Associations of Cardiorespiratory Fitness With Estimated Remnant Cholesterol and Non–High-Density Lipoprotein Cholesterol in Healthy Men

Remnant cholesterol (RC) and non–high-density lipoprotein cholesterol (non–HDL-C) may contribute to the residual risk for atherosclerotic cardiovascular disease. High cardiorespiratory fitness (CRF) is associated with favorable traditional lipid profiles, but its relation with RC and non–HDL-C remains unclear. We analyzed cross-sectional data on 4,613 healthy men (mean age 49 years). CRF was measured using peak oxygen uptake during incremental exercise testing and categorized into quartiles. RC was estimated as total cholesterol minus HDL-C and low-density lipoprotein cholesterol, and elevated RC was defined as ≥38 mg/100 ml (90 percentile). Non–HDL-C was calculated as total cholesterol minus HDL-C, and high non–HLD-C was defined as ≥190 mg/100 ml. CRF was inversely associated with RC (β −0.31, 95% confidence interval [CI] −0.39 to −0.24) and non–HDL-C (β −0.34, 95% CI −0.57 to −0.11) after adjustment for several risk factors. Each metabolic equivalent increment in CRF was associated with lower odds of having elevated RC (odds ratio [OR] 0.85, 95% CI 0.77 to 0.93) and non–HDL-C (OR 0.93, 95% CI 0.85 to 1.00) in multivariable analysis. Compared with the bottom quartile, the top quartile of CRF had significantly lower odds of elevated RC (OR 0.63, 95% CI 0.45 to 0.88) and non–HDL-C (OR 0.68, 95% CI 0.51 to 0.91). In conclusion, higher CRF was independently associated with lower levels of RC and non–HDL-C and lower odds of the prevalence of elevated RC and non–HDL-C in healthy men.