Functional capacity and quality of life in middle-age men and women with high and low number of metabolic risk factors

doi:10.1016/j.ijcard.2007.11.046

International Journal of Cardiology

Volume 133, Issue 2, 3 April 2009, Pages 281-283

https://doi.org/10.1016/j.ijcard.2007.11.046 Get rights and content

Abstract

It is not clear if men and women with high numbers of risk factors (HiMF) for metabolic syndrome (MetS) have impaired capacities to perform activities of daily living (ADL's) and lower quality of life (QoL) in the absence of symptomatic heart disease. Our results indicate that in women there is a correlation between the number of risk factors and the capacity to perform ADL's and QoL. This was not evident for men. These findings may partly explain why women tend to consult healthcare practitioners earlier in the disease process than men.

References (8)

M.J. LaMonte et al.
Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women
Circulation
(2005)
H.A. Doll et al.
Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire
Obes Res
(2000)
B.A. Chambers et al.
Cumulative effects of cardiovascular disease risk factors on quality of life
J Nutr Health Aging (Ed. esp.)
(2002)
D.G. Conaway et al.
Frequency of undiagnosed and untreated diabetes mellitus in patients with acute coronary syndromes
Expert Rev Cardiovasc Ther
(2006)

There are more references available in the full text version of this article.

Cited by (12)

