Cardiorespiratory Fitness Impact on All-Cause Mortality in Prediabetic Veterans

Eric S. Nylen, David Ni, Jonathan Myers, Manchin Chang, Mary T. Plunkett, Peter Kokkinos


Background: The objective of this study was to evaluate the role of cardiorespiratory fitness (CRF) on all-cause mortality in prediabetic veterans.

Methods: In this prospective cohort study, CRF was calculated from metabolic equivalents (METs) obtained from routine exercise tolerance testing in a cohort of 1,118 prediabetic veterans. Four fitness categories were established: low-fit (< 5.8 METs; lower 25th percentile), mild-fit (5.8 - 7 METs), moderate-fit (7.1 - 8.5 METs) and high-fit (> 8.5 METs; > 75th percentile). Date of death was verified from the Veterans Affairs Beneficiary Identification and Record Locator System File.

Results: The mean follow-up period was 7.7 years (8,610 person-years) and there were a total of 251 deaths, averaging 29.1 events per 1,000 person-years. An inverse and graded association between CRF and mortality risk was observed (P = 0.002). For every 1-MET increase in CRF, the adjusted mortality was lowered by 13% (hazard ratios (HR) = 0.87; CI: 0.81 - 0.94, P < 0.001). The mild-, moderate- and high-Fit subjects had mortality reductions of 32% (HR = 0.68; CI: 0.50 - 0.94, P = 0.02), 40% (HR = 0.60; CI: 0.41 - 0.87, P = 0.007) and 54% (HR = 0.46; CI: 0.30 - 0.70, P < 0.001) respectively.

Conclusions: A strong inverse and graded association between CRF and mortality risk was observed in these prediabetic veterans. Mortality risk was 13% lower for every 1-MET increase in CRF and approximately 50% lower in high-fit individuals (exercise capacity > 8.5 METs) compared to least-fit individuals. With increasing incidence of prediabetes as well as diminished response to preventative lifestyle modifications, enhanced CRF should be advocated in prediabetic individuals.

J Endocrinol Metab. 2015;5(3):215-219


Cardiorespiratory fitness; Prediabetes; All-cause mortality

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.