Blood-Based Fingerprint of Cardiorespiratory Fitness and Long-Term Health Outcomes in Young Adulthood.
Blood-Based Fingerprint of Cardiorespiratory Fitness and Long-Term Health Outcomes in Young Adulthood.
复制标题
呼吸疾病适应性的血液指纹和成年后的长期健康结果。
DOI：
10.1161/jaha.122.026670
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发表时间：
2022-09-20
影响因子：
5.4
通讯作者：
Nayor, Matthew
中科院分区：
文献类型：
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作者：
Shah, Ravi, V;Miller, Patricia;Colangelo, Laura A.;Chernofsky, Ariel;Houstis, Nicholas E.;Malhotra, Rajeev;Velagaleti, Raghava S.;Jacobs, David R., Jr.;Gabriel, Kelley Pettee;Reis, Jared P.;Lloyd-Jones, Donald M.;Clish, Clary B.;Larson, Martin G.;Vasan, Ramachandran S.;Murthy, Venkatesh L.;Lewis, Gregory D.;Nayor, Matthew
心肺适能是健康结果的有力预测指标，但目前在初级预防中未得到充分利用，尤其是在年轻人中。我们试图开发一种基于血液的心肺健康生物标志物，易于在人群中翻译。在FHS （Framingham Heart Study; 2016-2019）中进行了最大努力心肺运动测试，以量化心肺健康（通过峰值摄氧量）和静止时bbb200代谢物的分析。代谢组健康评分在FHS中得到/验证，并与较年轻的CARDIA（年轻人冠状动脉风险发展）研究的长期结果相关。在FHS（推导，N=451；验证，N=914；年龄54±8岁，53%女性，体重指数27.7±5.3 kg/m2）中，我们使用LASSO（最小绝对收缩和选择算子）回归建立多代谢物评分来预测峰值吸氧（与峰值吸氧相关r=0.77推导，0.61验证，均P<0.0001）。在包含临床危险因素的线性模型中，代谢组学健康评分≈1‐SD与年龄增加9.2岁时的峰值摄氧量具有同等程度的相关性。在CARDIA研究中（N=2300，中位随访26.9年，年龄32±4岁，44%女性，44%黑人），在调整年龄、性别和种族的模型中，1‐SD高的代谢组健康评分与死亡风险降低44%（危险比[HR]， 0.56 [95% CI, 0.47-0.68]； P<0.0001）和心血管疾病风险降低32% （HR, 0.68 [95% CI, 0.55-0.84]； P=0.0003）相关，在调整临床危险因素后，这一结果仍然稳健。一种基于血液的心肺健康生物标志物在很大程度上独立于传统的危险因素，与年轻人心血管疾病的长期风险和死亡率相关。
Cardiorespiratory fitness is a powerful predictor of health outcomes that is currently underused in primary prevention, especially in young adults. We sought to develop a blood‐based biomarker of cardiorespiratory fitness that is easily translatable across populations. Maximal effort cardiopulmonary exercise testing for quantification of cardiorespiratory fitness (by peak oxygen uptake) and profiling of >200 metabolites at rest were performed in the FHS (Framingham Heart Study; 2016–2019). A metabolomic fitness score was derived/validated in the FHS and was associated with long‐term outcomes in the younger CARDIA (Coronary Artery Risk Development in Young Adults) study. In the FHS (derivation, N=451; validation, N=914; age 54±8 years, 53% women, body mass index 27.7±5.3 kg/m2), we used LASSO (least absolute shrinkage and selection operator) regression to develop a multimetabolite score to predict peak oxygen uptake (correlation with peak oxygen uptake r=0.77 in derivation, 0.61 in validation; both P<0.0001). In a linear model including clinical risk factors, a ≈1‐SD higher metabolomic fitness score had equivalent magnitude of association with peak oxygen uptake as a 9.2‐year age increment. In the CARDIA study (N=2300, median follow‐up 26.9 years, age 32±4 years, 44% women, 44% Black individuals), a 1‐SD higher metabolomic fitness score was associated with a 44% lower risk for mortality (hazard ratio [HR], 0.56 [95% CI, 0.47–0.68]; P<0.0001) and 32% lower risk for cardiovascular disease (HR, 0.68 [95% CI, 0.55–0.84]; P=0.0003) in models adjusted for age, sex, and race, which remained robust with adjustment for clinical risk factors. A blood‐based biomarker of cardiorespiratory fitness largely independent of traditional risk factors is associated with long‐term risk of cardiovascular disease and mortality in young adults.