Comparison of objectively measured and estimated cardiorespiratory fitness to predict all-cause and cardiovascular disease mortality in adults: A systematic review and meta-analysis of 42 studies representing 35 cohorts and 3.8 million observations.

IF 9.7 1区 医学 Q1 HOSPITALITY, LEISURE, SPORT & TOURISM Journal of Sport and Health Science Pub Date : 2024-09-11 DOI:10.1016/j.jshs.2024.100986
Ben Singh,Cristina Cadenas-Sanchez,Bruno G G da Costa,José Castro-Piñero,Jean-Philippe Chaput,Magdalena Cuenca-García,Carol Maher,Nuria Marín-Jiménez,Ryan McGrath,Pablo Molina-Garcí,Jonathan Myers,Bethany Gower,Francisco B Ortega,Justin J Lang,Grant R Tomkinson
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Abstract

BACKGROUND Cardiorespiratory fitness (CRF) is a powerful health marker recommended by the American Heart Association as a clinical vital sign. Comparing the predictive validity of objectively measured CRF (the "gold standard") and estimated CRF is clinically relevant because estimated CRF is more feasible. Our objective was to meta-analyze cohort studies to compare the associations of objectively measured, exercise-estimated, and non-exercise-estimated CRF with all-cause and cardiovascular disease (CVD) mortality in adults. METHODS Systematic searches were conducted in 9 databases (MEDLINE, SPORTDiscus, Embase, Scopus, PsycINFO, Web of Science, PubMed, CINAHL, and the Cochrane Library) up to April 11, 2024. We included full-text refereed cohort studies published in English that quantified the association (using risk estimates with 95% confidence intervals (95%CIs)) of objectively measured, exercise-estimated, and non-exercise-estimated CRF with all-cause and CVD mortality in adults. CRF was expressed as metabolic equivalents (METs) of task. Pooled relative risks (RR) for all-cause and CVD mortality per 1-MET (3.5 mL/kg/min) higher level of CRF were quantified using random-effects models. RESULTS Forty-two studies representing 35 cohorts and 3,813,484 observations (81% male) (362,771 all-cause and 56,471 CVD deaths) were included. The pooled RRs for all-cause and CVD mortality per higher MET were 0.86 (95%CI: 0.83-0.88) and 0.84 (95%CI: 0.80-0.87), respectively. For both all-cause and CVD mortality, there were no statistically significant differences in RR per higher MET between objectively measured (RR range: 0.86-0.90) and maximal exercise-estimated (RR range: 0.85-0.86), submaximal exercise-estimated (RR range: 0.91-0.94), and non-exercise-estimated CRF (RR range: 0.81-0.85). CONCLUSION Objectively measured and estimated CRF showed similar dose-response associations for all-cause and CVD mortality in adults. Estimated CRF could provide a practical and robust alternative to objectively measured CRF for assessing mortality risk across diverse populations. Our findings underscore the health-related benefits of higher CRF and advocate for its integration into clinical practice to enhance risk stratification.
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比较客观测量和估计的心肺功能,预测成人全因和心血管疾病死亡率:对代表 35 个队列和 380 万观察数据的 42 项研究进行系统回顾和荟萃分析。
背景心肺功能(CRF)是美国心脏协会推荐作为临床生命体征的一个强有力的健康指标。比较客观测量的心肺功能("黄金标准")和估计的心肺功能的预测有效性具有临床意义,因为估计的心肺功能更可行。我们的目标是对队列研究进行荟萃分析,比较客观测量的、运动估算的和非运动估算的 CRF 与成人全因死亡率和心血管疾病(CVD)死亡率之间的关系。方法截至 2024 年 4 月 11 日,我们在 9 个数据库(MEDLINE、SPORTDiscus、Embase、Scopus、PsycINFO、Web of Science、PubMed、CINAHL 和 Cochrane Library)中进行了系统检索。我们纳入了用英语发表的、量化了客观测量的、运动估算的和非运动估算的 CRF 与成人全因死亡率和心血管疾病死亡率的相关性(使用带有 95% 置信区间 (95%CIs) 的风险估计值)的经审阅的队列研究全文。CRF以任务的代谢当量(METs)表示。结果纳入了代表 35 个队列、3,813,484 名观察对象(81% 为男性)(362,771 例全因死亡和 56,471 例心血管疾病死亡)的 42 项研究,其中包括 35 个队列、3,813,484 名观察对象(81% 为男性)(362,771 例全因死亡和 56,471 例心血管疾病死亡)。MET越高,全因死亡率和心血管疾病死亡率的总RR分别为0.86(95%CI:0.83-0.88)和0.84(95%CI:0.80-0.87)。就全因死亡率和心血管疾病死亡率而言,客观测量值(RR 范围:0.86-0.90)与最大运动量估算值(RR 范围:0.85-0.86)、亚最大运动量估算值(RR 范围:0.91-0.94)和非运动量估算值(RR 范围:0.81-0.85)之间,每增加 1 MET 的死亡率在统计学上没有显著差异。在评估不同人群的死亡风险时,估算的 CRF 可作为客观测量 CRF 的一种实用而可靠的替代方法。我们的研究结果强调了较高的 CRF 对健康的益处,并主张将其纳入临床实践,以加强风险分层。
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来源期刊
CiteScore
18.30
自引率
1.70%
发文量
101
审稿时长
22 weeks
期刊介绍: The Journal of Sport and Health Science (JSHS) is an international, multidisciplinary journal that aims to advance the fields of sport, exercise, physical activity, and health sciences. Published by Elsevier B.V. on behalf of Shanghai University of Sport, JSHS is dedicated to promoting original and impactful research, as well as topical reviews, editorials, opinions, and commentary papers. With a focus on physical and mental health, injury and disease prevention, traditional Chinese exercise, and human performance, JSHS offers a platform for scholars and researchers to share their findings and contribute to the advancement of these fields. Our journal is peer-reviewed, ensuring that all published works meet the highest academic standards. Supported by a carefully selected international editorial board, JSHS upholds impeccable integrity and provides an efficient publication platform. We invite submissions from scholars and researchers worldwide, and we are committed to disseminating insightful and influential research in the field of sport and health science.
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