Associations of Fitness, Fatness Indices and Fit-Fat Index Variants With Cardiovascular and All-Cause Mortality in
Nzechukwu M Isiozor1, Setor K Kunutsor2,3, Sudhir Kurl4
1Institute of Clinical Medicine School of Medicine University of Eastern Finland Kuopio Finland.
Background:
Fit-Fat Index (FFI), defined as the ratio of cardiorespiratory fitness (CRF) to waist-to-height ratio (WHtR), combines measures of fitness and fatness, and may offer a more accurate assessment of cardiometabolic risk than either component alone. The prospective associations of CRF, fatness indices, and mortality were examined.
Methods:
CRF and fatness indices (body mass index [BMI], waist-to-hip ratio [WHR], and WHtR) were assessed in 1089 men aged 42-61 years. FFI variants (FFIBMI, FFIWHR, and FFIWHtR) were calculated by dividing CRF by each corresponding fatness measure. Hazard ratios (HRs) with 95% confidence intervals (CIs) and risk prediction metrics were estimated.
Results:
Over a median follow-up of 31.2 years, 288 CVD deaths and 695 all-cause deaths were recorded. After multivariable adjustment, the HR (95% CI) for CVD death per 1 SD increase was 0.81 (0.70-0.93) for CRF, 1.09 (0.96-1.23) for BMI, 1.13 (1.02-1.25) for WHR, 1.13 (0.99-1.30) for WHtR, 0.82 (0.71-0.95) for FFIBMI, 0.78 (0.68-0.91) for FFIWHR, and 0.80 (0.69-0.93) for FFIWHtR. Findings were similar for all-cause mortality. Addition of CRF and FFI variants to a model containing established risk factors significantly improved CVD mortality risk prediction and reclassification (p-value for all < 0.05).
Conclusions:
Combining aerobic fitness and fatness into FFI measures may provide better risk stratification than either aerobic fitness or fatness alone.
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