Oxygen-Uptake Efficiency Slope as a Determinant of Fitness in Overweight Adolescents

Rehabilitation Medicine Department, Mark O. Hatfield Clinical Research Center, National Institutes of Health, Bethesda, MD, USA.
Medicine &amp Science in Sports &amp Exercise (Impact Factor: 3.98). 11/2007; 39(10):1811-6. DOI: 10.1249/mss.0b013e31812e52b3
Source: PubMed


Peak oxygen uptake (VO2peak) is frequently difficult to assess in overweight individuals; therefore, submaximal measures that predict VO2peak are proposed as substitutes. Oxygen uptake efficiency slope (OUES) has been suggested as a submaximal measurement of cardiorespiratory fitness that is independent of exercise intensity. There are few data examining its value as a predictor of V O2peak in severely overweight adolescents.
One hundred seven severely overweight (BMI Z 2.50 +/- 0.34) and 43 nonoverweight (BMI Z 0.13 +/- 0.84) adolescents, performed a maximal cycle ergometer test with respiratory gas-exchange measurements. OUES was calculated through three exercise intensities: lactate inflection point (OUES LI), 150% of lactate inflection point (OUES 150), and VO2peak (OUES PEAK).
When adjusted for lean body mass, VO2peak and OUES at all exercise intensities were lower in overweight subjects (VO2peak: 35.3 +/- 6.4 vs 46.8 +/- 7.9 mL.kg(-1) LBM.min(-1), P < 0.001; OUES LI: 37.9 +/- 10.0 vs 43.7 +/- 9.2 mL.kg(-1) LBM.min(-1).logL(-1) P < 0.001; OUES 150: 41.6 +/- 9.0 vs 49.8 +/- 11.1 mL.kg(-1) LBM.min(-1).logL(-1) P < 0.001; and OUES PEAK: 45.1 +/- 8.7 vs 52.8 +/- 9.6 mL.kg(-1) LBM.min(-1).logL(-1) P < 0.001). There was a significant increase in OUES with increasing exercise intensity in both groups (P < 0.001). OUES at all exercise intensities was a significant predictor of VO2peak for both groups (r2 = 0.35-0.83, P < 0.0001). However, limits of agreement for predicted VO2peak relative to actual VO2peak were wide (+/- 478 to +/- 670 mL.min(-1)).
OUES differs significantly in overweight and nonoverweight adolescents. The wide interindividual variation and the exercise intensity dependence of OUES preclude its use in clinical practice as a predictor of VO2peak.

