Pediatric Cardiology Unit, Department of Child and Adolescent, University Hospitals of Geneva, 6 rue Willy-Donze, 1211 Geneva 14, Switzerland.
J Am Coll Cardiol. 2009 Dec 15;54(25):2396-406. doi: 10.1016/j.jacc.2009.08.030.
The aim of this study was to determine the effects of physical activity on systemic blood pressure (BP) and early markers of atherosclerosis in pre-pubertal obese children.
Hypertension and endothelial dysfunction are premature complications of obesity.
We performed a 3-month randomized controlled trial with a modified crossover design: 44 pre-pubertal obese children (age 8.9 + or - 1.5 years) were randomly assigned (1:1) to an exercise (n = 22) or a control group (n = 22). We recruited 22 lean children (age 8.5 + or - 1.5 years) for baseline comparison. The exercise group trained 60 min 3 times/week during 3 months, whereas control subjects remained relatively inactive. Then, both groups trained twice/week during 3 months. We assessed changes at 3 and 6 months in office and 24-h BP, arterial intima-media thickness (IMT) and stiffness, endothelial function (flow-mediated dilation), body mass index (BMI), body fat, cardiorespiratory fitness (maximal oxygen consumption [VO(2)max]), physical activity, and biological markers.
Obese children had higher BP, arterial stiffness, body weight, BMI, abdominal fat, insulin resistance indexes, and C-reactive protein levels, and lower flow-mediated dilation, VO(2)max, physical activity, and high-density lipoprotein cholesterol levels than lean subjects. At 3 months, we observed significant changes in 24-h systolic BP (exercise -6.9 + or - 13.5 mm Hg vs. control 3.8 + or - 7.9 mm Hg, -0.8 + or - 1.5 standard deviation score [SDS] vs. 0.4 + or - 0.8 SDS), diastolic BP (-0.5 + or - 1.0 SDS vs. 0 + or - 1.4 SDS), hypertension rate (-12% vs. -1%), office BP, BMI z-score, abdominal fat, and VO(2)max. At 6 months, change differences in arterial stiffness and IMT were significant.
A regular physical activity program reduces BP, arterial stiffness, and abdominal fat; increases cardiorespiratory fitness; and delays arterial wall remodeling in pre-pubertal obese children. (Effects of Aerobic Exercise Training on Arterial Function and Insulin Resistance Syndrome in Obese Children: A Randomized Controlled Trial; NCT00801645).
本研究旨在探讨体力活动对青春期前肥胖儿童全身血压（BP）和动脉粥样硬化早期标志物的影响。
高血压和内皮功能障碍是肥胖的早期并发症。
我们进行了一项为期 3 个月的随机对照试验，采用改良交叉设计：44 名青春期前肥胖儿童（年龄 8.9 ± 1.5 岁）被随机分配（1:1）至运动组（n = 22）或对照组（n = 22）。我们招募了 22 名瘦儿童（年龄 8.5 ± 1.5 岁）作为基线比较。运动组在 3 个月内每周训练 3 次，每次 60 分钟，而对照组保持相对不活动。然后，两组在 3 个月内每周训练两次。我们在 3 个月和 6 个月时评估了诊室和 24 小时血压、动脉内膜中层厚度（IMT）和僵硬度、内皮功能（血流介导的扩张）、体重指数（BMI）、体脂、心肺功能（最大摄氧量[VO2max]）、体力活动和生物标志物的变化。
肥胖儿童的血压、动脉僵硬度、体重、BMI、腹部脂肪、胰岛素抵抗指数和 C 反应蛋白水平均高于瘦儿童，而血流介导的扩张、VO2max、体力活动和高密度脂蛋白胆固醇水平则低于瘦儿童。在 3 个月时，我们观察到 24 小时收缩压（运动组-6.9 ± 13.5mmHg，对照组 3.8 ± 7.9mmHg，-0.8 ± 1.5 标准差[SD]，对照组 0.4 ± 0.8 SD）、舒张压（-0.5 ± 1.0 SD 对 0 ± 1.4 SD）、高血压发生率（-12%对-1%）、诊室血压、BMI z 评分、腹部脂肪和 VO2max 均有显著变化。在 6 个月时，动脉僵硬度和 IMT 的变化差异有统计学意义。
定期进行体育锻炼可降低青春期前肥胖儿童的血压、动脉僵硬度和腹部脂肪；增加心肺功能；并延缓动脉壁重塑。（有氧运动训练对肥胖儿童动脉功能和胰岛素抵抗综合征的影响：一项随机对照试验；NCT00801645）。
