Send to

Choose Destination
Pediatr Diabetes. 2018 Jun;19(4):593-602. doi: 10.1111/pedi.12623. Epub 2017 Dec 19.

Relationships among cardiorespiratory fitness, muscular fitness, and cardiometabolic risk factors in Japanese adolescents: Niigata screening for and preventing the development of non-communicable disease study-Agano (NICE EVIDENCE Study-Agano) 2.

Author information

Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan.
Department of Human Life Science, Tokushima Bunri University, Tokushima, Japan.
Department of Pediatrics, Niigata University Faculty of Medicine, Niigata, Japan.
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan.



To examine the independent and combined associations of cardiorespiratory fitness (CRF) and muscular fitness (MF) with cardiometabolic risk factors in Japanese adolescents.


A cross-sectional study including 993 Japanese adolescents (aged 13-14 years) was undertaken. Height, body mass, blood pressure, lipid profile (non-fasting), and HbA1c were measured. The physical fitness (PF) test included measurements of CRF (20 m multistage shuttle run test), upper limb strength (hand grip strength), lower limb strength (standing long jump), and muscular endurance (sit-ups). The clustered cardiometabolic risk (CCMR) was estimated by summing standardized Z-scores of body mass index (BMI), mean arterial pressure (MAP), non-high-density lipoprotein cholesterol (non-HDL-C), and HbA1c.


Linear regression analysis showed that all PF factors except for muscular endurance were inversely correlated with CCMR (P < .001). Among metabolic risk components, HbA1c was unrelated to PF, while non-HDL-C was inversely associated with CRF (B = -2.40; P < .001), upper limb strength (B = -1.77; P < .05), and lower limb strength (B = -1.53; P < .05) after adjustment for lifestyle factors. Logistic regression showed that the probability of having high CCMR (≥1SD) was synergistically higher in those with the lowest tertiles of both CRF and upper limb strength (P for interaction = .001); however, a substantially lower likelihood of having high CCMR was observed among individuals with the lowest tertile of upper limb strength but moderate CRF.


Lower CRF and MF were significantly and synergistically associated with an unhealthier metabolic risk profile.


blood pressure; glycated hemoglobin A1c; lipids; metabolic abnormality; physical fitness


Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center