{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:51:27Z","timestamp":1788187887882,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019000","name":"Medical Affairs Bureau","doi-asserted-by":"publisher","award":["MND\u2010MAB\u2010D\u2010113200"],"award-info":[{"award-number":["MND\u2010MAB\u2010D\u2010113200"]}],"id":[{"id":"10.13039\/501100019000","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019813","name":"Hualien Armed Forces General Hospital","doi-asserted-by":"publisher","award":["HAFGH\u2010D\u2010113008"],"award-info":[{"award-number":["HAFGH\u2010D\u2010113008"]}],"id":[{"id":"10.13039\/100019813","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiorespiratory fitness (CRF) could reduce the risk of metabolic syndrome (MetS) while the association between muscular endurance capacity (MEC) and incident MetS has rarely been investigated in young adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 2890 military men and women, aged 18\u201339\u00a0years, free of baseline MetS in Taiwan, were followed for incident MetS from baseline (2014) until the end of 2020. All subjects received annual health examinations for assessment of MetS. Physical fitness was assessed by CRF (estimated maximal oxygen uptake, VO<jats:sub>2<\/jats:sub> max [mL\/kg\/min], in a 3000\u2010m run) and MEC (numbers of 2\u2010min push\u2010ups). MetS was defined according to the International Diabetes Federation (IDF) criteria. Multiple Cox regression analysis was conducted with adjustments for baseline age, sex, substance use status and physical activity to determine the associations of CRF and MEC with incidences of new\u2010onset MetS and related features, for example, central obesity, hypertension, dyslipidaemia and prediabetes or diabetes. To examine the combined effects of CRF and MEC status on incidence of MetS, high and low levels of CRF and MEC were separately defined by over and under the sex\u2010specific median in each exercise test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a median follow\u2010up of 5.8\u00a0years, there were 673 (23.3%) new\u2010onset MetS. Higher CRF was associated with a lower incidence of MetS (hazard ratio [HR] and 95% confidence interval: 0.905 [0.877\u20130.933]), and its components separately, except hypertension. No association was observed between MEC and incident MetS, and its components separately, except hypertension. When evaluating the combined effects of MEC and CRF status on the incidence of MetS, it was observed that compared with the low CRF\/low MEC, the high CRF\/high MEC (HR: 0.553 [0.439\u20130.697]) and the high CRF\/low MEC (HR: 0.730 [0.580\u20130.918]) had a lower incidence of new\u2010onset MetS (<jats:italic>P<\/jats:italic> value for the intergroup difference\u00a0=\u00a00.04). There was no significant result for the low CRF\/high MEC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study highlights that although the protective effects of MEC to reduce the incidence of MetS and most of its related features were mainly driven by CRF in young adults, there was an addictive effect of greater MEC on CRF to prevent the development of new\u2010onset MetS before midlife.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13503","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T08:24:23Z","timestamp":1717748663000},"page":"1483-1490","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The combined effect of cardiorespiratory and muscular fitness on the incidence of metabolic syndrome before midlife"],"prefix":"10.1002","volume":"15","author":[{"given":"Kun\u2010Zhe","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Medicine Hualien Armed Forces General Hospital  Hualien Taiwan"},{"name":"Department of Stomatology of Periodontology Mackay Memorial Hospital  Taipei Taiwan"},{"name":"Department of Periodontology School of Dentistry, National Defense Medical Center and Tri\u2010Service General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen\u2010Chih","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Medicine Tri\u2010Service General Hospital and National Defense Medical Center  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Chun","family":"Huang","sequence":"additional","affiliation":[{"name":"College of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Department of Critical Care Medicine Kaohsiung Veterans General Hospital  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, Arnold School of Public Health University of South Carolina  Columbia SC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl J.","family":"Lavie","sequence":"additional","affiliation":[{"name":"John Ochsner Heart and Vascular Institute, Ochsner Clinical School University of Queensland School of Medicine  New Orleans LA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5509-1056","authenticated-orcid":false,"given":"Gen\u2010Min","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine Hualien Armed Forces General Hospital  Hualien Taiwan"},{"name":"Department of Medicine Tri\u2010Service General Hospital and National Defense Medical Center  Taipei 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