The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare

Abstract Background Cardiorespiratory fitness (CRF) and physical activity (PA) are well-established predictors of morbidity and all-cause mortality. However, CRF is not routinely measured and PA not routinely prescribed as part of standard healthcare. The American Heart Association (AHA) recently pr...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ken B. Hanscombe, Elodie Persyn, Matthew Traylor, Kylie P. Glanville, Mark Hamer, Jonathan R. I. Coleman, Cathryn M. Lewis
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cardiorespiratory fitness Physical activity Genetics Genome-wide association UK Biobank Medicine R QH426-470
Acceso en línea:	https://doaj.org/article/619993f082df4c9d9a4ad56bdd0a416a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:619993f082df4c9d9a4ad56bdd0a416a
record_format	dspace
spelling	oai:doaj.org-article:619993f082df4c9d9a4ad56bdd0a416a2021-11-14T12:27:41ZThe genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare10.1186/s13073-021-00994-91756-994Xhttps://doaj.org/article/619993f082df4c9d9a4ad56bdd0a416a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13073-021-00994-9https://doaj.org/toc/1756-994XAbstract Background Cardiorespiratory fitness (CRF) and physical activity (PA) are well-established predictors of morbidity and all-cause mortality. However, CRF is not routinely measured and PA not routinely prescribed as part of standard healthcare. The American Heart Association (AHA) recently presented a scientific case for the inclusion of CRF as a clinical vital sign based on epidemiological and clinical observation. Here, we leverage genetic data in the UK Biobank (UKB) to strengthen the case for CRF as a vital sign and make a case for the prescription of PA. Methods We derived two CRF measures from the heart rate data collected during a submaximal cycle ramp test: CRF-vo2max, an estimate of the participants' maximum volume of oxygen uptake, per kilogram of body weight, per minute; and CRF-slope, an estimate of the rate of increase of heart rate during exercise. Average PA over a 7-day period was derived from a wrist-worn activity tracker. After quality control, 70,783 participants had data on the two derived CRF measures, and 89,683 had PA data. We performed genome-wide association study (GWAS) analyses by sex, and post-GWAS techniques to understand genetic architecture of the traits and prioritise functional genes for follow-up. Results We found strong evidence that genetic variants associated with CRF and PA influenced genetic expression in a relatively small set of genes in the heart, artery, lung, skeletal muscle and adipose tissue. These functionally relevant genes were enriched among genes known to be associated with coronary artery disease (CAD), type 2 diabetes (T2D) and Alzheimer’s disease (three of the top 10 causes of death in high-income countries) as well as Parkinson’s disease, pulmonary fibrosis, and blood pressure, heart rate, and respiratory phenotypes. Genetic variation associated with lower CRF and PA was also correlated with several disease risk factors (including greater body mass index, body fat and multiple obesity phenotypes); a typical T2D profile (including higher insulin resistance, higher fasting glucose, impaired beta-cell function, hyperglycaemia, hypertriglyceridemia); increased risk for CAD and T2D; and a shorter lifespan. Conclusions Genetics supports three decades of evidence for the inclusion of CRF as a clinical vital sign. Given the genetic, clinical and epidemiological evidence linking CRF and PA to increased morbidity and mortality, regular measurement of CRF as a marker of health and routine prescription of PA could be a prudent strategy to support public health.Ken B. HanscombeElodie PersynMatthew TraylorKylie P. GlanvilleMark HamerJonathan R. I. ColemanCathryn M. LewisBMCarticleCardiorespiratory fitnessPhysical activityGeneticsGenome-wide associationUK BiobankMedicineRGeneticsQH426-470ENGenome Medicine, Vol 13, Iss 1, Pp 1-19 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cardiorespiratory fitness Physical activity Genetics Genome-wide association UK Biobank Medicine R Genetics QH426-470
spellingShingle	Cardiorespiratory fitness Physical activity Genetics Genome-wide association UK Biobank Medicine R Genetics QH426-470 Ken B. Hanscombe Elodie Persyn Matthew Traylor Kylie P. Glanville Mark Hamer Jonathan R. I. Coleman Cathryn M. Lewis The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
description	Abstract Background Cardiorespiratory fitness (CRF) and physical activity (PA) are well-established predictors of morbidity and all-cause mortality. However, CRF is not routinely measured and PA not routinely prescribed as part of standard healthcare. The American Heart Association (AHA) recently presented a scientific case for the inclusion of CRF as a clinical vital sign based on epidemiological and clinical observation. Here, we leverage genetic data in the UK Biobank (UKB) to strengthen the case for CRF as a vital sign and make a case for the prescription of PA. Methods We derived two CRF measures from the heart rate data collected during a submaximal cycle ramp test: CRF-vo2max, an estimate of the participants' maximum volume of oxygen uptake, per kilogram of body weight, per minute; and CRF-slope, an estimate of the rate of increase of heart rate during exercise. Average PA over a 7-day period was derived from a wrist-worn activity tracker. After quality control, 70,783 participants had data on the two derived CRF measures, and 89,683 had PA data. We performed genome-wide association study (GWAS) analyses by sex, and post-GWAS techniques to understand genetic architecture of the traits and prioritise functional genes for follow-up. Results We found strong evidence that genetic variants associated with CRF and PA influenced genetic expression in a relatively small set of genes in the heart, artery, lung, skeletal muscle and adipose tissue. These functionally relevant genes were enriched among genes known to be associated with coronary artery disease (CAD), type 2 diabetes (T2D) and Alzheimer’s disease (three of the top 10 causes of death in high-income countries) as well as Parkinson’s disease, pulmonary fibrosis, and blood pressure, heart rate, and respiratory phenotypes. Genetic variation associated with lower CRF and PA was also correlated with several disease risk factors (including greater body mass index, body fat and multiple obesity phenotypes); a typical T2D profile (including higher insulin resistance, higher fasting glucose, impaired beta-cell function, hyperglycaemia, hypertriglyceridemia); increased risk for CAD and T2D; and a shorter lifespan. Conclusions Genetics supports three decades of evidence for the inclusion of CRF as a clinical vital sign. Given the genetic, clinical and epidemiological evidence linking CRF and PA to increased morbidity and mortality, regular measurement of CRF as a marker of health and routine prescription of PA could be a prudent strategy to support public health.
format	article
author	Ken B. Hanscombe Elodie Persyn Matthew Traylor Kylie P. Glanville Mark Hamer Jonathan R. I. Coleman Cathryn M. Lewis
author_facet	Ken B. Hanscombe Elodie Persyn Matthew Traylor Kylie P. Glanville Mark Hamer Jonathan R. I. Coleman Cathryn M. Lewis
author_sort	Ken B. Hanscombe
title	The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
title_short	The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
title_full	The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
title_fullStr	The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
title_full_unstemmed	The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
title_sort	genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
publisher	BMC
publishDate	2021
url	https://doaj.org/article/619993f082df4c9d9a4ad56bdd0a416a
work_keys_str_mv	AT kenbhanscombe thegeneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT elodiepersyn thegeneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT matthewtraylor thegeneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT kyliepglanville thegeneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT markhamer thegeneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT jonathanricoleman thegeneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT cathrynmlewis thegeneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT kenbhanscombe geneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT elodiepersyn geneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT matthewtraylor geneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT kyliepglanville geneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT markhamer geneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT jonathanricoleman geneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare AT cathrynmlewis geneticcaseforcardiorespiratoryfitnessasaclinicalvitalsignandtheroutineprescriptionofphysicalactivityinhealthcare
_version_	1718429229344882688

The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare

Ejemplares similares