Metabolic syndrome status changes with fitness level change: a retrospective analysis.
ABSTRACT Cardiorespiratory fitness level is inversely related to the incidence of Metabolic Syndrome (MetS). This study examined the effects of changes in cardiorespiratory fitness level on MetS status.
Male and female participants in a health enhancement program (n = 212) were clinically examined for changes in their MetS status and estimated aerobic capacity over a 3-year period. Two physical examinations, each including a maximal treadmill stress test, occurred within this time frame. Participants were divided into three groups: Group 1 (n = 103) was composed of individuals who presented with MetS at exam 1 and reversed their MetS disease status by exam 2; Group 2 (n = 75) members presented with MetS at both exams; and Group 3 (n = 34) individuals were MetS-free at exam 1 but acquired MetS by exam 2. The relationships between MetS clinical characteristics at exam 1 and exam 2 and changes in graded exercise test (GXT) duration were contrasted for the three groups.
GXT duration, estimated aerobic capacity (VO(2) max), and MetS characteristics improved significantly in Group 1 (P < 0.01). Group 2 individuals also increased GXT duration (P < 0.05) but showed only nonsignificant improvements (P > 0.05) in clinical characteristics. Group 3 members declined in most MetS characteristics and in estimated VO(2) max (P < 0.05).
Increases in GXT duration accompanied MetS reversal while declines in GXT duration occurred with MetS acquisition. On an individual basis, these changes in GXT duration may be an indicator of disease status.
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ABSTRACT: This study sought examine the independent and combined associations of changes in fitness and fatness with the subsequent incidence of the cardiovascular disease (CVD) risk factors of hypertension, metabolic syndrome, and hypercholesterolemia. The relative and combined contributions of fitness and fatness to health are controversial, and few studies are available on the associations of changes in fitness and fatness with the development of CVD risk factors. We followed up 3,148 healthy adults who received at least 3 medical examinations. Fitness was determined by using a maximal treadmill test. Fatness was expressed by percent body fat and body mass index. Changes in fitness and fatness between the first and second examinations were categorized into loss, stable, or gain groups. During the 6-year follow-up after the second examination, 752, 426, and 597 adults developed hypertension, metabolic syndrome, and hypercholesterolemia, respectively. Maintaining or improving fitness was associated with lower risk of developing each outcome, whereas increasing fatness was associated with higher risk of developing each outcome, after adjusting for possible confounders and fatness or fitness for each other (all p for trend <0.05). In the joint analyses, the increased risks associated with fat gain appeared to be attenuated, although not completely eliminated, when fitness was maintained or improved. In addition, the increased risks associated with fitness loss were also somewhat attenuated when fatness was reduced. Both maintaining or improving fitness and preventing fat gain are important to reduce the risk of developing CVD risk factors in healthy adults.Journal of the American College of Cardiology 02/2012; 59(7):665-72. · 15.34 Impact Factor
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ABSTRACT: Cardiovascular disease (CVD) is a leading cause of death worldwide, and the number of people at risk is continuously growing. New methods for early risk prediction are therefore needed to actuate prevention strategies before the individuals are diagnosed with CVD. Several studies report that aerobic fitness level, measured as maximal oxygen uptake (VO(2max)), is the single best predictor of future CVD mortality in healthy people. Based on this, we wanted to study differences between healthy individuals with a large difference in VO(2max)-level to identify new biomarkers of low aerobic fitness that may also have potential as early biomarkers of CVD risk. Serum samples from 218 healthy individuals with a low VO(2max) (n = 108, 63 women) or high VO(2max) (n = 110, 64 women) were analysed with MR metabolomics. In addition, standard clinical-chemical analyses for glucose, lipids, liver enzymes, micro-CRP, and colorimetric analysis on circulating choline were performed. Individuals in the low VO(2max)-group had increased serum levels of free choline, decreased phosphatidylcholine, increased glucosę and decreased unsaturated fatty acids compared to the individuals in the high VO(2max)-group. Aerobic fitness dependent differences in serum levels of free choline and phosphatidylcholine are observed. They should be further studied as potential early markers of CVD risk.PLoS ONE 07/2012; 7(7):e42330. · 3.53 Impact Factor
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ABSTRACT: BACKGROUND: Early detection and treatment of the metabolic syndrome may prevent diabetes and cardiovascular disease. Our aim was to assess remission of the metabolic syndrome and its determinants after a population based screening without predefined intervention in the Netherlands. METHODS: In 2006 we detected 406 metabolic syndrome cases (The National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) definition) among apparently healthy individuals with an increased waist circumference. They received usual care in a primary care setting. After three years metabolic syndrome status was re-measured. We evaluated which baseline determinants were independently associated with remission. RESULTS: The remission rate among the 194 participants was 53%. Baseline determinants independently associated with a remission were the presence of more than three metabolic syndrome components (OR 0.46) and higher levels of waist circumference (OR 0.91), blood pressure (OR 0.98) and fasting glucose (OR 0.60). CONCLUSIONS: In a population with screen-detected metabolic syndrome receiving usual care, more than half of the participants achieved a remission after three years. This positive result after a relatively simple strategy provides a solid basis for a nation-wide implementation. Not so much socio-demographic variables but a higher number and level of the metabolic syndrome components were predictors of a lower chance of remission. In such cases, primary care physicians should be extra alert.BMC Public Health 09/2012; 12(1):778. · 2.32 Impact Factor