Objectives To examine the associations between physical fitness in male adolescents and coronary and carotid atherosclerosis in middle age. Methods This population-based cohort study linked physical fitness data from the Swedish Military Conscription Register during adolescence to atherosclerosis data from the Swedish CArdioPulmonary bioImage Study in middle age. Cardiorespiratory fitness was assessed using a maximal cycle-ergometer test, and knee extension muscular strength was evaluated through an isometric dynamometer. Coronary atherosclerosis was evaluated via Coronary Computed Tomography Angiography (CCTA) stenosis and Coronary Artery Calcium (CAC) scores, while carotid plaques were evaluated by ultrasound. The associations were analysed using multinomial logistic regression, adjusted (marginal) prevalences and restricted cubic splines. Results The analysis included 8986 male adolescents (mean age 18.3 years) with a mean follow-up of 38.2 years. Physical fitness showed a reversed J-shaped association with CCTA stenosis and CAC, but no consistent association was observed for carotid plaques. After adjustments, compared with adolescents in the lowest tertile of cardiorespiratory fitness and muscular strength, those in the highest tertile had 22% (OR 0.78; 95% CI 0.61 to 0.99) and 26% (OR 0.74; 95% CI 0.58 to 0.93) lower ORs for severe (≥50%) coronary stenosis, respectively. The highest physical fitness group (high cardiorespiratory fitness and muscular strength) had 33% (OR 0.67; 95% CI 0.52 to 0.87) lower OR for severe coronary stenosis compared with those with the lowest physical fitness. Conclusion This study supports that a combination of high cardiorespiratory fitness and high muscular strength in adolescence is associated with lower coronary atherosclerosis, particularly severe coronary stenosis, almost 40 years later. Data are available upon reasonable request. The data underlying this article cannot be shared publicly due to legal reasons as well as the privacy of individuals that participated in the study. However, by contacting the study organisation (www.scapis.org) or the corresponding author, information will be provided regarding the procedures for accessing data following Swedish legislation.

中文翻译：

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男性青少年的身体健康与中年动脉粥样硬化：一项基于人群的队列研究

目的 研究男性青少年的身体健康与中年冠状动脉和颈动脉粥样硬化之间的关系。方法 这项基于人群的队列研究将瑞典军事征兵登记处青少年时期的身体健康数据与瑞典 CArdioPulmonary 生物图像研究中年期间的动脉粥样硬化数据联系起来。使用最大循环测力计测试评估心肺健康，并通过等长测力计评估膝关节伸展肌肉力量。通过冠状动脉计算机断层扫描血管造影（CCTA）狭窄和冠状动脉钙（CAC）评分评估冠状动脉粥样硬化，而通过超声评估颈动脉斑块。使用多项逻辑回归、调整（边际）患病率和限制三次样条对这些关联进行分析。结果 分析包括 8986 名男性青少年（平均年龄 18.3 岁），平均随访时间为 38.2 年。身体素质与 CCTA 狭窄和 CAC 呈反向 J 形关联，但与颈动脉斑块没有观察到一致的关联。调整后，与心肺健康和肌肉力量最低三分位的青少年相比，最高三分位的青少年分别为22%（OR 0.78；95% CI 0.61至0.99）和26%（OR 0.74；95% CI 0.58至0.93）严重（≥50%）冠状动脉狭窄的 OR 分别较低。与体能最低组相比，体能最高组（心肺健康和肌肉力量较高）的严重冠状动脉狭窄 OR 低 33%（OR 0.67；95% CI 0.52 至 0.87）。结论 这项研究支持青春期高心肺健康和高肌肉力量的结合与近 40 年后的下冠状动脉粥样硬化，特别是严重的冠状动脉狭窄有关。数据可根据合理要求提供。由于法律原因以及参与研究的个人的隐私，本文所依据的数据无法公开共享。但是，通过联系研究组织 (www.scapis.org) 或通讯作者，我们将提供有关根据瑞典立法访问数据的程序的信息。