Referenzwerte für die kardiorespiratorische Fitness der allgemeinen Bevölkerung: Die Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) 2008–2011

Zusammenfassung

Ziel der Studie Das Ziel dieser Auswertung ist die Erstellung bundesweiter, bevölkerungsbezogener Referenzwerte für herzfrequenzbasierte Indikatoren der kardiorespiratorischen Fitness sporttauglicher Erwachsener im Alter von 18 bis 64 Jahren.

Methodik Auf der Datenbasis von 2826 Teilnehmenden des submaximalen Fahrradergometer-Tests in der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) 2008–2011 wurden folgende körpergewichtsbezogene Indikatoren gebildet: Physical Working Capacity (herzfrequenzbezogene Leistung) bei 150 und 130 S/min, bei 75% der geschätzten maximalen Herzfrequenz (PWC130, PWC150 und PWC75%) sowie die herzfrequenzbasiert geschätzte maximale Sauerstoffaufnahme (VO₂max). Die Referenzwerteberechnung erfolgte mit der LMS-Methode nach Cole & Green 1992.

Ergebnisse Das 25., 50. und 75. Perzentil der PWC150 liegt bei Männer bei 1,50, 1,77 und 2,08 Watt/kg. Die entsprechenden Werte bei Frauen sind 1,18, 1,44 und 1,69. Das 25., 50. und 75. Perzentil der PWC130 liegt bei Männer bei 1,16, 1,41 und 1,68 Watt/kg. Die entsprechenden Werte bei Frauen sind 0,81, 1,05 und 1,29. Die altersabhängigen Mediane bei Männern und Frauen sind für die PWC75% 1,87 – Alter in Jahren× 0,01 und 1,31 – (Alter in Jahren/100)² x 0,98 und für die VO₂max bei Männern 41,7 – Alter× 0,15.

Schlussfolgerung Die präsentierten Ergebnisse können als Referenzwerte für die Einschätzung der individuellen kardiorespiratorischen Fitness von in Deutschland lebenden Erwachsenen eingesetzt werden. Sie können außerdem als Basis für ein regelmäßiges Monitoring dienen.

Abstract

Aim of study This study aims to provide population-based reference values for heart rate-based indicators of cardiorespiratory fitness for adults with physical activity readiness aged 18 to 64 years living in Germany.

Methods Based on data on 2,826 individuals who participated in a submaximal cycle ergometer exercise test as part of the German National Health Interview and Examination Survey for Adults (DEGS1) between 2008 and 2011, we calculated the following indicators: physical working capacity at 150 and 130 beats/min and at 75% of estimated maximum heart rate (PWC150, PWC130 and PWC75%) as well as heart rate-based estimated maximum oxygen uptake (VO₂max). We used the LMS method by Cole & Green 1992 to calculate reference values.

Results 25^th, 50^th and 75^th percentiles of PWC150 were 1.5, 1.77 and 2.08 watts/kg among men and 1.18, 1.44 and 1.69 among women. 25^th, 50^th and 75^th percentiles of PWC130 were 1.16, 1.41 and 1.68 watts/kg among men and 0.81, 1.05 and 1.29 among women. Age-dependent median PWC75% values among men and women were 1.87 – age in years× 0.01 and 1.31 – (age in years/100)²× 0.98, respectively, and VO₂max among men is 41.7 – age× 0.15.

Conclusions The references values presented can be used for individual rating of cardiorespiratory fitness among adults living in Germany. Furthermore, they can serve as a basis for regular monitoring purposes.

Schlüsselwörter

Kardiorespiratorische Fitness - Ausdauerleistungsfähigkeit - Referenzwerte - Erwachsene - Deutschland

Key words

Cardiorespiratory fitness - endurance capacity - reference values - adults - Germany

