Evidence map›Paper›PMID 25590619›Full record

ArticlePloS one2015

BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis.

Ana Díez-Fernández, Mairena Sánchez-López, Roberto Gulías-González, Blanca Notario-Pacheco, Jorge Cañete García-Prieto, Natalia Arias-Palencia, Vicente Martínez-Vizcaíno

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In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ana Díez-FernándezSocial and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain; Faculty of Occupational Therapy, Speech Therapy and Nursing, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain.
Mairena Sánchez-LópezSocial and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain; Faculty of Education, University of Castilla-La Mancha, Ciudad Real, Spain.
Roberto Gulías-GonzálezFaculty of Education, University of Castilla-La Mancha, Ciudad Real, Spain.
Blanca Notario-PachecoSocial and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain.
Jorge Cañete García-PrietoSocial and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain.
Natalia Arias-PalenciaSocial and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain.
Vicente Martínez-VizcaínoSocial and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMuscular fitness levels have been associated with cardiometabolic risk in children, although whether body weight acts as a confounder or as an intermediate variable in this relationship remains controversial. The aim of this study was to examine whether the association between muscular fitness and cardiometabolic risk factors is mediated by body mass index (BMI). DESIGN AND

methodsCross-sectional study using a sample of 1158 schoolchildren aged 8-11 years from the province of Cuenca, Spain. We measured anthropometrics and biochemical variables and we calculated a muscular fitness index as the sum of z-scores of handgrip dynamometry/weight and standing long jump, and we estimated a previously validated cardiometabolic risk index (CMRI). Linear regression models were fitted for mediation analysis to assess whether the association between muscular fitness and cardiometabolic risk was mediated by BMI.

resultsChildren with normal weight (NW) had a better cardiometabolic risk profile than their overweight (OW) or obese (OB) peers after controlling for muscular fitness. Marginal estimated mean ± SE values for NW, OW and OB categories of CMRI were -0.75 ± 0.06 < 0.84 ± 0.10 < 2.18 ± 0.16 in boys and -0.73 ± 0.06 < 0.96 ± 0.10 < 2.71 ± 0.17 in girls, both p < 0.001. Children with higher levels of muscular fitness had a better cardiometabolic risk profile (CMRI marginal estimated mean ± SE 1.04 ± 0.13 > 0.05 ± 0.09 >-1.16 ± 0.13 for lower, middle and upper quartiles of muscular fitness in boys and 1.01 ± 0.16 > 0.10 ± 0.09 > -1.02 ± 0.15 in girls, both p < 0.001), but differences disappeared when controlling for BMI. BMI acted as a full mediator between muscular fitness and most cardiometabolic risk factors (Sobel test z = -11.44 for boys; z = -11.83 for girls; p < 0.001 in CMRI mediation model) and as a partial mediator in the case of waist circumference (Sobel test z=-14.86 for boys; z=-14.51 for girls; p<0.001).

conclusionsBMI mediates the association between muscular fitness and cardiometabolic risk in schoolchildren. Overall, good muscular fitness is associated with lower cardiometabolic risk, but particularly when accompanied by normal weight.

Indexed as

Body Mass IndexCardiovascular DiseasesChildCross-Sectional StudiesFemaleHand StrengthHumansMaleMuscle, SkeletalObesityPhysical FitnessRisk FactorsWaist Circumference

Identifiers

PMID25590619
PMCPMC4295865

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.