| Purposes To study the the relationship between fitness indexes and 10-year risk of ischemic cardiovascular diseases(ICVD,including coronary heart disease and stroke),metabolic syndrome,atherosclerosis,hypertension,hyperglycemia and hyperlipidemia in Chinese adults.And then explore the evaluation method and the standard value of the application in physical fitness based on the association of disease risk for providing a reference to health promotion and prevention.Methods Common residents aged 40 to 59 in Tai Zhou city,Jiangsu province were surveyed with the method of stratified and cluster sampling.Of the 1123 participants,513 were females,610 were males.Physical fitness tests included body mass index,percent body fat,cardiorespiratory fitness,handgrip strength(handgrip strength/body mass),body flexion,single foot stand,reaction time.We used the procedure of YMCA recommended by ACSM to test cardiorespiratory fitness by a cycle ergometer and the method of bioelectrical impedance analysis to measure body fat.All objects were measured diseased indexes including blood pressure,blood cholesterol,blood glucose and pulse wave velocity / ankle-brachial index(PWV/ABI)to assess the risk of 10-year risk of ICVD,metabolic syndrome,atherosclerosis,hypertension,hyperglycemia and hyperlipidemia.Statistical methods: According to the prediction model of risk of ICVD in Chinese,we calculated risk score and evaluated the 10-year risk of ICVD for the objects.This study included correlation analysis and multivariate logistic regression testing between physical fitness indexes and risk of related diseases with adjusting traditional cardiovascular risk factors and physical fitness factors;According to the sensitivity,specificity and receiver operative characteristic(ROC)curve to predict 10-year risk of ICVD(clustering of risk factors),physical fitness indexes at the value with best sensitivity and specificity for identification of the risk of cardiovascular disease was recommended as the cut-off point for standard value.We analyze and verify the application value of BMI,body fat rate and muscle strength indexes by comparing the predictive value for identifying 10-year risk of ICVD,metabolic syndrome,atherosclerosis,hypertension,hyperglycemia and hyperlipidemia.Results(1)Cardiorespiratory fitness showed negative correlation between body mass index and percent body fat,the correlation coefficient were-0.285-0.257,-0.275--0.244.(P<0.01).Cardiorespiratory fitness did not showed correlation between reaction time,women body flexion,women single foot stand.(P>0.05)Handgrip strength did not showed correlation with cardiorespiratory fitness,however,handgrip strength/body mass showed positive correlation with cardiorespiratory fitness for men.(P<0.01)(2)Cardiorespiratory fitness and 10-year risk of ischemic cardiovascular diseases showed negative correlation.The correlation coefficient were-0.310 for men and-0.277 for women(P<0.01).Body mass index and percent body fat showed positive correlation to the score of 10-year risk of ICVD.The correlation coefficient were 0.316-0.578(P<0.01).Meanwhile the prevalence of 10-year risk of ICVD,metabolic syndrome,atherosclerosis,hypertension,hyperglycemia and hyperlipidemia has showed significant differences among low,medium and high cardiorespiratory fitness,percent body fat and handgrip strength/body mass groups(P<0.01).(3)Multivariate logistic regression testing adjusted gender,age,smoking history,exercise history,high blood pressure showed that cardiorespiratory fitness,percent body fat and handgrip strength/body mass,as a continuous variable,each unit addition respectively equal the odds ratio value 0.880(95%CI:0.848-0.956),1.082(95%CI:1.039-1.132),0.961(95%CI:0.948-0.985)to predict high 10-year risk of ICVD(P<0.01).