 (FM), 2.57 (insulin), 2.65 (HOMA-IR), and 2.81 (QUICKI) in L·min-1 on the CRF test may experience reduced risks in cardiometabolic risk factors.

CONCLUSION

The deleterious effects attributed to excess adiposity and unfavorable changes related to insulin resistance and sensitivity may be attenuated by CRF.

WHAT IS KNOWN

• Adiponectin, a protein derived from adipose tissue, may play a role as a potential marker of protection and predictor of cardiometabolic disorders and its relationship with cardiorespiratory fitness is controversial.

WHAT IS NEW

• The deleterious effects attributed to overweight and unfavorable changes related to insulin resistance and sensitivity may be attenuated by high cardiorespiratory fitness in adolescents.

Exercise Is a Vital Sign

Description In this review, we argue that exercise (physical activity) be monitored as a vital sign since no other basic sign or symptom provides as much information about a patient's health status. The influence of regular exercise on patient health is indisputable, with strong evidence to show the power of exercise to mitigate chronic disease and improve overall health. Several simple tools, such as Physical Activity as a Vital Sign and Exercise as a Vital Sign are available to assess patient physical activity. When properly applied, there is evidence to support the efficacy of these tools, but there are barriers that prevent broad inclusion in primary care, among which are time and provider knowledge. In our review, we also discussed the value of physician-led lifestyle discussions with patients and found they view these discussions favorably. There is also evidence that physicians who exercise are more likely to have these lifestyle discussions with their patients, but the proportion of physicians who exercise regularly is fairly low. We believe physicians' awareness of their patients' sedentary lifestyles should prompt a prescription to increase physical activity, but additional in-clinic support and community resources need to be in place for patients to get a regular dose.

A Coordinated School Health Program Effect on Cardiorespiratory Fitness of South Texas Preschool Children: A Cluster Randomized Trial

BACKGROUND

The purpose of this study was to assess the effects of the Bienestar/NEEMA Coordinated School Health Program (BN CSHP) on cardiorespiratory fitness (CRF) of preschool children.

METHODS

A cluster randomized trial was conducted of preschools in South Texas. Of 48 eligible schools, 28 were randomly assigned (14 intervention, 14 control). Family demographics and household health characteristics were collected from parents and CRF from children. Generalized linear mixed model (GLMM) was used to analyze the data.

RESULTS

Family demographics, household health characteristics, and children's weight, obesity prevalence, and sedentary activity of the control group were similar to the intervention group at baseline. After adjusting for covariates, the number of laps ran by children in the control group increased by 23% (CI: -5% to 60%) per each data collection period compared with 53% (CI: 7% to 119%) in the intervention group.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

State mandates, parent engagement, and funding are key for designing effective health and Physical Education (PE) programs.

CONCLUSION

Children in the BN CSHP, compared to those in the control group, had a significantly higher increase in their CRF. This finding is important because of the health benefits of CRF in children.

CLINICALTRIALS

gov Identifier: NCT05501392.

Lower adiponectin is associated with higher anthropometry and insulin resistance but not with low cardiorespiratory fitness in adolescents

PURPOSE

The aim of this study was to analyze the relationship between adiposity, cardiometabolic risk and cardiorespiratory fitness (CRF) according to different groups of adiponectin concentration.

METHODS

255 adolescents of both sexes, aged 11-17 years old, participated. Anthropometric and biochemical parameters such as body mass, height, abdominal circumference (AC), waist circumference (WC), fat mass, fat-free mass, total cholesterol (TC), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglycerides (TG), glucose, insulin, adiponectin, blood pressure, peak oxygen consumption (VO2peak) were measured. Body mass index (BMI), z-score BMI (BMI-z), triponderal mass index (TMI), waist-to-height ratio (WHtR), homeostasis model to assessment insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were calculated. Adiponectin was categorized: low adiponectin concentration (LAC  ≤ 5.18 µg/mL-1), intermediate (IAC = 5.18 and 7.63 µg/mL-1) and high (HAC ≥ 7.63 µg/ml-1).

RESULTS

LAC showed higher BMI, BMI-z and TMI than the other groups (p < 0.05) and higher AC, WC and WHtR that the HAC (p < 0.05). IAC showed lower values of TC, LDL-c and TG, and the LAC presented the highest values of insulin, HOMA-IR and QUICKI (p < 0.05) to the IAC and HAC. HAC presented the lower VO2peak than the other groups (p < 0.01). BMI, TMI, glucose, insulin, HOMA-IR showed inverse, and QUICKI a direct and weak correlation with adiponectin (p < 0.05). No significant association was found between adiponectin and VO2peak (p > 0.05).