• Literatur

• 1 Pandey A, Patel M, Gao A. et al. Changes in mid-life fitness predicts heart failure risk at a later age independent of interval development of cardiac and noncardiac risk factors: the Cooper Center Longitudinal Study. Am Heart J 2015; 169: 290-297.e291
• 2 Pandey A, Patel MR, Willis B. et al. Association Between Midlife Cardiorespiratory Fitness and Risk of Stroke: The Cooper Center Longitudinal Study. Stroke 2016; 47: 1720-1726
• 3 Lakoski SG, Willis BL, Barlow CE. et al. Midlife cardiorespiratory fitness, incident cancer, and survival after cancer in men: the cooper center longitudinal study. JAMA Oncol 2015; 1: 231-237
• 4 Schmid D, Leitzmann MF. Cardiorespiratory fitness as predictor of cancer mortality: a systematic review and meta-analysis. Ann Oncol 2015; 26: 272-278
• 5 Zaccardi F, O'Donovan G, Webb DR. et al. Cardiorespiratory fitness and risk of type 2 diabetes mellitus: A 23-year cohort study and a meta-analysis of prospective studies. Atherosclerosis 2015; 243: 131-137
• 6 Schuch FB, Vancampfort D, Sui X. et al. Are lower levels of cardiorespiratory fitness associated with incident depression? A systematic review of prospective cohort studies. Prev Med 2016; 93: 159-165
• 7 Baumeister SE, Leitzmann MF, Bahls M. et al. Associations of Leisure-Time and Occupational Physical Activity and Cardiorespiratory Fitness With Incident and Recurrent Major Depressive Disorder, Depressive Symptoms, and Incident Anxiety in a General Population. J Clin Psychiatry 2017; 78: e41-e47
• 8 Croci I, Coombes JS, Bucher Sandbakk S. et al. Non-alcoholic fatty liver disease: Prevalence and all-cause mortality according to sedentary behaviour and cardiorespiratory fitness. The HUNT Study. Prog Cardiovasc Dis 2019; 62: 127-134
• 9 Smart NA, King N, McFarlane JR. et al. Effect of exercise training on liver function in adults who are overweight or exhibit fatty liver disease: a systematic review and meta-analysis. Br J Sports Med 2018; 52: 834-843
• 10 Bahls M, Groß S, Baumeister SE. et al. Association of domain-specific physical activity and cardiorespiratory fitness with all-cause and cause-specific mortality in two population-based cohort studies. Sci Rep 2018; 8: 16066
• 11 Bachmann JM, DeFina LF, Franzini L. et al. Cardiorespiratory Fitness in Middle Age and Health Care Costs in Later Life. J Am Coll Cardiol 2015; 66: 1876-1885
• 12 Myers J, Doom R, King R. et al. Association Between Cardiorespiratory Fitness and Health Care Costs: The Veterans Exercise Testing Study. Mayo Clin Proc 2018; 93: 48-55
• 13 Kaminsky LA, Arena R, Beckie TM. et al. The importance of cardiorespiratory fitness in the United States: the need for a national registry: a policy statement from the American Heart Association. Circulation 2013; 127: 652-662
• 14 Kawakami R, Sawada SS, Matsushita M. et al. Reference values for cardiorespiratory fitness and incidence of type 2 diabetes. J Epidemiol 2014; 24: 25-30
• 15 Gore CJ, Booth ML, Bauman A. et al. Utility of pwc75% as an estimate of aerobic power in epidemiological and population-based studies. Med Sci Sports Exerc 1999; 31: 348
• 16 Sanders LF, Duncan GE. Population-based reference standards for cardiovascular fitness among U.S. adults: NHANES 1999–2000 and 2001–2002. Med Sci Sports Exerc 2006; 38: 701-707
• 17 Kaminsky LA, Arena R, Myers J. Reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: data from the fitness registry and the importance of exercise national database. Mayo Clin Proc 2015; 90: 1515-1523
• 18 Rossi Neto JM, Tebexreni AS, Alves ANF. et al. Cardiorespiratory fitness data from 18,189 participants who underwent treadmill cardiopulmonary exercise testing in a Brazilian population. PLoS One 2019; 14: e0209897
• 19 Löllgen H. Kardiopulmonale Funktionsdiagnostik. 4. neubearbeitete Auflage Nürnberg: Novatis Pharma; 2005
• 20 Finger JD, Gößwald A, Härtel S. et al. Messung der kardiorespiratorischen Fitness in der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 885-893
