Division of Respiratory Rehabilitation, H San Giuseppe, Istituto Auxologico Italiano, Verbania, Italy.
Clin Endocrinol (Oxf). 2010 Oct;73(4):491-6. doi: 10.1111/j.1365-2265.2010.03837.x.
Growth hormone (GH) secretion is normally sensitive to physical exercise. Intensity and duration of exercise, fitness and age can all influence the GH response to exercise. In obesity, GH secretion is decreased both in basal conditions and in response to exercise.
To analyse the dynamics of GH response to a progressive cycloergometric test, conducted up to exhaustion, in adult normal subjects and obese patients, after a reconditioning program at different workloads.
We studied eight lean subjects (four men, mean age 34.3 years, range 26-47 years, mean body mass index (BMI) 22.1 kg/m(2)). GH was sampled at baseline and during the last 30 s of each power output increase. Anaerobic threshold (AT) was detected by the V-slope method. The same test was carried out in 16 obese subjects (seven men, mean age 39.1 years, range 20-59 years, mean BMI 35.8 kg/m(2)) and repeated after a 4-week reconditioning program consisting of aerobic workout (Group A, eight subjects, three men, mean age 40.5 years, range 22-59 years, mean BMI 33.6 kg/m(2)), and aerobic plus anaerobic work (group B, eight subjects, four men, mean age 37.6 years, range 20-56 years, mean BMI 38.0 kg/m(2)) for 6 days/week, with no dietary restrictions.
Mean exercise peak occurred at higher intensity in controls (140 vs 110 W, P < 0.05), and AT exceeded at higher work outputs than in obese subjects (102 vs 74 W, P < 0.05). In controls, GH response to exercise was prompt and further sustained after AT; in obese subjects, GH increased slowly and insignificantly before AT, thereafter it increased to lower levels than in controls (P < 0.001). Following the reconditioning period, both Group A and Group B of obese subjects failed to improve exercise performance as well as GH response to exercise before AT; beyond AT, a greater GH response to exercise occurred in Group B than Group A (7.59 ± 0.32 μg/l at peak of exercise) with significantly different Delta AUCs (Area Under the Curves) following AT: 30.5 ± 12 μg.min/l in Group A vs 124.2 ± 38 μg.min/l in Group B, P < 0.05.
Our results confirm the blunted GH response to exercise in obese adults when compared to lean counterparts. With obesity, aerobic training poorly increases the GH response beyond AT, while supplemental anaerobic workload appears to increase GH response beyond AT. These observations may have implications for the prescription of physical exercise, which is one of the recommendations in the management of obesity.
生长激素(GH)的分泌通常对体育锻炼敏感。运动的强度和持续时间、健康状况和年龄都可以影响运动对 GH 的反应。在肥胖中,无论是在基础条件下还是在运动反应中,GH 的分泌都减少了。
分析在不同工作负荷下进行康复计划后,正常体重成人和肥胖患者对渐进性踏车运动试验的 GH 反应动力学,直至衰竭。
我们研究了 8 名瘦受试者(4 名男性,平均年龄 34.3 岁,范围 26-47 岁,平均体重指数(BMI)22.1kg/m²)。在每次功率输出增加的最后 30 秒内采样 GH。无氧阈(AT)通过 V-斜率法检测。在 16 名肥胖受试者(7 名男性,平均年龄 39.1 岁,范围 20-59 岁,平均 BMI 35.8kg/m²)中进行了相同的测试,并在进行了为期 4 周的康复计划后重复进行,该计划包括有氧运动(A 组,8 名受试者,3 名男性,平均年龄 40.5 岁,范围 22-59 岁,平均 BMI 33.6kg/m²)和有氧运动加无氧运动(B 组,8 名受试者,4 名男性,平均年龄 37.6 岁,范围 20-56 岁,平均 BMI 38.0kg/m²),每周 6 天,没有饮食限制。
对照组的平均运动峰值出现在更高的强度(140 对 110W,P<0.05),AT 超过了比肥胖组更高的工作输出(102 对 74W,P<0.05)。在对照组中,GH 对运动的反应迅速,并且在 AT 后进一步持续;在肥胖组中,GH 在 AT 之前缓慢而不显著地增加,此后,GH 水平升高至低于对照组的水平(P<0.001)。在康复期后,肥胖组的 A 组和 B 组均未能改善运动表现以及 AT 前的 GH 反应;在 AT 之后,B 组的 GH 对运动的反应大于 A 组(运动峰值时为 7.59±0.32μg/l),并且 AT 后 Delta AUC(曲线下面积)的差异具有统计学意义:A 组为 30.5±12μg.min/l,B 组为 124.2±38μg.min/l,P<0.05。
我们的结果证实,与瘦对照组相比,肥胖成年人的 GH 对运动的反应迟钝。在肥胖中,有氧运动训练在 AT 之后很少增加 GH 的反应,而补充性的无氧工作负荷似乎会增加 AT 之后的 GH 反应。这些观察结果可能对运动处方有影响,运动处方是肥胖管理的建议之一。