Is low cardiorespiratory fitness a feature of metabolic syndrome in children and adults?

J Sci Med Sport. 2022 Nov;25(11):923-929. doi: 10.1016/j.jsams.2022.08.002. Epub 2022 Aug 4.


Objectives: Cardiorespiratory fitness has been inversely associated with risk of cardiometabolic diseases. However, there are no studies comparing the independent associations of cardiorespiratory fitness scaled by body size and composition using different approaches with cardiometabolic risk factors between children and adults. We therefore investigated these associations in children and adults using same measures for cardiorespiratory fitness and cardiometabolic risk factors.

Design: Cross-sectional.

Methods: A total of 352 children (47.2 % girls) and 572 men were included in the study. Peak oxygen uptake (V̇O2peak) was measured during a maximal exercise test on a cycle ergometer and was scaled by total body mass, total fat free mass, and allometrically modelled body mass, fat free mass, and stature. Insulin, glucose, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were assessed from fasting blood samples and systolic blood pressure and diastolic blood pressure were measured. Homeostatic model assessment for insulin resistance and continuous metabolic risk score were computed.

Results: V̇O2peak scaled by body mass was inversely associated with insulin, homeostatic model assessment for insulin resistance, triglycerides, diastolic blood pressure, the cardiometabolic risk score and the number of cardiometabolic risk factors in children and adults. However, these associations attenuated remarkably when V̇O2peak was scaled by total fat free mass or allometrically modelled body mass, fat free mass, or stature. V̇O2peak was consistently and positively associated with high-density lipoprotein cholesterol in children and adults irrespective of the scaling approach.

Conclusions: The inverse associations of cardiorespiratory fitness with cardiometabolic risk factors among children and adults attenuated remarkably when body size and composition were appropriately controlled for. However, the positive association between cardiorespiratory fitness and high-density lipoprotein cholesterol was consistent irrespective of the scaling approach.

Keywords: Body composition; Fitness; Insulin resistance; Metabolic syndrome; Obesity; Paediatrics.

MeSH terms

  • Adult
  • Blood Pressure
  • Cardiorespiratory Fitness*
  • Cardiovascular Diseases*
  • Child
  • Cholesterol, HDL
  • Cross-Sectional Studies
  • Female
  • Humans
  • Insulin
  • Insulin Resistance*
  • Male
  • Metabolic Syndrome*
  • Physical Fitness
  • Risk Factors
  • Triglycerides


  • Cholesterol, HDL
  • Triglycerides
  • Insulin