Peak oxygen uptake cut-points to identify children at increased cardiometabolic risk - The PANIC Study

We aimed to develop cut-points for directly measured peak oxygen uptake (VO2peak) to identify boys and girls at increased cardiometabolic risk using different scaling methods to control for body size and composition. Altogether 352 children (186 boys, 166 girls) aged 9-11 years were included in the analyses. We measured V ? O-2peak directly during a maximal cycle ergometer exercise test and lean body mass (LM) by bioelectrical impedance. We computed a sex- and age-specific cardiometabolic risk score (CRS) by summing important cardiometabolic risk factors and defined increased cardiometabolic risk as >1 standard deviation above the mean of CRS. Receiver operating characteristics curves were used to detect V ? O-2peak cut-points for increased cardiometabolic risk. Boys with V ? O-2peak <45.8 mL kg body mass (BM)(-1) min(-1) (95% confidence interval [CI] = 45.1 to 54.6, area under the curve [AUC] = 0.86, P < 0.001) and <63.2 mL kg LM-1 min(-1) (95% CI =52.4 to 67.5, AUC = 0.65, P = 0.006) had an increased CRS. Girls with V ? O-2peak <44.1 mL kg BM-1 min(-1) (95% CI = 44.0 to 58.6, AUC = 0.67, P = 0.013) had an increased CRS. V ? O-2peak scaled by BM-0.49 and LM-0.77 derived from log-linear allometric modeling poorly predicted increased cardiometabolic risk in boys and girls. In conclusion, directly measured VO2peak <45.8 mL kg BM-1 min(-1) among boys and <44.1 mL kg BM-1 min(-1) among girls were cut-points to identify those at increased cardiometabolic risk. Appropriately controlling for body size and composition reduced the ability of cardiorespiratory fitness to identify children at increased cardiometabolic risk.