• 21 Scheidt-Nave C, Kamtsiuris P, Gößwald A. et al. German health interview and examination survey for adults (DEGS) – design, objectives and implementation of the first data collection wave. BMC Public Health 2012; 12: 730
• 22 Canadian Society for Exercise Physiology. Physical Activity Readiness Questionnaire – PAR-Q (revised 2002). Ottawa: Health Canada; 2002
• 23 Deutsche Gesellschaft für Sportmedizin und Prävention (DGSP). PAR-Q-Fragebogen (deutsche Fassung). Frankfurt am Main: DGSP; 2017
• 24 Lange Andersen K, Shephard R, Denolin H. et al. Fundamentals of Exercise Testing. Geneva: World Health Organisation; 1971
• 25 Astrand I. The physical work capacity of workers 50-64 years old. Acta Physiol Scand 1958; 42: 73-86
• 26 Wahlund H. Determinants of the physical work capacity. A physiological and clinical study with special reference to standardization of cardio-pulmonary functional test. Acta Med Scand 1948; 132 : 78
• 27 Finger JD, Krug S, Gößwald A. et al. Kardiorespiratorische Fitness bei Erwachsenen in Deutschland. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 772-778
• 28 Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol 2001; 37: 153-156
• 29 American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 5^th Edition ed. Baltimore: Williams & Wilkins; 1995: 280
• 30 Kamtsiuris P, Lange M, Hoffmann R. et al. Die erste Welle der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1): Stichprobendesign, Response, Gewichtung und Repräsentativität. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 620-630
• 31 Cole TJ, Green PJ. Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 1992; 11: 1305-1319
• 32 Pan H, Cole TJ. A comparison of goodness of fit tests for age-related reference ranges. Stat Med 2004; 23: 1749-1765
• 33 American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription. seventh edition Philadelphia: Lippincott Williams & Wilkins; 2006
• 34 Kodama S, Saito K, Tanaka S. et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. Jama 2009; 301: 2024-2035
• 35 Lin X, Zhang X, Guo J. et al. Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2015; 4: e002014
• 36 Finger JD, Busch MA, Du Y. et al. Zeitliche Trends kardiometaboler Risikofaktoren bei Erwachsenen. Dtsch Arztebl International 2016; 113: 712-719
• 37 Guthold R, Stevens GA, Riley LM. et al. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet Glob Health 2018; 6: e1077-e1086
• 38 Ng SW, Popkin BM. Time use and physical activity: a shift away from movement across the globe. Obes Rev 2012; 13: 659-680
• 39 Lamoureux NR, Fitzgerald JS, Norton KI. et al. Temporal Trends in the Cardiorespiratory Fitness of 2,525,827 Adults Between 1967 and 2016: A Systematic Review. Sports Med 2019; 49: 41-55
• 40 Tomkinson GR, Lang JJ, Tremblay MS. Temporal trends in the cardiorespiratory fitness of children and adolescents representing 19 high-income and upper middle-income countries between 1981 and 2014. Br J Sports Med 2019; 53: 478-486
• 41 Rost R, Hollmann W. Belastungsuntersuchungen in der Praxis. Stuttgart: Thieme Verlag; 1982
• 42 Kaminsky LA, Myers J, Arena R. Determining Cardiorespiratory Fitness With Precision: Compendium of Findings From the FRIEND Registry. Prog Cardiovasc Dis 2019; 62: 76-82
• 43 Gläser S, Ittermann T, Schäper C. et al. Referenzwerte für die Spiroergometrie – Ergebnisse der Study of Health in Pomerania (SHIP). Pneumologie 2013; 67: 58-63
• 44 Rapp D, Scharhag J, Wagenpfeil S. et al. Reference values for peak oxygen uptake: cross-sectional analysis of cycle ergometry-based cardiopulmonary exercise tests of 10 090 adult German volunteers from the Prevention First Registry. BMJ Open 2018; 8: e018697
• 45 Lollgen H, Leyk D. Exercise testing in sports medicine. Dtsch Arztebl Int 2018; 115: 409-416
• 46 Evans HJ, Ferrar KE, Smith AE. et al. A systematic review of methods to predict maximal oxygen uptake from submaximal, open circuit spirometry in healthy adults. J Sci Med Sport 2015; 18: 183-188