Cardiorespiratory Fitness, Sedentary Behaviour and Physical Activity Are Independently Associated with the Metabolic Syndrome, Results from the SCAPIS Pilot Study

Abstract

Background: Previous studies on the relation between lifestyle and the metabolic syndrome lack one or several aspects of the physical activity pattern in the analyses or cardiorespiratory fitness. Likewise, both uni- and triaxial accelerometry have been used, though, the predictive validity of these two modes has not been compared.

Objectives: The aims of the present study were firstly to investigate the independent relation between cardiorespiratory fitness and physical activity pattern to the metabolic syndrome (MetS) and secondly to examine the predictive validity of uni- and triaxial accelerometry, respectively.

Methods: Data was extracted from the SCAPIS pilot study (n=930, mean age 57.7 yrs). Physical activity pattern was assessed by accelerometry. Cardiorespiratory fitness was estimated using cycle ergometry. MetS was defined per the Adult Treatment Panel III from the National Cholesterol Education Program definition.

Results: Time spent sedentary (OR: 2.38, 95% CI: 1.54-4.24 for T3 vs T1), in light intensity (OR: 0.50, 95% CI: 0.28-0.90) and in moderate-to-vigorous activity (OR: 0.33, 95% CI: 0.18-0.61), as well as cardiorespiratory fitness (OR: 0.24, 95% CI:0.12-0.48), were all independently related to the prevalence of MetS after adjustment for potential confounders, fitness and/or the other aspects of the physical activity pattern. In addition, we found that triaxial analyses were more discriminant, with ORs farther away from the reference group and additional significant ORs.

Conclusion: The finding that several aspects of the physical activity pattern reveal independent relations to the MetS makes new possible targets for behaviour change of interest, focusing on both exercise and everyday life. When assessing the risk status of a patient, it is advised that triaxial accelerometry is used.

Fig 1. Relationship between tertiles of fitness and having unfavourable levels of sub-components of METs.

ORs are adjusted for gender, age, education level (university degree vs. not), energy intake (kcal·d^-1 in quartiles), smoking habits (regular smoker vs. not) and psycho-social stress (self-reported into four levels), % of wear time spent in SED and % of wear time spent in MVPA (in tertiles). * Denotes significant difference to reference group.

Fig 2. Relationship between tertiles of SED and unfavourable sub-components of METs.

ORs are adjusted for gender, age, education level (university degree vs. not), energy intake (kcal·d^-1 in quartiles), smoking habits (regular smoker vs. not) and psycho-social stress (self-reported into four levels), % of wear time spent in MVPA (in tertiles), and estimated VO₂max (ml·min^-1·kg^-1, in tertiles). * Denotes significant difference to reference group.

Fig 3. Relationship between tertiles of LIPA and unfavourable sub-components of METs.

ORs are adjusted for gender, age, education level (university degree vs. not), energy intake (kcal·d^-1 in quartiles), smoking habits (regular smoker vs. not) and psycho-social stress (self-reported into four levels), % of wear time spent in MVPA (in tertiles), and estimated VO₂max (ml·min^-1·kg^-1, in tertiles). * Denotes significant difference to reference group.

Fig 4. Relationship between tertiles of MVPA and for unfavourable sub-components of METs.

ORs are adjusted for gender, age, education level (university degree vs. not), energy intake (kcal·d^-1 in quartiles), smoking habits (regular smoker vs. not) and psycho-social stress (self-reported into four levels), % of wear time spent in SED (in tertiles), and estimated VO₂max (ml·min^-1·kg^-1, in tertiles). * Denotes significant difference to reference group.

Fig 5. Stratified analysis across SED tertiles in high (above median) and low (below median) MVPA.

ORs are adjusted for gender, age (yrs.), education level (university degree vs. not), energy intake (kcal·d^-1, in quartiles), smoking habits (regular vs. not), psychosocial stress (self-reported into four levels) and fitness (in tertiles).