Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Kinesiology & Public Health Education

First Advisor

Grant R. Tomkinson

Abstract

Purpose: To identify criterion-referenced cut-points in cardiorespiratory fitness (CRF) associated with metabolic syndrome (MetS) in a nationally-representative sample of young- and middle-aged American adults. Methods: The analytic sample comprised 3302 Americans aged 20–49 years who participated in the 1999–2000, 2001–2002, and 2003–2004 cycles of the National Health and Nutrition Examination Survey. CRF was assessed by a submaximal run/walk test on a treadmill. MetS was determined using American Heart Association criteria, measured as the presence of three or more risk factors (high waist circumference, high blood pressure, high fasting triglycerides, high fasting glucose, and low high-density lipoprotein cholesterol). Receiver operating characteristic (ROC) curves were used to identify gender- and age group-specific cut-points for CRF associated with increased MetS. Effect sizes of 0.56, 0.64, and 0.71 were used as thresholds for low, moderate and high, respectively. Results: ROC analysis demonstrated high discriminatory ability of CRF to detect MetS for men aged 20–29 years (AUC = 0.77, 95% confidence interval [CI] = 0.65, 0.89), with low discriminatory ability for women aged 20–29 years (AUC = 0.59, 95%CI = 0.46, 0.72) and 40–49 years (AUC = 0.59, 95%CI = 0.49, 0.70). There was negligible discriminatory ability for all other gender and age groups (i.e., AUC <0.56). Conclusion: This study identified the first criterion-referenced cut-points in CRF associated with MetS in a nationally-representative sample of young- and middle-aged American adults. It shows that CRF was inconsistently associated with MetS, with high discriminatory ability for men aged 20–29 years and negligible to low discriminatory ability for all other gender and age groups. CRF, therefore, shows poor utility as a screening tool for MetS except for young men.

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