RT journal article T1 Mediation role of cardiorespiratory fitness on the association between fatness and cardiometabolic risk in European adolescents: The HELENA study A1 Cristi-Montero, Carlos A1 Courel-Ibáñez, Javier A1 Ortega, Francisco B. A1 Castro Piñero, José A1 Santaliestra-Pasias, Alba A1 Polito, Ángela A1 Vanhelst, Jeremy A1 Marcos, Ascesión A1 Moreno, Luis M. A1 Ruiz, Jonatan R. A1 HELENA study group A2 Didáctica de la Educación FísicaPlástica y Musical K1 Cardiovascular disease K1 Children K1 Fat mass K1 Fitness K1 Health K1 Physical activity AB Purpose: This study was aimed to analyze the mediation role of cardiorespiratory fitness (CRF) on the association between fatness and cardiometa-bolic risk scores (CMRs) in European adolescents.Methods: A cross-sectional study was conducted in adolescents (n = 525; 46% boys; 14.1 +/- 1.1 years old, mean +/- SD) from 10 European cities involved in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. CRF was measured by means of the shuttle run test, while fatness measures included body mass index (BMI), waist to height ratio, and fat mass index estimated from skinfold thicknesses. A clustered CMRs was computed by summing the standardized values of homeostasis model assessment, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and leptin.Results: Linear regression models indicated that CRF acted as an important and partial mediator in the association between fatness and CMRs in 12-17-year-old adolescents (for BMI: coefficients of the indirect role beta = 0.058 (95% confidence interval (95%CI): 0.023-0.101), Sobel test z = 3.11 (10.0% mediation); for waist to height ratio: beta = 4.279 (95%CI: 2.242-7.059), z = 3.86 (11.5% mediation); and for fat mass index: beta = 0.060 (95%CI: 0.020-0.106), z = 2.85 (9.4% mediation); all p < 0.01).Conclusion: In adolescents, the association between fatness and CMRs could be partially decreased with improvements to fitness levels; therefore, CRF contribution both in the clinical field and public health could be important to consider and promote in adolescents independently of their fatness levels. PB ELSEVIER SN 2095-2546 YR 2021 FD 2021-05 LK http://hdl.handle.net/10498/25184 UL http://hdl.handle.net/10498/25184 LA eng NO We thank the adolescents who participated in the study and their parents and teachers for their collaboration. We also acknowledge the HELENA study members involved in fieldwork for their efforts. The HELENA project was supported by the European Community 6th Framework Programme for Research and Technological Development (contract FOODCT-2005-007034). The data for this study were gathered under the aegis of the HELENA project, and further analysis was additionally supported by the Spanish Ministry of Economy and Competitiveness (Grants RYC-2010-05957 and RYC-2011-09011), the Spanish Ministry of Health: Maternal, Child Health and Development Network (Grants RD08/0072 and RD16/0022), the Fondo Europeo de Desarrollo Regional (MICINN-FEDER), and the University of Granada, Plan Propio de Investigaci~on 2016, Excellence Actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). The content of this article reflects the authors' views alone, and the European Community is not liable for any use that may be made of the information contained herein. DS Repositorio Institucional de la Universidad de Cádiz RD 12-nov-2026