Nomogram-Based Evaluation of Exercise Capacity Based on Metabolic Equivalents (METs), Age, Body Mass Index(BMI), and Waist Circumference

Özge Çetinarslan

doi:10.31067/acusaglik.1766166

Nomogram-Based Evaluation of Exercise Capacity Based on Metabolic Equivalents (METs), Age, Body Mass Index(BMI), and Waist Circumference

Abstract

Background/Purpose: Raw metabolic-equivalent (MET) cut-offs ignore how age and body size shape oxygen demand. The aim is derivation and validation of sex-specific nomograms that adjust treadmill MET performance for age, body-mass index (BMI) and waist circumference (WC). Methods: A prospective derivation cohort of 1 067 West-Eurasian adults who completed symptom-limited Bruce tests (January–December 2024) was analysed with multivariable linear regression (predictors: age, BMI, WC, sex). Internal validity used 1 000-fold bootstrap. External performance was assessed, without re-calibration, in an independent retrospective cohort of 900 tests from a separate laboratory. Results: Age, BMI and WC were independent determinants of absolute METs; smoking and resting heart rate were not. The model explained 24% of variance in women and 20% in men; optimism-corrected calibration was excellent (slope 0.99, intercept +0.08 METs). In the external cohort it retained good accuracy (R² = 0.32; SEE = 1.66 METs) and calibration (slope 1.06, intercept –0.84 METs). Compared with the age-only Gulati (women) and Morris (men) equations, the new model showed negligible bias (–0.12 ± 1.86 METs) and the lowest error (Brier 3.45 vs 11.21/9.68). Conclusions: Nomograms that integrate age, BMI and WC translate raw treadmill data into personalised, size-adjusted targets and flag values <85% of expectation as “reduced capacity”, enabling earlier identification of functional shortfall and more precise exercise prescription.

Keywords

Ethical Statement

All procedures involving human participants complied with the Declaration of Helsinki and were approved by the Ethics Committee of T.C. Demiroğlu Bilim University (Protocol 51016662/41201, 28 August 2024). Informed consent was obtained from all participants. The ethics decision letter will be uploaded with the submission.

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Details

Primary Language

English

Subjects

Cardiovascular Medicine and Haematology (Other)

Journal Section

Research Article

Authors

Özge Çetinarslan ^*
0000-0003-4825-6489
Türkiye

Early Pub Date

September 17, 2025

Publication Date

October 1, 2025

Submission Date

August 15, 2025

Acceptance Date

September 1, 2025

Published in Issue

Year 2025 Volume: 16 Number: 4

DOI

https://doi.org/10.31067/acusaglik.1766166

IZ

https://izlik.org/JA63ZB87XM

Cite

RIS / Bibtex

EndNote

Çetinarslan Ö (October 1, 2025) Nomogram-Based Evaluation of Exercise Capacity Based on Metabolic Equivalents (METs), Age, Body Mass Index(BMI), and Waist Circumference. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 16 4 540–550.