Physical performance and disability in schizophrenia
2014, Schizophrenia Research: Cognition
Citation Excerpt :
Despite the ubiquitously poor fitness levels of patients with schizophrenia and the recognized impact of fitness on health status and physical and cognitive functioning reported in non-psychiatric samples, little information is available concerning how different physical performance factors can impact health and daily activities in schizophrenia patients. Without this information targeted interventions to improve health and reduce disability are not possible Capodaglio et al., 2010; Fleg et al., 2000; Levinger et al., 2009. We have developed a comprehensive model (Fig. 1) to conceptualize the multimodal relationships between the known and novel factors presented above that may predict ADL disability in schizophrenia.
Despite 50 years of pharmacological and psychosocial interventions, schizophrenia remains one of the leading causes of disability. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. The end result is a considerably reduced lifespan that is marred by reduced levels of independence, with few novel treatment options available.
Disability is a multidimensional construct that results from different, and often interacting, factors associated with specific types and levels of impairment. In schizophrenia, the most poignant and well characterized determinants of disability are symptoms, cognitive and related skills deficits, but there is limited understanding of other relevant factors that contribute to disability. Here we conceptualize how reduced physical performance interacts with aging, neurobiological, treatment-emergent, and cognitive and skills deficits to exacerbate ADL disability and worsen physical health. We argue that clearly defined physical performance components represent underappreciated variables that, as in mentally healthy people, offer accessible targets for exercise interventions to improve ADLs in schizophrenia, alone or in combination with improvements in cognition and health. And, finally, due to the accelerated aging pattern inherent in this disease – lifespans are reduced by 25 years on average – we present a training model based on proven training interventions successfully used in older persons. This model is designed to target the physical and psychological declines associated with decreased independence, coupled with the cardiovascular risk factors and components of the metabolic syndrome seen in schizophrenia due to their excess prevalence of obesity and low fitness levels.
Relationship between low muscle strength and metabolic risk factors in obese postmenopausal women: A pilot study
2012, Canadian Journal of Diabetes
Citation Excerpt :
Accordingly, Atlantis et al (8) observed that muscle strength was a strong independent protective factor of insulin sensitivity. Levinger et al (18) also found some evidence to suggest that having a high number of metabolic risk factors, even without symptomatic heart disease, may affect exercise capacity, muscle strength and the capacity to perform activities of daily living as well as the quality of life in women. When combined with obesity, low muscle strength has recently been shown to be associated with a more impaired physical function than low muscle strength or obesity alone (19).
To examine the relationship between low muscle strength and the metabolic profile in obese postmenopausal women.
Forty-seven obese postmenopausal women were recruited (age: 60 ± 5 y; body mass index: 34.1 ± 3.5 kg/m²). Obesity was defined as a fat mass % >40. Subjects were considered as having low muscle strength levels based on a cut-point of handgrip strength measurement of <28.56 kg. Outcome measures were anthropometric measurements, body composition (dual-energy x-ray absorptiometry [DXA]), handgrip strength and cardiometabolic risk factors (i.e. lipid profile, insulin sensitivity).
No significant differences were observed between women with low and normal handgrip strength for anthropometric measurements, body composition and lipid profile. However, we observed that insulin (p=0.049), glucose (p=0.036) and homeostatic model assessment (p=0.048) were significantly lower, and insulin sensitivity (Matsuda index) significantly higher (p=0.042) in women with low muscle strength compared to women with normal muscle strength.
Low muscle strength seems to be associated with a better insulinemic profile in obese postmenopausal women.
Examiner le lien entre la faible force musculaire et le profil métabolique chez les femmes postménopausées obèses.
Quarante-sept (47) femmes postménopausées obèses ont été recrutées (âge : 60 ± 5 a; indice de masse corporelle : 34,1 ± 3,5 kg/m²). L’obésité a été définie comme un % de masse grasse > 40. Les sujettes ont été considérées comme ayant un niveau de force musculaire faible selon un seuil de mesure de la force au dynamomètre < 28,56 kg. Les critères d’évaluation étaient les mesures anthropométriques, la composition corporelle (DEXA : dual-energy x-ray absorptiometry qui signifie absorptiométrie à rayons X en double énergie), la force au dynamomètre et les facteurs de risque cardiométabolique (c.-à-d. le bilan lipidique, la sensibilité à l’insuline).
Aucune différence significative des mesures anthropométriques, de la composition corporelle et du profil métabolique n’a été observée entre les femmes ayant une force au dynamomètre, faible ou normale. Cependant, nous avons observé que l’insuline (p = 0,049), le glucose (p = 0,036) et le modèle d’évaluation homéostatique (p = 0,048) étaient significativement plus faibles, et la sensibilité à l’insuline (indice de Matsuda), significativement plus élevée (p = 0,042) chez les femmes ayant une faible force musculaire comparativement aux femmes ayant une force musculaire normale.
Une faible force musculaire semble être associée à un meilleur profil insulinémique chez les femmes postménopausées obèses.
Low cardiorespiratory fitness and physical functional capacity in obese patients with schizophrenia
2011, Schizophrenia Research
Citation Excerpt :
Because the level of cardiorespiratory fitness may be extremely low in patients with schizophrenia, amounting to a state of deconditioning and a very low capacity for sustained physical activity that is high in intensity, activities promoting low to moderate activity levels may serve the population well and lead to highly relevant improvements in health prospects. 2) On a more fundamental level, cardiorespiratory fitness translates directly into the ability to engage in aerobic, i.e., oxygen-using, work, and as such, is a requirement for all activities of daily living (Levinger et al., 2009; Fleg et al., 2000). Cardiorespiratory fitness, in this context, becomes an important predeterminant for health-related quality of life, and increases in cardiorespiratory fitness commensurately increase functional capacity (Fleg et al., 2000).
Low cardiorespiratory fitness is a prominent behavioral risk factor for cardiovascular disease (CVD) morbidity and mortality, as cardiorespiratory fitness is strongly associated with CVD outcomes. High rates of CVD have been observed in the schizophrenia population, translating into a markedly reduced life expectancy as compared to healthy controls. Surprisingly however, while cardiorespiratory fitness is an eminent indicator for overall cardiovascular health as well as eminently modifiable risk factor for CVD, no studies have systematically assessed cardiorespiratory fitness in schizophrenia.
Community-dwelling schizophrenia patients underwent graded-exercise tests, to ascertain maximal oxygen uptake (Max Vo2), considered to be the gold standard for the evaluation of cardiorespiratory fitness and physical functional capacity. The modified Bruce protocol was used to ascertain cardiorespiratory fitness and physical functional capacity; data was normalized and compared to population standards derived from the ACLS (Aerobics Center Longitudinal Study) and the National Health and Nutrition Examination Surveys (NHANES), Cycles III and IV.
Data for n = 117 participants (41% male, 46% white) was analyzed. Mean age (y) was 43.2 ± 9.9, and mean BMI was 37.2 ± 7.3. Peak HR attained during exercise was 145.6 ± 19.6, after 8.05 ± 3.6 min, achieving 111.2 ± 44.2 W. Max Vo2 was 1.72 ± 6.6 l/min, MaxVCo2 1.85 ± 7.2 l/min, and minute ventilation (VE) was 55.6 ± 21.9 ml/s. PANSS Positive subscores (13.3 ± 4.4; r = −0.21, p = 0.024) were inversely correlated with Max Vo2 ml^− 1min^− 1kg^− 1. Neither PANSS Total (56.3 ± 12.3; r = −0.105, p = 0.72), PANSS Negative (14 ± 5.1; r = −0.52, p = 0.57) nor PANSS General Psychopathology (28.4 ± 7.4; r = −0.28, p = 0.76) scores were correlated with Max Vo2 ml^− 1min^− 1kg^− 1. Peak heart rate and duration of exercise were not correlated with PANSS scores. Compared to healthy controls derived from the ACLS and NHANES, respectively, 115 participants achieved ‘low levels’ of fitness only, as well as highly significantly reduced Max Vo2, across all age groups.
The test was generally well received and tolerated by those who elected to participate; and adherence to the protocol was good. Among participants with schizophrenia, most of whom were obese, and across all age groups, cardiorespiratory fitness was exceedingly poor. Only two participants in our entire sample fit the categorization of ‘moderate fitness level’; that is, a fitness level at or above the 20th percentile of ACLS-derived population comparisons. Conversely, this left 98.3% of participants with schizophrenia below population standards. Low cardiorespiratory fitness emerges as an eminent modifiable risk factor for CVD mortality and morbidity in schizophrenia complicated by obesity.
Sex differences in relationships between metabolic syndrome components and factors associated with health-related quality of life in middle-aged adults living in the community: A cross-sectional study in Taiwan
2018, Health and Quality of Life Outcomes
Pilates exercise to improve lower limb strength and abdominal endurance in the workplace
2016, Journal of Physical Education and Sport
Live strong and prosper: the importance of skeletal muscle strength for healthy ageing
2016, Biogerontology

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Letter to the EditorFunctional capacity and quality of life in middle-age men and women with high and low number of metabolic risk factors

Abstract

Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women

Circulation

Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire

Obes Res

Cumulative effects of cardiovascular disease risk factors on quality of life

J Nutr Health Aging (Ed. esp.)

Frequency of undiagnosed and untreated diabetes mellitus in patients with acute coronary syndromes

Expert Rev Cardiovasc Ther

Letter to the Editor
Functional capacity and quality of life in middle-age men and women with high and low number of metabolic risk factors