title: The associations of cardiorespiratory fitness, adiposity and sports participation with arterial stiffness in youth with chronic diseases or physical disabilities.
abstract: Background The evidence on the associations of cardiorespiratory fitness, body adiposity and sports participation with arterial stiffness in children and adolescents with chronic diseases or physical disabilities is limited. Methods Altogether 140 children and adolescents with chronic diseases or physical disabilities participated in this cross-sectional study. 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 by body weight or fat-free mass. Body adiposity was assessed using waist circumference, body mass index standard deviation score and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity and augmentation index were assessed by a non-invasive oscillometric tonometry device. Results Peak oxygen uptake/body weight (standardised regression coefficient β -0.222, 95% confidence interval (CI) -0.386 to -0.059, P = 0.002) and peak oxygen uptake/fat-free mass (β -0.173, 95% CI -0.329 to -0.017, P = 0.030) were inversely and waist circumference directly (β 0.245, 95% CI 0.093 to 0.414, P = 0.002) associated with aortic pulse wave velocity. However, the associations of the measures of cardiorespiratory fitness with aortic pulse wave velocity 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 body mass index standard deviation score (β 0.218, 95% CI -0.382 to -0.054, P = 0.010) were related to lower augmentation index. 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.
authors.affiliation: 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.|2 Institute of Biomedicine, University of Eastern Finland, Finland.|3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.
authors.forename: Eero A
authors.initials: EA
authors.lastname: Haapala
authors.affiliation: 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.|5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.
authors.forename: Kristel
authors.initials: K
authors.lastname: Lankhorst
authors.affiliation: 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.|4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.|5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.
authors.forename: Janke
authors.initials: J
authors.lastname: de Groot
authors.affiliation: 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.|6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands.
authors.forename: Maremka
authors.initials: M
authors.lastname: Zwinkels
authors.affiliation: 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.|6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands.
authors.forename: Olaf
authors.initials: O
authors.lastname: Verschuren
authors.affiliation: 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.
authors.forename: Harriet
authors.initials: H
authors.lastname: Wittink
authors.affiliation: 7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands.
authors.forename: Frank Jg
authors.initials: FJ
authors.lastname: Backx
authors.affiliation: 6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands.|7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Visser-Meily
authors.affiliation: 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.|5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Takken
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D000072599:Cardiorespiratory Fitness; D002648:Child; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D019988:Children with Disabilities; D005080:Exercise Test; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D063177:Pulse Wave Analysis; D013177:Sports; D011795:Surveys and Questionnaires; D059289:Vascular Stiffness; D055105:Waist Circumference
keywords: Youth; arterial stiffness; cardiorespiratory fitness; chronic disease; exercise; obesity