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The cross-sectional study, conducted by Alessandro Gatti and colleagues from the Laboratory of Adapted Motor Activity (LAMA) at the University of Pavia, examined the association between physical fitness and metabolic syndrome severity in children with obesity. Metabolic syndrome, characterized by a cluster of cardiometabolic risk factors including high blood pressure, abnormal lipid levels, and increased waist circumference, is increasingly observed in the pediatric population, particularly in those with obesity.

The researchers assessed 62 children and adolescents aged 7–17 years with a BMI z-score greater than two standard deviations. Physical fitness was evaluated across three domains: cardiorespiratory fitness, muscular strength, and speed-agility. The severity of metabolic syndrome was determined using a MetS risk score derived from BMI z-score, HDL cholesterol, systolic blood pressure, triglycerides, and fasting glucose.

Based on the study, the researchers reported the following findings:

• Lower limb muscular strength, assessed through the standing broad jump test, was significantly linked to reduced odds of metabolic syndrome.
• A 1 standard deviation (24 cm) increase in jump distance was associated with a 53% lower risk (OR: 0.47).
• Cardiorespiratory fitness and speed-agility did not show significant associations with metabolic syndrome or other cardiometabolic outcomes in this group.
• Muscular strength demonstrated inverse relationships with BMI z-score, systolic blood pressure, and waist-to-height ratio.

These results emphasize the role of maintaining muscle integrity in supporting metabolic health during childhood and adolescence.

The authors noted that while the sample size was relatively small, the study maintained sufficient statistical power and followed strict ethical and methodological guidelines, including the STROBE recommendations. They acknowledged that the cross-sectional design limits causal interpretation, but the findings provide valuable insights into the linear relationship between physical fitness components and metabolic syndrome risk in children with obesity.

Importantly, this is the first study to explore these associations in Italian children and adolescents with obesity using a comprehensive battery of physical fitness tests. The findings emphasize the need to integrate muscle-strengthening activities into early-life physical activity programs to promote balanced growth, skeletal muscle health, and long-term prevention of metabolic diseases.

“Educating children about the importance of daily physical activity from a young age is crucial for fostering lifelong healthy habits,” the authors stated, adding that public health initiatives should prioritize strategies to enhance muscular strength among pediatric populations at risk.

The authors concluded, “By encouraging regular physical activity and incorporating targeted strength exercises, healthcare providers and caregivers can play a vital role in reducing metabolic risks and supporting overall health in children struggling with obesity.”

Reference:

Vandoni, M., Gatti, A., Carnevale Pellino, V. et al. Exploring the link between metabolic syndrome risk and physical fitness in children with obesity: a cross-sectional study. Eur J Pediatr 184, 497 (2025). https://doi.org/10.1007/s00431-025-06339-7

Conducted by Anne E. Ioannides and her colleagues at the School of Public Health, Imperial College London, the prospective cohort study utilised electronic health records from across England between 2010 and 2019. Researchers analysed data from the Clinical Practice Research Datalink Aurum, which was linked with hospital and mortality records, to assess outcomes in COPD patients who experienced at least one hospitalisation compared to those who did not.

The study focused on two primary outcomes: non-fatal MACE—including acute coronary syndrome, arrhythmia, heart failure, or ischemic stroke—and cause-specific mortality over one year post-hospitalisation. Participants were stratified based on whether the hospitalisation was elective or emergency, and by the cause of admission (cardiovascular, respiratory, or other causes).

The following were the key findings of the study:

• Cardiovascular risk significantly increased in COPD patients following hospitalisation.
• Emergency hospitalisation was associated with an eight-fold higher risk of major cardiovascular events within one year (adjusted hazard ratio [aHR] 8.85).
• Elective hospitalisations were linked to a seven-fold increase in cardiovascular event risk (aHR 7.04) compared to those who were not hospitalised.
• All-cause mortality was notably higher after hospitalisation, especially for emergency admissions (aHR 2.49).
• Elective cardiovascular hospitalisations did not show a significant rise in mortality risk.
• The cause and type of hospitalisation influenced cause-specific mortality outcomes.
• Respiratory-related hospitalisations were more likely to lead to respiratory-related deaths, highlighting a connection between the reason for admission and the eventual cause of death.

The researchers acknowledged several limitations, including potential misclassification of disease causes and lack of data on in-hospital treatments or medication use. Nonetheless, the study leveraged a robust dataset representative of the UK population and employed validated methodological approaches, including sensitivity analyses and propensity score adjustments.

From a clinical and public health standpoint, the study emphasizes the need for proactive cardiovascular screening and management in all COPD patients following hospitalisation, regardless of the reason for admission. Given that cardiovascular disease often remains underdiagnosed and undertreated in COPD patients, hospitalisation presents a key opportunity to initiate preventive strategies aimed at reducing MACE and mortality.

The study concludes that every hospital encounter for individuals with COPD should be viewed as a critical juncture to assess and manage cardiovascular risks. By doing so, healthcare systems may help mitigate the often-overlooked burden of cardiovascular complications and improve long-term outcomes in this high-risk population.

Reference:

Ioannides AE, Whittaker HR, Quint JK. Major Adverse Cardiovascular Events and Cause-Specific Mortality After Hospitalisation in COPD. Int J Chron Obstruct Pulmon Dis. 2025;20:2549-2560

https://doi.org/10.2147/COPD.S529171