Cardiorespiratory Fitness and Metabolic Syndrome in Postmenopausal African-American Women

Abstract

We examined the association of cardiorespiratory fitness with metabolic syndrome in overweight/obese postmenopausal African-American women. Pooled baseline data on 170 African-American women from 2 exercise trials were examined. Metabolic syndrome was defined as at least 3 of the following: abdominal obesity, glucose intolerance, hypertension, low high-density lipoprotein cholesterol (HDL-C), and high triglycerides. Cardiorespiratory fitness (VO_2peak) was determined using the Bruce treadmill protocol and categorized as: Very Low (VLCRF<18 mL·kg⁻¹ min⁻¹), Low (LCRF=18.0–220–22–22.0 mL·kg⁻¹ min⁻¹), and Moderate (MCRF>22.0 mL·kg⁻¹ min⁻¹). Associations of metabolic syndrome with cardiorespiratory fitness were analyzed using one-way ANOVA and linear regression. VO_2peak was significantly lower in the VLCRF compared to the MCRF group. Lower cardiorespiratory fitness was associated with higher prevalence of metabolic syndrome, abdominal obesity, hypertriglyceridemia, and low HDL among overweight/obese postmenopausal African-American women. In fully adjusted models, higher waist circumference and triglycerides were associated with lower VO_2peak levels (P<0.01) and higher HDL-C was associated with higher VO_2peak levels (P=0.03). Overweight/obese postmenopausal African-American women with very low cardiorespiratory fitness are more likely to have metabolic syndrome, higher body mass index, and unhealthier levels of certain metabolic syndrome components than women with moderate cardiorespiratory fitness.

