Objective Current evidence of the associations between cardiorespiratory fitness (CRF) and mortality is limited. We performed a meta-analysis to assess the dose–response association of CRF with mortality from all causes, cardiovascular disease (CVD) and cancer in healthy population. Methods PubMed, EMBASE and Web of Science were searched up to 26 December 2019 for reports of cohort studies giving risk estimates for all-cause, CVD and cancer mortality by level of CRF. Cohort studies were included if CRF was assessed by an exercise stress test and reported as at least three levels or per incremental increase, and the association of CRF with all-cause, CVD and cancer mortality was evaluated. Generalised least-squares regression models were used to assess the quantitative relation of CRF with all-cause, CVD and cancer mortality. Results 34 cohort studies were eligible for the meta-analysis. The pooled relative risks (RRs) for all-cause, CVD and cancer mortality per one-metabolic equivalent increase in CRF were 0.88 (95% CI 0.83 to 0.93), 0.87 (95% CI0.83 to 0.91) and 0.93 (95% CI 0.91 to 0.96), respectively. As compared with lowest CRF, with intermediate CRF, the summary RRs for all-cause, CVD and cancer mortality were 0.67 (95% CI 0.61 to 0.74), 0.60 (95% CI 0.51 to 0.69) and 0.76 (95% CI 0.69 to 0.84), respectively, and with highest CRF were 0.47 (95% CI 0.39 to 0.56), 0.49 (95% CI 0.42 to 0.56) and 0.57 (95% CI 0.46 to 0.70), respectively. Conclusion Our analysis showed inverse dose–response associations of CRF with all-cause, CVD and cancer mortality, which provides evidence for public health recommendations for preventing all-cause, CVD and cancer mortality. PROSPERO registration number CRD42020208883. Data are available on reasonable request. Not applicable.

中文翻译：

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所有原因、心血管疾病和癌症的心肺健康和死亡率：队列研究的剂量反应荟萃分析

目的 目前关于心肺健康 (CRF) 与死亡率之间关联的证据有限。我们进行了一项荟萃分析，以评估 CRF 与健康人群中全因死亡率、心血管疾病 (CVD) 和癌症的剂量反应关联。方法 搜索截至 2019 年 12 月 26 日的 PubMed、EMBASE 和 Web of Science，以获取按 CRF 水平对全因、CVD 和癌症死亡率进行风险估计的队列研究报告。如果 CRF 通过运动压力测试评估并报告为至少三个水平或每次增加，则纳入队列研究，并评估 CRF 与全因、CVD 和癌症死亡率的关联。广义最小二乘回归模型用于评估 CRF 与全因、CVD 和癌症死亡率的定量关系。结果 34 项队列研究符合荟萃分析的条件。CRF 每增加一个代谢当量，全因、CVD 和癌症死亡率的汇总相对风险 (RR) 分别为 0.88（95% CI 0.83 至 0.93）、0.87（95% CI0.83 至 0.91）和 0.93（95% CI 0.91 至 0.96），分别。与最低 CRF 和中等 CRF 相比，全因、CVD 和癌症死亡率的总 RR 分别为 0.67（95% CI 0.61 至 0.74）、0.60（95% CI 0.51 至 0.69）和 0.76（95% CI 0.69 至0.84），最高 CRF 分别为 0.47（95% CI 0.39 至 0.56）、0.49（95% CI 0.42 至 0.56）和 0.57（95% CI 0.46 至 0.70）。结论 我们的分析显示 CRF 与全因、CVD 和癌症死亡率呈反剂量反应关联，这为预防全因、CVD 和癌症死亡率的公共卫生建议提供了证据。PROSPERO 注册号 CRD42020208883。可根据合理要求提供数据。不适用。