CONCLUSION

The LAC group had higher means in the anthropometric variables and the worst results related to insulin resistance and sensitivity. Thus, adiponectin may play an important role in obesity and reduced concentration may be a factor in the development of obesity-associated morbidities.

Cross-sectional associations between physical fitness and biomarkers of inflammation in children-The PANIC study

BACKGROUND

Systemic low-grade inflammation has been proposed as an underlying pathophysiological mechanism for cardiometabolic diseases. We investigated the associations of physical fitness with a systemic low-grade inflammatory state in a population sample of children.

METHODS

Altogether 391 children aged 6-9 years were examined. Cardiorespiratory fitness (maximal power output, W_max ) was assessed by a maximal cycle ergometer test and neuromuscular fitness by hand grip strength, sit-up, standing long jump, 50-meter shuttle run, static balance, sit-and-reach, and box and block tests. Body fat percentage (BF%) and lean mass (LM) were assessed by dual-energy X-ray absorptiometry (DXA). High sensitivity C-reactive protein (hs-CRP), leptin, leptin receptor, high molecular weight adiponectin (HMW-adiponectin), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and glycoprotein acetyls (GlycA) were assessed from fasting blood samples. The modified inflammatory score (IS) was calculated using the population-specific z-scores and formula (^z hs-CRP + ^z leptin + ^z IL-6 + ^z TNF-α + ^z GlycA)-^z leptin receptor-^z HMW-adiponectin. The data were analyzed using linear regression analyses.

RESULTS

Higher W_max /kg of body mass (β = -0.416, 95% CI = -0.514 to -0.318), higher number of completed sit-ups (β = -0.147, 95% CI = -0.244 to -0.049), a longer distance jumped in the standing long jump test (β = -0.270, 95% CI = -0.371 to -0.169), and a shorter time in the 50-meter shuttle run test (β = 0.123, 95% CI = 0.022 to 0.223) were associated with lower IS. None of these associations remained statistically significant after adjustment for BF%.

CONCLUSIONS

Higher physical fitness is associated with a more favorable inflammatory biomarker profile in children. However, the associations were explained by BF%.

The obesity paradox: Retinopathy, obesity, and circulating risk markers in youth with type 2 diabetes in the TODAY Study

AIM

To understand the relationship of obesity and 27 circulating inflammatory biomarkers to the prevalence of non-proliferative diabetic retinopathy (NPDR) in youth with type 2 diabetes.

METHODS

Youth with type 2 diabetes who participated in the TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) study were followed for 2-6.5 years. Digital fundus photographs were obtained in the last year of the study. Blood samples during the study were processed for inflammatory biomarkers, and these were correlated with obesity tertiles and presence of retinopathy.

RESULTS

Higher BMI was associated with an increase in circulating levels of metabolic biomarkers including high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor 1 (PAI-1), fibrinogen, LDL-cholesterol (LDL-C) and Apolipoprotein B (ApoB), tumor necrosis factor receptors 1 and 2 (TNFR-1 and -2), interleukin 6 (IL-6), E-selectin, and homocysteine, as well as a decrease in the metabolic risk markers HDL-cholesterol (HDLC), and insulin-like growth factor binding protein 1 (IGFBP-1). Although NPDR risk decreased with increasing obesity, it was not associated with any of the measured biomarkers.

CONCLUSIONS

Circulating levels of measured biomarkers did not elucidate the "obesity paradox" of decreased NPDR in the most obese participants in the TODAY study.

TRIAL REGISTRATION

clinicaltrials.govNCT00081328.

Cardiorespiratory Fitness: Reference on the Six-Minute Walk Test and Oxygen Consumption in Adolescents from South-Central Chile

Cardiorespiratory fitness (CRF) provides oxygen to the exercising muscles and is related to body adiposity, with cardiometabolic variables. The aim was to develop reference values and a predictive model of CRF in Chilean adolescents. A total of 741 adolescents of both genders (15.7 years old) participated in a basic anthropometry, performance in the six-minute walk test (SMWT), and in Course Navette was measured. Percentiles were determined for the SMWT, for the V̇O₂max, and an equation was developed to estimate it. The validity of the equation was checked using distribution assumptions and the Bland–Altman diagram. The STATA v.14 program was used (p < 0.05). The 50th percentile values for males and females in the SMWT and in the V̇O₂max of Course Navette were, respectively, from 607 to 690 and from 630 to 641 m, and from 43.9 to 45 and from 37.5 to 31.5 mlO₂·kg·min⁻¹, for the range of 13 to 17 years. For its part, the model to predict V̇O₂max incorporated gender, heart rate, height, waist-to-height ratio (WHR), and distance in the SMWT (R² = 0.62; estimation error = 0.38 LO₂·min⁻¹; p <0.001). Reference values can guide physical fitness in Chilean adolescents, and V̇O₂max was possible to predict from morphofunctional variables.