Cardiorespiratory Fitness as a Feature of Metabolic Syndrome in Older Men and Women

The Dose-Responses to Exercise Training Study (DR's EXTRA)

  1. Maija Hassinen, MSC1,
  2. Timo A. Lakka, MD12,
  3. Kai Savonen, MD1,
  4. Hannu Litmanen, MD1,
  5. Leena Kiviaho, MSC1,
  6. David E. Laaksonen, MD23,
  7. Pirjo Komulainen, MSC1 and
  8. Rainer Rauramaa, MD14
  1. 1Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
  2. 2Institute of Biomedicine, Department of Physiology, University of Kuopio, Kuopio, Finland
  3. 3Institute of Clinical Medicine, Department of Medicine, Kuopio University Hospital, Kuopio, Finland
  4. 4Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
  1. Corresponding author: Maija Hassinen, Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FIN-70100 Kuopio, Finland. E-mail: maija.hassinen{at}


OBJECTIVE—We studied the associations of cardiorespiratory fitness with metabolic syndrome in older men and women, because such data are limited in representative population samples.

RESEARCH DESIGN AND METHODS—We studied a population sample of 671 men and 676 women aged 57–79 years at baseline of a randomized controlled intervention study. We assessed maximal oxygen uptake (Vo2max) by respiratory gas analysis during a maximal bicycle exercise test.

RESULTSVo2max had a strong, inverse, and graded association with the risk of having metabolic syndrome as defined by the National Cholesterol Education Program criteria. Men and women in the lowest third of Vo2max had 10.2- and 10.8-fold higher risks and those in the middle third had 2.9- and 4.7-fold higher risks (P < 0.001 all) of metabolic syndrome than those with the highest Vo2max after multivariable adjustments. Factor analysis generated a principal factor that was strongly loaded by the main components of metabolic syndrome and Vo2max (−0.68 in men and −0.70 in women).

CONCLUSIONS—Low cardiorespiratory fitness is associated with metabolic syndrome in older men and women. Our findings suggest that low cardiorespiratory fitness could be considered a feature of metabolic syndrome.


  • Published ahead of print at on 10 March 2008. DOI: 10.2337/dc07-2298. Clinical trial reg. no. ISRCTN45977199,

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted February 28, 2008.
    • Received December 5, 2007.
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  1. Diabetes Care vol. 31 no. 6 1242-1247
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