(4)According to the sensitivity,specificity and receiver operative characteristic(ROC)curve to predict 10-year risk of ICVD,cardiorespiratory fitness at 8.8MET(age for 40-49 years),8.55MET(age to 50-59 years)for men and 7.5MET(age to 40-49 years),7.05MET(age to 50-59 years)for women;percent body fat at 25.5%(age to 40-49 years),25.45%(age to 50-59 years)for men and 34.65%(age to 40-49 years),36.15%(age to 50-59 years)for women;handgrip strength/body mass at 60.5(age to 40-49 years),57.5(age to 50-59 years)for men and 44(age to 40-49 years),41.5(age to 50-59 years)for women were recommended as the cut-off points.(5)The odds ratio of unqualified group for 10-year risk of ICVD,hypertension and arteriosclerosis were 1.58-2.1,1.36-2.07 and 1.27-1.68 respectively.Analysis of population attributable risk percent(PAR%)illustrated that changing the indexes of cardiorespiratory fitness,percent body fat and handgrip strength/body mass to normal range could respectively prevent 16.7%-33.1%,31.6%-34.0%,12.7%-24.3% high 10-year risk of ICVD,11.1%-32.2%,24.2%-28.5%,11.3%-18.1% hypertension and 8.5%-22.7%,26.3%-34.1%,5.8%-25.8% arteriosclerosis.(6)Predictive value of BMI to diagnose obesity(defined by percent body fat)are respectively 0.932(for WHO),0.881(for ASBP)in women and 0.840 in men by nonparametric tests,P<0.01.According to ROC curves we got the adjusted cut-off points of BMI are respectively 25.95 kg/m2 in men and 25.25 kg/m2 in women for WHO criteria or 25.95 kg/m2 in men and 23.05 kg/m2 in women for ASBP criteria,while the specificity of predicting obesity decreased from 96%-99% to 78%-86%,but the sensitivity significant increased from 18%-42% to 73%-87%.As a result,WHO criteria showed higher sensitivity and specificity to diagnose obesity in Chinese adults.(7)Areas under ROC curves showed that both BMI and percent body fat can effectively predict the risk of 10-year risk of ICVD,metabolic syndrome,atherosclerosis,hypertension,hyperglycemia and hyperlipidemia,P<0.01.There is almost no statistical difference between BMI and percent body fat.(8)Handgrip strength did not showed correlation with systolic blood pressure,diastolic blood pressure,fasting blood glucose,total cholesterol,triglycerides(P>0.05), however,handgrip strength/body mass had negative correlation with Systolic blood pressure,diastolic blood pressure,male fasting blood glucose,triglyceride,pulse wave velocity and can effectively predict the risk of 10-year risk of ICVD,metabolic syndrome,female atherosclerosis,male hypertension,male hyperlipidemia,(P<0.01).Conclusion(1)Physical fitness indexes such as cardiorespiratory fitness,percent body fat,handgrip strength/body mass and 10-year risk of ischemic cardiovascular diseases showed correlation.The lower cardiorespiratory fitness,muscle strength indicated the higher risk of cardiovascular disease.On the contrary,The lower percent body fat showed the lower risk of cardiovascular disease.(2)Low cardiorespiratory fitness,muscle strength,high percent body fat are independent risk factors for 10-year risk of ischemic cardiovascular diseases.Each nuit additional of cardiorespiratory fitness,handgrip strength/body mass is equal to prevent 12%,3.9% 10-year risk of ischemic cardiovascular diseases while 1% additional of percent body fat showed increase of 8.2% 10-year risk of ischemic cardiovascular diseases.(3)The optimal cut-off points of cardiorespiratory fitness,percent body fat,handgrip strength/body mass are respectively 8.75 Mets,25.5,59 to men and 7.30 Mets,35%,43 to women,and thus below this qualified standard indicates a higher risk of cardiovascular disease.(4)Using BMI and PBF can all predict 10-year risk of ischemic cardiovascular diseases,hypertension and arteriosclerosis effectively,thus,obesity can be evaluated suitably by both BMI and PBF in large-scale population study,especially in women.Relatively,WHO criteria of PBF is more suitable for Chinese adults to evaluate obesity than ASBP criteria.(5)Handgrip strength/body mass showed independent correlation with 10-year risk of ICVD and thus it can predict the risk of cardiovascular diseases more effectively than handgrip strength. |
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