Key words

obesity - metabolic syndrome - african-american - cardiorespiratory fitness

• References

• 1 American Heart Association, National Heart, Lung, and Blood Institue. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith Jr SC, Spertus JA, Costa F. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary. Cardiol Rev 2005; 13: 322-327
• 2 Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB, Froberg K. European Youth Heart Study (EYHS). Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS). Diabetes Care 2004; 27: 2141-2148
• 3 Campbell KL, Westerlind KC, Harber VJ, Friedenreich CM, Courneya KS. Associations between aerobic fitness and estrogen metabolites in premenopausal women. Med Sci Sports Exerc 2005; 37: 585-592
• 4 Clark LT, El-Atat F. Metabolic syndrome in African Americans: implications for preventing coronary heart disease. Clin Cardiol 2007; 30: 161-164
• 5 Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health And Nutrition Examination Survey 1999-2002. Diabetes Care 2006; 29: 1263-1268
• 6 Dagan SS, Segev S, Novikov I, Dankner R. Waist circumference vs body mass index in association with cardiorespiratory fitness in healthy men and women: a cross sectional analysis of 403 subjects. Nutr J 2013; 12 12-2891-12-12
• 7 Despres JP. Visceral obesity, insulin resistance, and dyslipidemia: contribution of endurance exercise training to the treatment of the plurimetabolic syndrome. Exerc Sport Sci Rev 1997; 25: 271-300
• 8 Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care 2012; 35: 2402-2411
• 9 Farrell SW, Cheng YJ, Blair SN. Prevalence of the metabolic syndrome across cardiorespiratory fitness levels in women. Obes Res 2004; 12: 824-830
• 10 Ferdinand KC. Coronary artery disease in minority racial and ethnic groups in the United States. Am J Cardiol 2006; 97: 12A-19A
• 11 Finley CE, LaMonte MJ, Waslien CI, Barlow CE, Blair SN, Nichaman MZ. Cardiorespiratory fitness, macronutrient intake, and the metabolic syndrome: the Aerobics Center Longitudinal Study. J Am Diet Assoc 2006; 106: 673-679
• 12 Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-359
• 13 Gaillard TR, Sherman WM, Devor ST, Kirby TE, Osei K. Importance of aerobic fitness in cardiovascular risks in sedentary overweight and obese African-American women. Nurs Res 2007; 56: 407-415
• 14 Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith Jr SC, Spertus JA, Fernando C. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement: Executive Summary. Crit Pathw Cardiol 2005; 4: 198-203
• 15 Haffner SM, D'Agostino R, Saad MF, Rewers M, Mykkanen L, Selby J, Howard G, Savage PJ, Hamman RF, Wagenknecht LE. Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-Hispanic whites. The Insulin Resistance Atherosclerosis Study. Diabetes 1996; 45: 742-748
• 16 Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA 2003; 290: 199-206
• 17 Hakola L, Komulainen P, Hassinen M, Savonen K, Litmanen H, Lakka TA, Rauramaa R. Cardiorespiratory fitness in aging men and women: the DR’s EXTRA study. Scand J Med Sci Sports 2011; 21: 679-687
• 18 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2016 update. Int J Sports Med. 2015 36. 1121-1124
• 19 Johnson JL, Slentz CA, Houmard JA, Samsa GP, Duscha BD, Aiken LB, McCartney JS, Tanner CJ, Kraus WE. Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise). Am J Cardiol 2007; 100: 1759-1766
• 20 Keller C, Larkey L, Distefano JK, Boehm-Smith E, Records K, Robillard A, Veres S, Al-Zadjali M, O’Brian AM. Perimenopausal obesity. J Womens Health (Larchmt) 2010; 19: 987-996
• 21 Lakka TA, Laaksonen DE, Lakka HM, Mannikko N, Niskanen LK, Rauramaa R, Salonen JT. Sedentary lifestyle, poor cardiorespiratory fitness, and the metabolic syndrome. Med Sci Sports Exerc 2003; 35: 1279-1286
• 22 LaMonte MJ, Barlow CE, Jurca R, Kampert JB, Church TS, Blair SN. Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. Circulation 2005; 112: 505-512
• 23 Mastorakos G, Valsamakis G, Paltoglou G, Creatsas G. Management of obesity in menopause: diet, exercise, pharmacotherapy and bariatric surgery. Maturitas 2010; 65: 219-224
• 24 Mesch VR, Boero LE, Siseles NO, Royer M, Prada M, Sayegh F, Schreier L, Benencia HJ, Berg GA. Metabolic syndrome throughout the menopausal transition: influence of age and menopausal status. Climacteric 2006; 9: 40-48
• 25 Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Despres JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler 3rd ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2015 update: a report from the American Heart Association. Circulation 2015; 131: e29-e322
• 26 Ogawa T, Spina RJ, Martin 3rd WH, Kohrt WM, Schechtman KB, Holloszy JO, Ehsani AA. Effects of aging, sex, and physical training on cardiovascular responses to exercise. Circulation 1992; 86: 494-503
• 27 Reaven GM. The insulin resistance syndrome: definition and dietary approaches to treatment. Annu Rev Nutr 2005; 25: 391-406
• 28 Reaven GM. Banting Lecture 1988. Role of insulin resistance in human disease. 1988. Nutrition 1997; 13: 65 discussion 64, 66
• 29 Ross R, Katzmarzyk PT. Cardiorespiratory fitness is associated with diminished total and abdominal obesity independent of body mass index. Int J Obes Relat Metab Disord 2003; 27: 204-210
• 30 Ross R, Dagnone D, Jones PJ, Smith H, Paddags A, Hudson R, Janssen I. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000; 133: 92-103
• 31 Silva G, Aires L, Martins C, Mota J, Oliveira J, Ribeiro JC. Cardiorespiratory fitness associates with metabolic risk independent of central adiposity. Int J Sports Med 2013; 34: 912-916
• 32 Sumner AE, Cowie CC. Ethnic differences in the ability of triglyceride levels to identify insulin resistance. Atherosclerosis 2008; 196: 696-703
• 33 Sutton-Tyrrell K, Zhao X, Santoro N, Lasley B, Sowers M, Johnston J, Mackey R, Matthews K. Reproductive hormones and obesity: 9 years of observation from the Study of Women’s Health Across the Nation. Am J Epidemiol 2010; 171: 1203-1213
• 34 Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Johnson WD, Blair SN, Church TS, Newton Jr RL. Racial differences in the response of cardiorespiratory fitness to aerobic exercise training in Caucasian and African American postmenopausal women. J Appl Physiol 1985; 2013; 114: 1375-1382
• 35 Teede HJ, Lombard C, Deeks AA. Obesity, metabolic complications and the menopause: an opportunity for prevention. Climacteric 2010; 13: 203-209