Abstract
Purpose: This study examinedthe independent and joint association of fitness and fatness with clustered cardiovascular disease risk (CVDrs) in 11–18 year-old Nigerian adolescents. Methods: A hundred and ninety seven adolescents (100 girls and 97 boys) were evaluated forfitness, fatness and CVDrs. Fitness was evaluated with the progressive aerobic cardiovascular endurance run test while fatness was assessed using body mass index. A clustered CVDrs was computed from the standardized residuals of total cholesterol, high density lipoprotein cholesterol, Low density lipoprotein cholesterol, triglycerides, plasma glucose, systolic blood pressure, and diastolic blood pressure. Regression models controlling for waist circumference assessed the association of fitness and fatness with CVDrs. Results: Prevalence of clustered CVD risk was 7.1% (girls = 3.0%; boys = 4.1%). Based on risk factor abnormalities, 52.8% of participants had one or more CVD risk factor abnormalities with more boys (27.4%) affected. Low fitness was associated with clustered CVDrs in both girls (R2 = 9.8%, β = −0.287, p = 0.05) and boys (R2 = 17%, β = −0.406, p < 0.0005). Fatness was not associated with the CVDrs in both sexes. After controlling for all the variables in the model, only fitness (R2 = 10.4%) and abdominal fat (R2 = 19.5%) were associated with CVDrs respectively. Unfit girls were 3.2 (95% CI = 1.31–7.91, p = 0.011) times likely to develop CVD risk abnormality compared to their fit counterparts. The likelihood of unfit boys developing CVD risk abnormality was 3.9 (95% CI = 1.15–10.08, p = 0.005) times compared to their fit peers. Conclusions: Fitness but not fatness was a better predictor of CVDrs in Nigerian boys and girls. The result of this study suggests that any public health strategies aimed at preventing or reversing the increasing trends of CVD risk in adolescents should emphasize promotion of aerobic fitness.
Highlights
Epidemiological studies consistently demonstrate that clustering of cardiovascular disease (CVD)risk factors called the metabolic syndrome (MS) increases the risk of CVD, type 2 diabetes (T2DM)and some forms of cancer [1,2]
Recentcross-sectional and longitudinal studies in Western societies have shown that overweight and unfit adolescents display adverse CVD risks compared to their healthy weight and fit peers [12,32]
It is well known that progressive aerobic cardiovascular endurance run (PACER) and body mass index (BMI) are related to CVD or MS risk factors in youth [7], a number of these studies suffered some methodological shortcomings mainly due to lack of a unified definition of childhood MS or CVD risk, as they used dichotomous classifications for each variable [5,7], but there is increasing evidence in support of the use of a clustered MS or CVD score which is more sensitive and less error prone [6,32]
Summary
Epidemiological studies consistently demonstrate that clustering of cardiovascular disease (CVD)risk factors called the metabolic syndrome (MS) increases the risk of CVD, type 2 diabetes (T2DM)and some forms of cancer [1,2]. Epidemiological studies consistently demonstrate that clustering of cardiovascular disease (CVD). Risk factors called the metabolic syndrome (MS) increases the risk of CVD, type 2 diabetes (T2DM). Some forms of cancer [1,2]. When biological risk factors aggregate in the same individual, there is a multiplicative effect [3], which from a clinical perspective is instructive. The clinical endpoints for CVD rarely exist in pediatric populations, the development of fatty streaks begins in childhood [4]. One methodological shortcoming in the study of metabolic syndrome in youth is the lack of unanimous definition of the disorder in this population. Res. Public Health 2020, 17, 5861; doi:10.3390/ijerph17165861 www.mdpi.com/journal/ijerph
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