{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:26:19Z","timestamp":1793759179544,"version":"4.6.1"},"reference-count":49,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100020013","name":"NIHR Leicester Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020624","name":"NIHR Nottingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020624","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate associations of cardiorespiratory fitness (CRF) with metabolic syndrome (MetS) trait count, MetS prevalence and individual MetS traits in a large population\u2010based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study analysed data for 39\u2009197 adults from a UK\u2010based independent healthcare charity (mean\u2009\u00b1\u2009SD: age, 45.8\u2009\u00b1\u20099.0\u2009years; BMI, 26.3\u2009\u00b1\u20094.1\u2009kg\u22c5m\n                      <jats:sup>\u22122<\/jats:sup>\n                      ; 31% female). CRF was estimated as peak oxygen uptake from submaximal treadmill or cycle ergometer protocols and analysed continuously and as sex\u2010 and mode\u2010specific quintiles. MetS was defined using established criteria, with outcomes examined as trait count (0\u20135), presence (\u2265\u20093 traits) and individual traits. Associations were assessed using negative binomial regression for trait count and Poisson regression for MetS presence. Models were sequentially adjusted for demographics (primary model), adiposity (BMI) and hepatic steatosis (fatty liver index [FLI]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each 1\u2009mL\u22c5kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u22c5min\n                      <jats:sup>\u22121<\/jats:sup>\n                      higher CRF was associated with a 2.9% lower MetS trait count and 6.0% lower MetS prevalence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Compared with the highest CRF quintile, the lowest quintile had a 2.4\u2010fold higher MetS trait count and 5.4\u2010fold higher MetS prevalence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Associations persisted after BMI and FLI adjustment, although attenuated. Spline analyses demonstrated graded, non\u2010linear inverse associations, steepest at lower CRF levels. Higher CRF was inversely associated with all individual MetS traits, strongest for central obesity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher CRF was associated with lower metabolic risk burden and MetS prevalence, which remained after adjustment for adiposity\u2010related measures. These findings support the potential public health relevance of modest fitness improvements, particularly among the least fit adults, as a strategy that may help reduce MetS burden even when adiposity changes are limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71367","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:47:17Z","timestamp":1789710437000},"page":"11608-11620","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Higher Cardiorespiratory Fitness Is Associated With a Lower Burden of Metabolic Syndrome Traits: A Cross\u2010Sectional Analysis of 39\u2009197\n                    <scp>UK<\/scp>\n                    Adults"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8624-1427","authenticated-orcid":false,"given":"Scott A.","family":"Willis","sequence":"first","affiliation":[{"name":"National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences Loughborough University  Loughborough UK"},{"name":"NIHR Leicester Biomedical Research Centre University Hospitals of Leicester NHS Trust and the University of Leicester  Leicester UK"},{"name":"Diabetes Research Centre, College of Life Sciences University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalena","family":"Phillipp","sequence":"additional","affiliation":[{"name":"National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences Loughborough University  Loughborough UK"},{"name":"Department for Physical Activity in Public Health Institute of Movement and Neurosciences, German Sport University Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Deighton","sequence":"additional","affiliation":[{"name":"National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences Loughborough University  Loughborough UK"},{"name":"Nuffield Health Research Group Nuffield Health  Epsom UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Nuffield Health Research Group Nuffield Health  Epsom UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Cuthbertson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences, University of Liverpool  Liverpool UK"},{"name":"Liverpool University Hospitals NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley E.","family":"Keating","sequence":"additional","affiliation":[{"name":"School of Human Movement and Nutrition Sciences The University of Queensland  St Lucia Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J. A.","family":"Pugh","sequence":"additional","affiliation":[{"name":"School of Life Course &amp; Population Health Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan G.","family":"Stine","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Penn State Health Milton S. Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga\u00ebl","family":"Ennequin","sequence":"additional","affiliation":[{"name":"Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P) Clermont Auvergne University  Clermont\u2010Ferrand France"},{"name":"International Research Chair Health in Motion Clermont Auvergne University Foundation  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Couret","sequence":"additional","affiliation":[{"name":"Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P) Clermont Auvergne University  Clermont\u2010Ferrand France"},{"name":"International Research Chair Health in Motion Clermont Auvergne University Foundation  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Stensel","sequence":"additional","affiliation":[{"name":"National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences Loughborough University  Loughborough UK"},{"name":"NIHR Leicester Biomedical Research Centre University Hospitals of Leicester NHS Trust and the University of Leicester  Leicester UK"},{"name":"Faculty of Sport Sciences Waseda University  Tokorozawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guruprasad P.","family":"Aithal","sequence":"additional","affiliation":[{"name":"Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine University of Nottingham  Nottingham UK"},{"name":"NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust and the University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Yates","sequence":"additional","affiliation":[{"name":"NIHR Leicester 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