Davidson Lance E, Hudson Robert, Kilpatrick Katherine, Kuk Jennifer L, McMillan Kathleen, Janiszewski Peter M, Lee SoJung, Lam Miu, Ross Robert
School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada.
Arch Intern Med. 2009 Jan 26;169(2):122-31. doi: 10.1001/archinternmed.2008.558.
Authorities advocate that resistance and aerobic exercise are essential for reducing risk factors for chronic disease and disability in older adults. However, the incremental effects of combined resistance and aerobic exercise compared with either modality alone on risk factors for disease and disability is generally unknown.
Participants were 136 sedentary, abdominally obese older men and women recruited from September 30, 2002, through November 15, 2006, at Queen's University. Participants were randomized to 1 of the following 4 groups for 6 months: resistance exercise, aerobic exercise, resistance and aerobic exercise (combined exercise), or nonexercise control. Primary outcomes were analyzed by an intent-to-treat model and included changes in insulin resistance by hyperinsulinemic-euglycemic clamp and functional limitation using the average change in 4 tests combined (average z score).
After controlling for age, sex, and baseline value, insulin resistance improved compared with controls in the aerobic exercise and the combined exercise groups but not in the resistance exercise group. Improvement (mean [SE]) in the combined exercise group was greater than in the resistance exercise group (9.2 [1.3] vs 1.8 [1.3] mg/mL/microIU per kilogram of skeletal muscle per minute x100 [P < .001]) but not in the aerobic exercise group (9.2 [1.3] vs 6.5 [1.3] mg/mL/microIU per kilogram of skeletal muscle per minute x100 [P = .46]). Functional limitation improved significantly in all groups compared with the control group. Improvement in the combined exercise group was greater than in the aerobic exercise group (0.5 [0.1] vs -0.0 [0.1]; standard units, z score [P = .003]) but not in the resistance exercise group. Improvement in the resistance exercise group was not different from the aerobic exercise group.
The combination of resistance and aerobic exercise was the optimal exercise strategy for simultaneous reduction in insulin resistance and functional limitation in previously sedentary, abdominally obese older adults.
clinicaltrials.gov Identifier: NCT00520858.
权威机构提倡抗阻运动和有氧运动对于降低老年人慢性病和残疾风险因素至关重要。然而，与单独进行任何一种运动方式相比，抗阻运动和有氧运动相结合对疾病和残疾风险因素的增量影响总体上尚不清楚。
研究对象为2002年9月30日至2006年11月15日在女王大学招募的136名久坐不动、腹部肥胖的老年男性和女性。参与者被随机分为以下4组之一，为期6个月：抗阻运动组、有氧运动组、抗阻和有氧运动组（联合运动组）或非运动对照组。主要结局采用意向性分析模型进行分析，包括通过高胰岛素-正常血糖钳夹法测定的胰岛素抵抗变化以及使用4项测试综合平均变化（平均z评分）来评估功能受限情况。
在控制年龄、性别和基线值后，有氧运动组和联合运动组的胰岛素抵抗与对照组相比有所改善，但抗阻运动组未改善。联合运动组的改善程度（均值[标准误]）大于抗阻运动组（每千克骨骼肌每分钟9.2[1.3] vs 1.8[1.3]毫克/毫升/微国际单位×100[P <.001]），但与有氧运动组相比无差异（每千克骨骼肌每分钟9.2[1.3] vs 6.5[1.3]毫克/毫升/微国际单位×100[P =.46]）。与对照组相比，所有组的功能受限情况均有显著改善。联合运动组的改善程度大于有氧运动组（0.5[0.1] vs -0.0[0.1]；标准单位，z评分[P =.003]），但与抗阻运动组相比无差异。抗阻运动组的改善程度与有氧运动组无差异。
对于既往久坐不动、腹部肥胖的老年人，抗阻运动和有氧运动相结合是同时降低胰岛素抵抗和功能受限的最佳运动策略。
clinicaltrials.gov标识符：NCT00520858。
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