Reference Value Prediction Model for Peak Oxygen Uptake in the Dutch Population Measured by Incremental Cardiopulmonary Exercise Cycle Ergometry

Abstract

Maximal oxygen uptake represents the functional limit of the body’s ability to deliver and extract oxygen to meet the metabolic demands of vigorous exercise. It is recognized as the gold-standard for aerobic fitness and as an important component in estimating health risk. Therefore, it is essential to have accurate reference values to know what constitutes a healthy value. Currently, there is no existing consensus in scientific literature for the trajectory of the VO2peak development across a person’s entire lifespan. Therefore, there is a risk miss interpreting risk stratification if inadequate varieties of regression models are utilized. Aim: To determine the nature of the regression model for the VO2peak with the progression of age across a person’s entire lifespan in a cohort of healthy Dutch participants. Methods: A multi-center cross-sectional study was conducted by using the Low-lands Fitness Registry. The database contains measurements collected between January 2010 and December 2016 across 11 healthcare centers in the Netherlands. Generalized Additive Models are used as a semi-parametric way to identify the regression model for the VO2peak. Results: An additive model including weight, height and gender plus an interaction between age and gender best suited the trajectory of VO2peak across a person’s lifespan. This model yields an adjusted R2=0.641, Akaike information criterion=42386.51, Bayesian information criterion=42478.83. Conclusion: The trajectory of VO2peak across a lifespan, can be modeled by semi-parametric regression without testing for various polynomial transformations of age. Clinical Relevance: Representative values of aerobic fitness are sincerely needed since the current lack of data in the Dutch population. The prediction equation presented in this study can be used to determine reference values for the Dutch population. In future research aimed at determining reference value prediction equations for other nationalities, the type of regression equation fitted to the data should be modeled by semi-parametric regression.