Meyer Andreas A, Kundt Günther, Lenschow Ute, Schuff-Werner Peter, Kienast Wolfgang
Division of Pediatric Cardiology, Children's Hospital, University of Rostock, Rostock, Germany.
J Am Coll Cardiol. 2006 Nov 7;48(9):1865-70. doi: 10.1016/j.jacc.2006.07.035. Epub 2006 Oct 17.
The present study aimed to assess the effect of a 6-month exercise program in obese children on flow-mediated vasodilation (FMD) carotid intima-media thickness (IMT) and cardiovascular risk factors (RF).
Childhood obesity contributes to adult obesity and subsequent cardiovascular disease. Physical inactivity is a major RF for obesity, endothelial dysfunction, and elevated carotid IMT, culminating in early atherosclerotic disease.
Sixty-seven obese subjects (age 14.7 +/- 2.2 years) were randomly assigned to 6 months' exercise or non-exercise protocol. We examined the influence of exercises (1 h, 3 times/week) on FMD, IMT, and cardiovascular risk profile.
Compared with lean control subjects, obese children demonstrated at baseline significantly impaired FMD (4.09 +/- 1.76% vs. 10.65 +/- 1.95%, p < 0.001), increased IMT (0.48 +/- 0.08 mm vs. 0.37 +/- 0.05 mm, p < 0.001), and a number of obesity-related cardiovascular RF. Significant improvements were observed in the exercise group for IMT (0.44 +/- 0.08 mm, p = 0.012, -6.3%) and FMD (7.71 +/- 2.53%, p < 0.001, +127%). This improvement correlated with reduced RF, such as body mass index standard deviation scores, body fat mass, waist/hip ratio, ambulatory systolic blood pressure, fasting insulin, triglycerides, low-density lipoprotein/high-density lipoprotein ratio, and low-degree inflammation (C-reactive protein, fibrinogen).
The present study documented increased IMT, impaired endothelial function, and various elevated cardiovascular RF in young obese subjects. Regular exercise over 6 months restores endothelial function and improves carotid IMT associated with an improved cardiovascular risk profile in obese children.
本研究旨在评估一项为期6个月的运动计划对肥胖儿童的血流介导的血管舒张功能（FMD）、颈动脉内膜中层厚度（IMT）和心血管危险因素（RF）的影响。
儿童肥胖会导致成人肥胖及后续心血管疾病。缺乏身体活动是肥胖、内皮功能障碍和颈动脉IMT升高的主要危险因素，最终会引发早期动脉粥样硬化疾病。
67名肥胖受试者（年龄14.7±2.2岁）被随机分配到为期6个月的运动或非运动方案组。我们研究了运动（每周3次，每次1小时）对FMD、IMT和心血管风险状况的影响。
与瘦的对照受试者相比，肥胖儿童在基线时FMD明显受损（4.09±1.76%对10.65±1.95%，p<0.001），IMT增加（0.48±0.08mm对0.37±0.05mm，p<0.001），以及一些与肥胖相关的心血管危险因素。运动组的IMT（0.44±0.08mm，p = 0.012，-6.3%）和FMD（7.71±2.53%，p<0.001，+127%）有显著改善。这种改善与危险因素的降低相关，如体重指数标准差评分、体脂肪量、腰臀比、动态收缩压、空腹胰岛素、甘油三酯、低密度脂蛋白/高密度脂蛋白比值和低度炎症（C反应蛋白、纤维蛋白原）。
本研究记录了年轻肥胖受试者IMT增加、内皮功能受损和各种心血管危险因素升高的情况。6个月的规律运动可恢复肥胖儿童的内皮功能，改善颈动脉IMT，并改善心血管风险状况。
