Combined impact of cardiorespiratory fitness and visceral adiposity on metabolic syndrome in overweight and obese adults in Korea.
BACKGROUND
Obesity, especially visceral obesity, is known to be an important correlate for cardiovascular disease and increased mortality. On the other hand, high cardiorespiratory fitness is suggested to be an effective contributor for reducing this risk. This study was conducted to determine the combined impact of cardiorespiratory fitness and visceral adiposity, otherwise known as fitness and fatness, on metabolic syndrome in overweight and obese adults.


METHODS
A total of 232 overweight and obese individuals were grouped into four subtypes according to their fitness level. This was measured by recovery heart rate from a step test in addition to visceral adiposity defined as the visceral adipose tissue area to subcutaneous adipose tissue area ratio (VAT/SAT ratio). Associations of fitness and visceral fatness were analyzed in comparison with the prevalence of metabolic syndrome.


RESULTS
The high visceral fat and low fitness group had the highest prevalence of metabolic syndrome [Odds Ratio (OR) 5.02; 95% Confidence Interval (CI) 1.85-13.61] compared with the reference group, which was the low visceral adiposity and high fitness group, after adjustments for confounding factors. Viscerally lean but unfit subjects were associated with a higher prevalence of metabolic syndrome than more viscerally obese but fit subjects (OR 3.42; 95% CI 1.27-9.19, and OR 2.70; 95% CI 1.01-7.25, respectively).


CONCLUSIONS
Our study shows that visceral obesity and fitness levels are cumulatively associated with a higher prevalence of metabolic syndrome in healthy overweight and obese adults. This suggests that cardiorespiratory fitness is a significant modifier in the relation of visceral adiposity to adverse metabolic outcomes in overweight and obese individuals.
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Sue
S
Kim
Department of Sport and Leisure Studies, Yonsei University, Seoul, Korea.
Ji-Young
JY
Kim
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Duk-Chul
DC
Lee
Biostatistics Collaboration Units, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea.
Hye-Sun
HS
Lee
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Ji-Won
JW
Lee
Department of Sport and Leisure Studies, Yonsei University, Seoul, Korea.
Justin Y
JY
Jeon
D050154:Adiposity; D000328:Adult; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D010809:Physical Fitness; D056910:Republic of Korea; D055815:Young Adult