Abstract
Objectives. (1) Determine the predictive value of a school-based test of cardiovascular fitness (CVF) for insulin resistance (IR); (2) compare a “school-based” prediction of IR to a “laboratory-based” prediction, using various measures of fitness and body composition. Methods. Middle school children (n = 82) performed the Progressive Aerobic Cardiovascular Endurance Run (PACER), a school-based CVF test, and underwent evaluation of maximal oxygen consumption treadmill testing (VO2 max), body composition (percent body fat and BMI z score), and IR (derived homeostasis model assessment index [HOMAIR]). Results. PACER showed a strong correlation with VO2 max/kg (rs = 0.83, P < .001) and with HOMAIR (rs = −0.60, P < .001). Multivariate regression analysis revealed that a school-based model (using PACER and BMI z score) predicted IR similar to a laboratory-based model (using VO2 max/kg of lean body mass and percent body fat). Conclusions. The PACER is a valid school-based test of CVF, is predictive of IR, and has a similar relationship to IR when compared to complex laboratory-based testing. Simple school-based measures of childhood fitness (PACER) and fatness (BMI z score) could be used to identify childhood risk for IR and evaluate interventions.
Highlights
Insulin Resistance (IR) is an independent predictor for the development of hypertension, coronary heart disease, stroke, cancer, and type 2 diabetes, and greater insulin sensitivity is a protective factor against these clinical conditions [1]
Regardless of how cardiovascular fitness (CVF) is expressed, boys had a higher CVF than girls
This study shows that the Progressive Aerobic Cardiovascular Endurance Run (PACER) is a valid school-based test of CVF and is predictive of IR, independent of body composition
Summary
Insulin Resistance (IR) is an independent predictor for the development of hypertension, coronary heart disease, stroke, cancer, and type 2 diabetes, and greater insulin sensitivity is a protective factor against these clinical conditions [1]. IR and type 2 diabetes are increasing in childhood and adolescence [2]. In addition to obesity and genetic predisposition, poor cardiovascular fitness (CVF) is an important independent risk factor for IR [3]. Poor CVF increases a person’s risk for cardiovascular disease, hypertension, and type 2 diabetes [4,5,6], and improved CVF attenuates the morbidities associated with obesity. An important public health goal is the improvement of CVF in the population in general, not just obese persons
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