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    • "Since the acidemia of heavy exercise stimulates ventilation , Baba and coworkers (Baba et al. 1996, 1999a, b, 2010; Van Laethem et al. 2005) transformed _ VE from a linear to log scale and found a near-linear relationship for slope of _ VO 2 -vs-log _ VE during an entire exercise period (OUES). They and other investigators, found these OUES measurements useful in evaluating fitness, severity of heart disease (Arena et al. 2010a; Drinkard et al. 2007; Hollenberg and Tager 2000), the effect of physical training or treatment (Van Laethem et al. 2007a, b; Defoor et al. 2006; Gademan et al. 2008; Mourot et al. 2004; Tsuyuki et al. 2003), and for prognosis of serious events or death (Myers et al. 2008; Arena et al. 2007, 2008, 2009, 2010b; Van Laethem et al. 2006; Davies et al. 2006; Kasikcioglu et al. 2009). Others, in evaluating lung and heart diseases, used the OUE value at peak exercise (Kumano et al. 1986; Aquilani et al. 2008; Leyenson et al. 2000; Gomibuchi et al. 1990). "
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    ABSTRACT: The relationship of oxygen uptake [Formula: see text] to ventilation [Formula: see text], i.e., oxygen uptake efficiency (OUE) is known to differ between normal subjects and patients with congestive heart failure. However, only the oxygen uptake efficiency slope (OUES, i.e., slope of [Formula: see text] has previously been reported. To understand the physiology and to improve the usefulness of OUE in assessing cardiovascular function, we analyzed the complete response pattern of OUE during entire incremental exercise tests and ascertained effect of age, body size, gender, fitness, and ergometer type on exercise OUE to generate reference values in normal healthy subjects. We investigated the effect of age, gender, and fitness on OUE using incremental cardiopulmonary exercise in 474 healthy subjects, age 17-78 years, of which 57 were highly fit. The final methods of OUE analysis were: (1) OUE plateau at the highest values (OUEP), (2) OUE at anaerobic threshold (OUE@AT), and (3) OUES using the entire exercise period. The OUEP and OUE@AT were similar, highly reproducible, less variable than the OUES (p < 0.0001), and unaffected by the study sites or types of ergometry. The resultant prediction equations from 417 normal subjects for men were OUEP (mL/L) = 42.18 - 0.189 × years + 0.036 × cm and OUES [L/min/log(L/min)] = -0.610 - 0.032 × years + 0.023 × cm + 0.008 × kg. For women, OUEP (mL/L) = 39.16 - 0.189 × years + 0.036 × cm and OUES [L/min/log(L/min)] = -1.178 - 0.032 × years + 0.023 × cm + 0.008 × kg. OUE@AT was similar to OUEP. Extreme fitness has a minimal effect on OUEP. OUEP is advantageous, since it measures maximal oxygen extraction from ventilated air but does not require high intensity exercise. The OUEP is a non-invasive parameter dependent only on age, gender, height, and cardiovascular health.
    Arbeitsphysiologie 06/2011; 112(3):919-28. DOI:10.1007/s00421-011-2030-0 · 2.19 Impact Factor
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    • "Initially, this index has been clinically applied in healthy subjects and in patients with heart disease [10]. At present, numerous data exists for different pathologies and conditions such as obesity [12], renal deficiency [13], ischemia [14] and hypoxia [15]. The OUES, even if calculated from only part of the test, is always determinable [10], reliable [16] and highly correlated with VO 2peak [10]. "
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    ABSTRACT: The present study investigated the validity and the reliability of the oxygen uptake efficiency slope (OUES) as a determinant of exercise tolerance in adults with cystic fibrosis (CF). 31 CF patients and 34 healthy controls performed a maximal incremental cycle test with respiratory gas-exchange measurements. OUES was calculated from data taken from different percentages of the entire exercise duration, including 80% (OUES(80)) and 100% (OUES(100)). Peak oxygen uptake (VO(2peak)) and gas exchange threshold (GET) were also determined. The agreement between submaximal parameters and VO(2peak) was assessed using Bland Altman plots. Test retest reliability was evaluated in CF patients using absolute (SEM) and relative indices (ICC). On the contrary to the GET, which was undetectable in 16% of the CF patients, the OUES was easily determined in all patients. Among all the submaximal variables, OUES(80) had the best reliability (ICC=0.94, SEM=7.3%) and agreement with VO(2peak) (r(2)=0.83, P<0.01; limits of agreement: ±365mL min(-1)) and did not differ from OUES(100). OUES(80) is a reliable and more useful submaximal parameter than the GET and may find use in the interpretation of exercise studies in CF patients who are unable to perform maximal exercise.
    Journal of cystic fibrosis: official journal of the European Cystic Fibrosis Society 03/2010; 9(5):307-13. DOI:10.1016/j.jcf.2010.03.003 · 3.48 Impact Factor
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    ABSTRACT: AimPhysical inactivity is considered to be a major health burden. Evidence has shown that physically active subjects have more longevity with a significant reduction of morbidity and mortality. Physical exercise prevents or reduces the deleterious effects of pathological conditions, such as arterial hypertension, coronary artery disease, atherosclerosis, diabetes mellitus, osteoporosis, Parkinson’s disease and Alzheimer's disease. Although there is less evidence of benefit for children, some risk factors for diseases in adults are associated with lower levels of physical activity in childhood. It has recently been demonstrated in a cohort of Swedish and Estonian children that cardiovascular fitness is associated with features of metabolic risk factors in children. MethodsThis review provides a brief update on the available new study evidence in children for the role of physical activity and cardiorespiratory fitness in reducing the general cardiovascular risk in adulthood and clarifies the role of the metabolic syndrome (MetS) as a potential risk marker to be included in public health studies investigating cardiorespiratory fitness. ResultsIdentifying factors that influence physical activity in childhood may help to develop better intervention strategies. Recently published studies add further supportive evidence to the body of knowledge suggesting that cardiorespiratory fitness in children is an important health marker and should therefore be included in a pan-European health-monitoring system. ConclusionsCurrently available study evidence reveals close relationships between physical activity and cardiorespiratory fitness in children and underlines cardiorespiratory fitness as an important health marker in childhood.
    Journal of Public Health 06/2008; 16(3):235-243. DOI:10.1007/s10389-008-0190-0 · 2.06 Impact Factor
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