The association of cardiorespiratory fitness with cardiometabolic factors, markers of inflammation, and endothelial dysfunction in Latino youth: findings from the Hispanic Community Children's Health Study/Study of Latino Youth

Abstract

Purpose: To evaluate the relationship of cardiorespiratory fitness (CRF) with cardiovascular disease risk factors and a biomarker of endothelial dysfunction (e-selectin) among Hispanic/Latino youth.

Methods: The study included 1380 Hispanic/Latino youths (8-16 years old) from the Hispanic Community Children's Health Study/Study of Latino Youth that enrolled from four cities (Bronx, Chicago, Miami, and San Diego). CRF was assessed by a 3-minute step test that uses postexercise heart rate to estimate maximal oxygen uptake. Regression models assessed differences in cardiometabolic markers across quartiles of CRF, adjusting for potential confounders.

Results: CRF was higher among boys (mean: 57.6 mL per kg/min, 95% confidence interval, 56.8-58.4) compared to girls (mean: 54.7 mL per kg/min, 95% confidence interval, 53.9-55.5). Higher levels of CRF were associated with more favorable levels of cardiometabolic, inflammation, and endothelial dysfunction factors (P-values <.001) and independently of physical activity and sedentary time. Compared to the lowest quartile of CRF, the odds of having greater than or equal to two cardiovascular disease risk factors was lower at higher quartiles of CRF, after adjustment for potential confounders.

Conclusions: Among Hispanic/Latino youth, CRF appears to be a strong protective factor for endothelial dysfunction and cardiometabolic risk factors. Strategies to improve CRF may be a useful approach for improving cardiovascular health in youth.

Keywords: Cardiometabolic risk; Cardiorrespiratory fitness; Children; Endothelial function; Hispanic.

Figure 1

Age and sex adjusted means of accelerometer-based physical activity and sedentary behavior across quartiles of cardiorespiratory fitness,* HCHS/SOL Youth (n=1,380)

Figure 2. Odds ratios (95% Confidence Interval) for the association of CRF (quartiles) with number of CVD risk factors. HCHS/SOL Youth (n=1380)

*CVD risk factors include obesity (BMI ≥95th percentile), high blood pressure, high fasting plasma glucose, high HbA1c, high total cholesterol, high LDL-cholesterol, high triglycerides, and low HDL-cholesterol **Derived from proportional odds model for ordinal dependent variable ***Odds ratios for each level of the dependent variable relative to zero cardiovascular risk factors, derived from multivariable adjusted generalized logit models ****Tests for a trend for increasing odds of 1 and ≥2 CVD risk factors, relative to 0 CVD risk factors, across higher quartiles of cardiorespiratory fitness Model 1 adjusted for age, sex, field center, Hispanic/Latino background, place of birth, annual household income, and parent education level, physical activity and sedentary behavior Model 2 is further adjusted for waist circumference