Abstract
PURPOSE: To investigate the associations of cardiorespiratory fitness, body adiposity, and sports participation, with arterial stiffness in 140 children and adolescents with chronic diseases or physical disabilities. METHODS: Cardiorespiratory fitness was assessed using maximal exercise test with respiratory gas analyses either using shuttle run, shuttle ride, or cycle ergometer test. Cardiorespiratory fitness was defined as peak oxygen uptake (VO2peak) by body weight or fat free mass (FFM). Body adiposity was assessed using waist circumference, body mass index standard-deviation score (BMI-SDS), and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity PWV (PWVao), as a measure of arteria stiffness, and augmentation index (AIX%), as a measure of peripheral arterial tone, were assessed by a non-invasive oscillometric tonometry device. RESULTS: VO2peak/body weight (standardized regression coefficient β=-0.222, 95% CI=-0.386 to -0.059, P=0.002) and VO2peak/FFM (β=-0.173, 95% CI=-0.329 to -0.017, P=0.030) were inversely and waist circumference directly (β=0.245, 95% confidence interval (CI)=0.093 to 0.414, P=0.002) associated with PWVao. However, the associations of the measures of cardiorespiratory fitness with PWVao were attenuated after further adjustment for waist circumference. A higher waist circumference (β=-0.215, 95% CI=-0.381 to -0.049, P=0.012) and a higher BMI-SDS (β=0.218, 95% CI=-0.382 to -0.054, P=0.010) were related to lower AIX%. CONCLUSIONS: Poor cardiorespiratory fitness and higher waist circumference were associated with increased arterial stiffness in children and adolescents with chronic diseases and physical disabilities. The association between cardiorespiratory fitness and arterial stiffness was partly explained by waist circumference.
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