Cardiorespiratory Fitness as a Feature of Metabolic Syndrome in Older Men and Women: The Dose-Responses to Exercise Training Study (DR's EXTRA)

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We studied the associations of cardiorespiratory fitness with metabolic syndrome in older men and women, because such data are limited in representative population samples.


We studied a population sample of 671 men and 676 women aged 57–79 years at baseline of a randomized controlled intervention study. We assessed maximal oxygen uptake (VO2max) by respiratory gas analysis during a maximal bicycle exercise test.


VO2max had a strong, inverse, and graded association with the risk of having metabolic syndrome as defined by the National Cholesterol Education Program criteria. Men and women in the lowest third of VO2max had 10.2- and 10.8-fold higher risks and those in the middle third had 2.9- and 4.7-fold higher risks (P < 0.001 all) of metabolic syndrome than those with the highest VO2max after multivariable adjustments. Factor analysis generated a principal factor that was strongly loaded by the main components of metabolic syndrome and VO2max (−0.68 in men and −0.70 in women).


Low cardiorespiratory fitness is associated with metabolic syndrome in older men and women. Our findings suggest that low cardiorespiratory fitness could be considered a feature of metabolic syndrome.

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