The Relationship of VO₂ Peak and the Blood Lactate Transition Threshold with Metabolic Syndrome and Its Component...

Improvements in cardiorespiratory fitness attenuate the risk for metabolic syndrome (MetS). However, the determinants of cardiorespiratory fitness measurements such as oxygen consumption (VO₂) peak and anaerobic threshold (AT) have not been investigated in persons with MetS. Therefore, the main aim of this study was to compare VO₂ peak and AT between subjects with and without MetS and to investigate determinants of cardiorespiratory fitness and its effects on the odds for MetS and its individual components. Thirty-one males with MetS and 24 healthy male participants each performed a VO₂ peak and a blood lactate transition threshold test. Waist circumference, body mass index (BMI), blood pressure, fasting plasma triglyceride, total cholesterol, high-density lipoprotein cholesterol, glucose, and insulin levels were measured. Separate multivariable linear regression models were developed in which VO₂ peak, AT, and the components of MetS were used as the dependent variables, while a multivariable logistic regression model was used for MetS. The VO₂ peak [median (interquartile range)] was lower in subjects with MetS compared with controls [27.9 (23.0-31.0) vs. 35.0 (32.0-45.0) mL·min^-1·kg^-1; P < 0.0001]. Multivariable regression analysis demonstrated that there was a bidirectional association between MetS and VO₂ peak that was mediated by waist circumference and blood pressure. The VO₂ peak was a strong negative determinant of waist circumference (β = -0.36, P < 0.0001), but not of BMI (β = -0.13, P = 0.21). A higher VO₂ peak is associated with a lower odds ratio for MetS, which is related to greater cardiorespiratory fitness in a cyclical relationship that is mediated by blood pressure and waist circumference. A higher VO₂ peak is specifically associated with lower waist circumference, and vice versa, possibly by effects on visceral fat.