Reference values for cardiorespiratory fitness in healthy Koreans: compared to western nations and nomogram

European Heart Journal(2019)

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Abstract Introduction Cardiorespiratory Fitness (CRF), defined as the integrated ability to properly oxygenate skeletal muscles during physical activity, is associated with a high risk of cardiovascular disease and all-cause mortality. The reference range for CRF may differ among nations, with Asians under-represented in previous data. Purpose In this study, we sought to establish reference values of CRF for Asians using a recent Korean cohort. Methods We analyzed 2646 healthy Korean adults recently enrolled in the Korea Institute of Sports Science Fitness Standards (KISS FitS) project with estimated maximal oxygen uptake (VO2max) values during treadmill test. Patients with cardiovascular or renal disease, systemic infection, pregnant women and those with orthopedic injuries unable to measure physical fitness were excluded. Age-specific mean VO2max values were compared with those from recent American, Norwegian, Danish cohorts and old Korean data. Results Age-specific reference values for healthy Korean adults in this cohort were as shown (Table). We were able to draw a nomogram to predict exercise capacity for a given age and MET value (Figure). When compared to other countries, less CRF reduction by aging was seen in Asians than in other Westerners. When compared to old Korean data from the 1980s, values were similar after adjustment for difference in methods, except for those under 30 years old which were decreased. Exercise capacity of healthy Korean Men Women Age VO2max (ml/kg/min) N P-value for trend Age VO2max (ml/kg/min) N P-value for trend 19–29 42.3±6.3± 209 <0.01 19–29 34.3±4.3± 110 <0.01 30–39 42.0±5.0± 170 39–39 32.2±4.5± 211 40–49 41.4±5.6± 238 40–49 30.8±4.6± 284 50–59 38.0±5.7± 274 50–59 28.3±4.6± 367 60–69 32.4±6.2± 134 60–69 26.0±5.7± 336 70–79 27.2±5.6± 83 70–79 23.9±4.4± 195 >80 24.1±4.0± 11 >80 21.0±3.7± 24 Total 38.6±7.4± 1119 Total 28.5±5.8 1527 Data are presented as mean ± standard deviation. VO2max, maximal oxygen uptake; N, number. Nomogram of exercise capacity in Koreans Conclusions While there was no significant change in CRF over time in the same ethnic group, there was a clear inter-ethnic difference. CRF should be assessed according to ethnic or national standards, and it is necessary to establish a reference for each nation or ethnicity with periodic updates. Acknowledgement/Funding National Sports Promotion Fund of the Korea Sports Promotion Foundation in 2015
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