RT Journal Article
SR Electronic
T1 Obesity as a Mediator of the Influence of Cardiorespiratory Fitness on Cardiometabolic Risk: A Mediation Analysis
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 855
OP 862
DO 10.2337/dc13-0416
VO 37
IS 3
A1 Díez-Fernández, Ana
A1 Sánchez-López, Mairena
A1 Mora-Rodríguez, Ricardo
A1 Notario-Pacheco, Blanca
A1 Torrijos-Niño, Coral
A1 Martínez-Vizcaíno, Vicente
YR 2014
UL http://care.diabetesjournals.org/content/37/3/855.abstract
AB OBJECTIVE The relationship between cardiorespiratory fitness (CRF) and metabolic syndrome (MetS) is well known, although the extent to which body weight may act as a confounder or mediator in this relationship is uncertain. The aim of this study was to examine whether the association between CRF and cardiometabolic risk factors is mediated by BMI.RESEARCH DESIGN AND METHODS A cross-sectional study including 1,158 schoolchildren aged 8–11 years from the province of Cuenca, Spain, was undertaken. We measured height, weight, waist circumference (WC), blood pressure, fasting plasma lipid profile and insulin, and CRF (20-m shuttle run test). A validated cardiometabolic risk index was estimated by summing standardized z scores of WC, log triglyceride-to-HDL cholesterol ratio (TG/HDL-c), mean arterial pressure (MAP), and log fasting insulin. To assess whether the association between CRF and cardiometabolic risk was mediated by BMI, linear regression models were fitted according to Baron and Kenny procedures for mediation analysis.RESULTS In girls, BMI acts as a full mediator in the relationship between CRF and cardiometabolic risk factors, with the exception of log TG/HDL-c ratio. In boys, BMI acts as a full mediator in the relationship between CRF and both log TG/HDL-c ratio and MAP, and as a partial mediator in the relationship between CRF and cardiometabolic risk factors.CONCLUSIONS BMI mediates the association between CRF and MetS in schoolchildren. Overall, good levels of CRF are associated with lower cardiometabolic risk, particularly when accompanied by weight reduction.