Atherosclerosis · Oct 31, 2026

High Cardiorespiratory Fitness predicts lower Risk of Progression and higher Chance of Regression of Arteriopathy during a Lifestyle Intervention

By Schuth S, Kantartzis K, Machann J et al.

Background and aims High carotid intima–media thickness (cIMT) is a marker of arterial injury, and cIMT can be used to track the regression, arrest, or progression of arteriopathy. Because high cardiorespiratory fitness (CRF) protects from cardiovascular disease and closely associates with mitochondrial function, we determined whether baseline CRF and change in CRF predict change in cIMT during a lifestyle intervention. Methods A total of 208 subjects at risk for type 2 diabetes who participated in the Tübingen Lifestyle Intervention Program underwent measurements of CRF, cIMT, glucose, and lipid metabolism, body fat mass and distribution, and liver fat content at baseline and after 9 months. Results During the intervention, almost all cardiometabolic risk parameters improved. However, there was a large variability in the change in cIMT. In a multivariable linear regression model, CRF at baseline (std.-ß –0.19, p=0.02) and change in CRF (std.-ß −0.18, p=0.01) were associated with change in cIMT. Subjects in the upper tertile of change in cIMT had a mean (SD) increase in cIMT of 14 (9)%, while subjects in the lower tertile had a mean decrease in cIMT of 16 (7)%. Larger increase in CRF was associated with lower odds of progression of cIMT (OR per SD increase 0.05 [95% CI 0.006−0.42], p=0.004) and with higher chance of regression of cIMT (OR per SD increase 13 [95% CI 2−111], p=0.01). Conclusions We provide novel findings that measuring CRF before and during a lifestyle intervention may help predict the progression and regression of arteriopathy.

doi.org/10.1016/j.atherosclerosis.2026.121945PubMed 42976701Interventions