Higher Cardiorespiratory Fitness Levels May Attenuate the Detrimental Association between Weight Status, Metabolic Phenotype and C-Reactive Protein in Adolescents—A Multi-Cohort Study

Abstract

Results from several studies show that only obese, unfit subjects, but not obese, fit subjects, are at higher mortality risk than are normal-weight fit subjects. The aim of the study was two-fold: (1) to examine the differences in C-reactive protein levels across different metabolic phenotypes (healthy and unhealthy) of weight status and (2) ascertain whether high levels of cardiorespiratory fitness (CRF) attenuate the association of C-reactive protein and metabolic phenotypes of weight status. This was a pooled study, which included data from three cross-sectional projects (1706 youth (921 girls) aged 12–18 years). We used a Shuttle run test to assess CRF. Adolescents were classified into six metabolic phenotypes (healthy and unhealthy) of weight status (non-overweight, overweight and obese), based on age- and sex-specific cutoff points for triglycerides, systolic blood pressure, HDL-cholesterol, glucose and body mass index. High-sensitivity assays were used to obtain the C-reactive protein as inflammatory biomarker. After adjustment for potential confounders (age, sex, pubertal stage and country), the analysis of covariance (ANCOVA) shows that C-reactive protein is directly associated with metabolic phenotypes of weight status. Subjects with obesity, regardless of their metabolic profile, had higher levels of C-reactive protein Z-score. In addition, (after adjustments for potential confounders) a two-way ANCOVA showed that high levels of CRF attenuated the associations of C-reactive protein levels in metabolic healthy non-overweight and in adolescents with obesity. In conclusion, higher CRF levels may attenuate the detrimental association between obesity and C-reactive protein independently of metabolic phenotype. Findings from this study are important for prevention, clinical practice on issues associated with adiposity and metabolic disorders.

Influence of prenatal exercise on the relationship between maternal overweight and obesity and select delivery outcomes

“…Interestingly, we found that early pregnancy aerobic capacity predicted the risk of cesarean birth, and although not significant, exercise during pregnancy reduced the magnitude of relative risk of cesarean birth rates. Previous research has demonstrated that fitness level, regardless of BMI, decreases inflammatory markers, i.e., C-reactive protein, associated with metabolic phenotype 26 . By reducing the amount of chronic inflammation at the beginning of pregnancy, during the development of the placenta, it is possible that OWOB women will be less likely to experience pregnancy and delivery complications associated with cesarean birth.…”

“…Lastly, we found that maternal exercise, aerobic capacity, and GWG predicted neonatal birth weight. It is plausible that fitness level, regardless of BMI, decreases inflammatory markers (i.e., C-reactive protein) 26 , thus improves placenta development and helps to normalize birth weight. Similar to previous studies, we also found that GWG was associated with birth weight 32 , 33 .…”

“…For the combination group, resistance exercises were performed at 15 repetitions (same exercises and equipment as the resistance group) and the aerobic exercises were performed on the same equipment as the aerobic group. To verify that the proper intensity was achieved during sessions, the Borg scale rating of perceived exertion (RPE) 26 , 29 , and the “talk test” were used. HR monitoring (Polar FS2C) ensured appropriate target HR ranges were maintained; target HR zones validated for pregnant women were utilized 27 .…”

Prognostic value of exercise capacity in incident diabetes: a country with high prevalence of diabetes

“…Individuals with low cardiorespiratory fitness have high insulin resistance [11], and low levels of CRF have fewer glucose transporters [12] compared with those more fit. It is thought to be mediated by positive changes in the human body tissue profile, reduced adiposity [13], and an immediate increase in insulin sensitivity and glucose disposal [14]. However, several studies have shown that impaired oxidative respiration due to mitochondrial dysfunction [15] underlies (continued) Table 1 the pathogenesis of diabetes reflecting a native genetic state independent of physical activity [16].…”

Visceral adiposity index performed better than traditional adiposity indicators in predicting unhealthy metabolic phenotype among Chinese children and adolescents

“…At present, the underlying mechanism for determining different metabolic phenotypes was unclear, which may be related to visceral fat accumulation 12 , inflammatory factors 13 , genetics 14 , dietary intake behaviors and lifestyle habits 15 . Some studies showed that visceral adipose tissue (VAT) was positively correlated with cardiometabolic risk factors 16 .…”