Prevalence and cardiovascular disease correlates of low cardiorespiratory fitness in adolescents and adults
Prevalence and cardiovascular disease correlates of low cardiorespiratory fitness in adolescents and adults
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DOI：
10.1001/jama.294.23.2981
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发表时间：
2005-12-21
影响因子：
120.7
通讯作者：
Greenland, P
中科院分区：
文献类型：
--
作者：
Carnethon, MR;Gulati, M;Greenland, P
人口调查表明，美国的体育活动水平很低。不运动的后果之一，低心肺适能，是心血管疾病（CVD）发病率和死亡率的一个确定的危险因素，但在具有代表性的美国人群样本中，心肺适能的患病率尚未被量化。目的描述美国12 - 49岁人群中低健康水平的患病率，并将低健康水平与该人群中心血管疾病的危险因素联系起来。设计、设置和参与者：采用1999-2002年具有全国代表性的全国健康和营养检查调查的数据进行初始队列研究。参与者为青少年（12-19岁，n=3110）和成人（20-49岁，n=2205），先前没有诊断为CVD，他们接受了亚最大值分级运动跑步机测试，以达到至少75%至90%的年龄预测最大心率。最大耗氧量(（V) /点o(2)max）通过测量心率对参考次最大工作水平的反应来估计。使用现有外部参考人群估计的(V) /点(2)max的百分位数切点定义的低适应度；根据标准方法测量的人体测量和其他心血管疾病危险因素。结果：33.6%的青少年（约750万美国青少年）和13.9%的成年人（约850万美国成年人）健康状况不佳；青少年女性患病率（34.4%）与男性患病率（32.9%）相似（P= 0.40），但成年女性患病率（16.2%）高于男性（11.8%）（P= 0.03）。非西班牙裔黑人和墨西哥裔美国人不如非西班牙裔白人健康。在所有年龄-性别组中，体重指数和腰围与健康、年龄和种族调整后超重或肥胖的优势比（体重指数>= 25）呈负相关，范围为2.1至3.7
Context Population surveys indicate that physical activity levels are low in the United States. One consequence of inactivity, low cardiorespiratory fitness, is an established risk factor for cardiovascular disease (CVD) morbidity and mortality, but the prevalence of cardiorespiratory fitness has not been quantified in representative US population samples.Objectives To describe the prevalence of low fitness in the US population aged 12 through 49 years and to relate low fitness to CVD risk factors in this population.Design, Setting, and Participants Inception cohort study using data from the cross-sectional nationally representative National Health and Nutrition Examination Survey 1999-2002. Participants were adolescents (aged 12-19 years; n=3110) and adults (aged 20-49 years; n=2205) free from previously diagnosed CVD who underwent submaximal graded exercise treadmill testing to achieve at least 75% to 90% of their age-predicted maximum heart rate. Maximal oxygen consumption ((V) over dot o(2)max) was estimated by measuring the heart rate response to reference levels of submaximal work.Main Outcome Measures Low fitness defined using percentile cut points of estimated ((V) over dot(2)max from existing external referent populations; anthropometric and other CVD risk factors measured according to standard methods.Results Low fitness was identified in 33.6% of adolescents (approximately 7.5 million US adolescents) and 13.9% of adults (approximately 8.5 million US adults); the prevalence was similar in adolescent females (34.4%) and males (32.9%) (P=.40) but was higher in adult females (16.2%) than in males (11.8%) (P=.03). Non-Hispanic blacks and Mexican Americans were less fit than non-Hispanic whites. In all age-sex groups, body mass index and waist circumference were inversely associated with fitness-, age- and race-adjusted odds ratios of overweight or obesity (body mass index >= 25) ranged from 2.1 to 3.7 (P