Cardiorespiratory fitness, fat mass and cardiometabolic health with endothelial function, arterial elasticity, and stiffness

PURPOSE To determine whether estimated cardiorespiratory fitness (CRF), fat mass (FM), lean mass (LM) and adiponectin bi-directionally associate with arterial function and structure and if CRF mediates the relationship between cardiometabolic health and arterial outcomes in 9-11-year-old children using the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, UK. METHODS Brachial artery flow-mediated dilation (FMD), distensibility coefficient (DC) and carotid-radial pulse wave velocity (PWV) was measured by ultrasonography; CRF was measured during submaximal ergometer test; total and trunk FM and LM by dual-energy Xray absorptiometry; plasma adiponectin by enzyme assay; and cardiometabolic health was computed using International Diabetes Federation criteria. We tested bi-directionality by including CRF, FM, LM, and adiponectin as exposures and FMD, DC, and PWV as outcomes, alternatively. RESULTS Among 5566 participants (2816 [51%] girls, median age 9.75 years), CRF/body mass-0.21 was directly related to DC (β [95% CI]) = 0.004 [<0.0001 to 0.008]; P = 0.046) while CRF/LM-0.54 was inversely associated with PWV (-0.034 [-0.063 to -0.003]; 0.032) after adjusting for covariates. These associations remained in bi-directional analyses. Total and trunk FM and LM were bi-directionally and positively associated with FMD and DC. Total and trunk FM but not LM had bi-directional and inverse associations with PWV. Adiponectin was not related to FMD, DC or PWV. CRF partially mediated the associations of cardiometabolic health with FMD (1.5% mediation); DC (12.1% mediation); and PWV (3.5% mediation). CONCLUSIONS Associations of poor cardiometabolic health with adverse arterial structure and function in childhood may be mitigated by increasing CRF. CRF and body composition were directly associated with arterial function. In the reverse analysis, better arterial function was associated with higher CRF and total FM.