The prognostic role of key indices of cardiopulmonary exercise testing in the overweight and obese Brazilian population.

• Grant number: 24/14823-3
• Support Opportunities: Regular Research Grants
• Start date: May 01, 2025
• End date: April 30, 2028
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Audrey Borghi Silva
• Grantee: Audrey Borghi Silva
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Associated researchers: Claudio Ricardo de Oliveira ; Jonathan Myers ; Ross Arena

Abstract

Introduction: Poor cardiorespiratory fitness (CRF) has been suggested as an independent risk factor in obese individuals. However, little is known about the coexistence of other comorbidities, such as hypertension, diabetes mellitus, smoking, alcoholism, among other pre-existing diseases, which may impact the morbidity and mortality of these individuals (asthma, coronary artery disease, obstructive sleep apnea, heart failure, among others). Objectives: The primary objective of the present study will be to evaluate the key variables of the cardiopulmonary exercise test (CPET) to predict morbidity and mortality from all causes in a cohort of obese and overweight individuals. Secondarily, we aimed to determine the relative risk (RR), the population attributable risk (RAP) and the exposure impact number (NIE) of the main CPET variables as well as the impact of the main most prevalent comorbidities in the studied population.Methods: Individuals over 18 years of age of both sexes who will undergo a CPET will be evaluated. All-cause mortality at 24 months will be the primary outcome. An analysis of the ROC curve will be performed to establish ideal cutoff points for CPET variables. Kaplan-Meier and Cox regression analyses will be used to determine the association between CPET variables and all-cause mortality, adjusted for age, smoking, hypertension, diabetes, and all comorbidities. The attributable risk (ARR) will be expressed as the overall impact of a given risk factor among an exposed minus an unexposed group. The exposure impact number (EIN), which represents the average number of patients subjected to a specific risk factor requiring removal of that exposure to prevent an additional adverse event or outcome, will also be calculated.Expected results: It is expected to obtain, through direct measures of CRF, key CPET indices for determining all-cause mortality in obese individuals. These findings may provide important benchmarks for future studies aimed at improving CRF in obese individuals. In addition, important epidemiological measures may translate into future recommendations for the obese population at risk of reduced CRF. These findings may serve as a basis for future studies on obese and overweight patients in other countries. (AU)