Diagnostic thresholds of cardiorespiratory fitness for identifying cardiometabolic risk in youth

Background and aim: Cardiorespiratory fitness, measured as peak oxygen uptake (VO2peak), is a key marker of metabolic health in youth, but age- and sex-specific diagnostic thresholds for identifying elevated cardiometabolic risk (CMR) remain undefined. This study aimed to establish age- and sex-spec...

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Detalles Bibliográficos
Autores: García Hermoso, Antonio, Yáñez-Sepúlveda, Rodrigo, Hormazábal Aguayo, Ignacio, Muñoz Pardeza, Jacinto, Hurtado-Almonácid, Juan, Ezzatvar, Yasmin, Sánchez López, Mairena, Martínez Vizcaíno, Vicente
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:dnet:academicae__::39540273134c87b12f92e88bbed393cc
Acceso en línea:https://hdl.handle.net/2454/56752
Access Level:acceso abierto
Palabra clave:Aerobic fitness
Cardiometabolic health
Cut-offs
Peak oxygen uptake
Youth
Descripción
Sumario:Background and aim: Cardiorespiratory fitness, measured as peak oxygen uptake (VO2peak), is a key marker of metabolic health in youth, but age- and sex-specific diagnostic thresholds for identifying elevated cardiometabolic risk (CMR) remain undefined. This study aimed to establish age- and sex-specific VO2peak cutpoints for elevated CMR by (i) conducting a cross-sectional diagnostic analysis that compared the diagnostic accuracy of commonly used VO2peak estimation equations (Barnett, L´eger, Matsuzaka) to select the bestperforming index, and (ii) performing a systematic review and meta-analysis to synthesize and validate findings. Methods and results: To establish diagnostic thresholds of VO2peak for identifying CMR in youth, we conducted a two-part study. First, a cross-sectional analysis was performed using data from 1059 children aged 8–11 years. Second, a systematic review and meta-analysis were conducted to synthesize evidence from existing observational studies. The literature search included four databases. Eligible studies included cross-sectional or cohort designs with participants aged 3–18 years, and reported cardiorespiratory fitness as VO2peak along with composite measures of CMR. We included 14 studies comprising a total of 20,780 children and adolescents. Optimal VO2peak thresholds for identifying elevated CMR were 43.2 mL/kg/min for boys and 41.9 mL/kg/min for girls aged <13 years, and 40.0 mL/kg/min for boys and 38.5 mL/kg/min for girls aged ≥13. These thresholds demonstrated moderate-to-strong diagnostic performance, and corresponded to the 20th-40th percentiles of international normative data. Conclusion: We report novel age- and sex-specific VO2peak thresholds for elevated CMR in youth, with good diagnostic performance, to aid early identification and prevention.