ERJ Open Research (Jun 2024)

Cardiopulmonary exercise testing and body composition

  • Per Karlsson,
  • Lars Lind,
  • Karl Michaëlsson,
  • Andrei Malinovschi

DOI
https://doi.org/10.1183/23120541.00970-2023
Journal volume & issue
Vol. 10, no. 3

Abstract

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Background The cardiopulmonary exercise test (CPET) evaluates cardiopulmonary function. In light of the obesity epidemic, it is important to understand how body composition affects interpretation of CPET results. The aim of the present study was to assess the relationship between CPET measures, other than peak oxygen uptake, and body composition. Method A total of 330 participants, aged 50 years, performed both a CPET and dual-energy X-ray absorptiometry (DXA). From the CPET, peak exercise respiratory exchange ratio (RER), ventilatory efficiency (V̇E/V̇CO2 slope) and work efficiency (ΔV̇O2/ΔWR) were recorded. Pearson's correlation was used to assess the association between CPET measures and selected body composition measures, including body mass index (BMI), waist circumference, fat mass, lean mass, body fat percentage and percentage trunk fat to fat mass. All analyses were done stratified by sex. A p-value <0.05 defined statistical significance. Results RER was negatively correlated with body composition measures; the strongest correlation was observed with waist circumference in females (r= −0.36). V̇E/V̇CO2 slope had no significant correlations with any body composition measures. ΔV̇O2/ΔWR was positively correlated with the body composition measures; the strongest correlation was observed with BMI (r=0.24). The additive role of percentage body fat and percentage trunk fat were studied in a linear regression model using waist circumference and BMI to predict the aforementioned CPET measures and no additive role was found. Conclusion RER and ΔV̇O2/ΔWR may be influenced by body composition while V̇E/V̇CO2 slope is not affected. Adiposity measures from DXA add no additional explanatory value to the CPET measures.