Key result
The PUTH equation accurately predicted VO2peak in Chinese adults with a minimal mean difference of 37.0 mL/min, demonstrating significantly reduced bias compared to existing reference equations.
Why the study?
Research on V̇O 2 peak reference values and predictive equations for the Chinese population remains limited.
Cohort (n=9,155)
No
Absolute Event Rate: 37% vs 209.6%
p-value: p=<0.001
The newly developed PUTH equation provides a more accurate and reliable tool for predicting V̇O2peak in Chinese adults compared to existing Western and domestic equations, improving cardiorespiratory fitness assessment.
Offers Chinese-specific V̇O2peak equation for CRF assessment; leaves open external validation before clinical adoption.
Accurately quantifying cardiorespiratory fitness (CRF) through cardiopulmonary exercise testing (CPET) is increasingly important for improving risk assessment and guiding clinical decisions. However, research on V̇O 2 peak reference values and predictive equations for the Chinese population remains limited. This study aimed to establish a V̇O 2 peak predictive equation for Chinese adults. This study analyzed healthy participants who underwent CPET at Peking University Third Hospital (PUTH) from September 1, 2017, to September 1, 2023. Data from September 1, 2017, and August 31, 2021 were used as the derivation cohort, and September 1, 2021, to September 1, 2023 were utilized as an external validation cohort for temporal validation. The derivation cohort underwent backward multivariate regression analysis to generate the V̇O 2 peak prediction equation, which was compared with the widely-used Wasserman, FRIEND and Xiangya equations. The PUTH derivation cohort (N = 4531, mean age: 50.7 years, 18–88 years) and validation cohort (N = 4624, mean age: 46.1 years, 18–89 years) included 48.8 and 48.5% men, respectively. With increasing age, both men and women V̇O 2 peak exhibited a general decline. The predictive equation for V̇O 2 peak was established based on the derivation cohort: V̇O 2 peak (mL·min −1 ) = −24364.9 − 621.3 × Sex (Women = 1, Men = 2) −10.7 × Age + 0.2 × Height 2 (cm) + 6464.7 × Log(BMI) −24997.2 × Log(BSA) +12388.6 × Log(LBM) (adjusted R 2 = 0.624, p < 0.001). It demonstrated higher consistency between measured and predicted results compared to Xiangya, Wasserman, and FRIEND equations. This study presents the PUTH equation, a new V̇O 2 peak prediction equation for Chinese adults. Compared to existing equations, the PUTH equation shows reduced bias and improved accuracy, providing a more reliable tool for assessing CRF and guiding clinical interventions in the Chinese population.
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Wang et al. (2025) conducted a cohort in Healthy adults undergoing cardiopulmonary exercise testing (n=9,155). PUTH prediction equation vs. Xiangya, Wasserman, and FRIEND equations was evaluated on Mean difference between measured and predicted VO2peak (mL/min) (p=<0.001). The PUTH equation accurately predicted VO2peak in Chinese adults with a minimal mean difference of 37.0 mL/min, demonstrating significantly reduced bias compared to existing reference equations.
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