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中年肥胖男性静息和运动时的血管反应性:短期、低强度运动训练的影响。

Vascular reactivity at rest and during exercise in middle-aged obese men: effects of short-term, low-intensity, exercise training.

机构信息

EA4278 Physiology and Physiopathology of Cardiovascular Adaptations to Exercise, Faculty of Sciences, Avignon, France.

出版信息

Int J Obes (Lond). 2011 Jun;35(6):820-8. doi: 10.1038/ijo.2010.206. Epub 2010 Sep 28.

Abstract

OBJECTIVE

Although increased blood flow (BF) in exercising muscles is thought to be impaired in obese subjects and may contribute to physical inactivity, data are scarce in this regard and the involvement of endothelium dysfunction remains partly hypothetical.

METHODS

A total of 16 middle-aged obese men (body mass index, BMI ≥ 30 kg m(-2)) and 16 normal-weight men (BMI<25 kg m(-2)), matched for age, were recruited. We used ultrasonography to compare intima-media thickness (IMT) and distensibility of the carotid artery, flow-mediated dilation (FMD), nitrate-dependent dilation (NDD) and peak BF during post-ischemic hyperemia in the brachial artery (a conduit artery), and leg BF during knee-extensor exercise (indicative of resistance vessel function) in obese and in normal-weight men. In addition, 10 obese men participated in an 8 week individualized low-intensity training program.

RESULTS

Compared with normal-weight men, obese men had higher carotid IMT (0.50 ± 0.01 vs 0.62 ± 0.04 mm, P < 0.05) but lower carotid distensibility (0.26 ± 0.03 vs 0.11 ± 0.03 mm Hg(-1) 10(-2), P < 0.05), FMD (5.7 ± 0.4 vs 3.3 ± 0.5%, P < 0.05) and peak BF during post-ischemic hyperemia (398 ± 52 vs 229 ± 24%, P < 0.05), despite similar maximal shear rate, without NDD differences. Lower limb BF (ml min(-1) 100 g(-1)) increased significantly from rest to maximal exercise in both groups with lower values in obese men (at peak power, 36.9 ± 1.6 vs 31.5+2.2 ml min(-1) 100 g(-1), P < 0.05). Exercise training normalized carotid distensibility (0.14 ± 0.04 before vs 0.23 ± 0.03 mm Hg(-1) 10(-2) after training, P = 0.09) and FMD (2.7 ± 0.4 before vs 4.8 ± 0.5% after training, P < 0.05), but did not improve brachial post-ischemic peak BF or exercising leg BF.

CONCLUSIONS

In obese men, conduit and resistance vessel reactivity is depressed, but a short-term low-intensity exercise training improves distensibility and endothelium dependent vasodilation in the large conduit artery, but not post ischemic or exercise muscle BF.

摘要

目的

尽管人们认为肥胖者的肌肉血流量(BF)增加受到损害,这可能导致体力活动减少,但这方面的数据很少,内皮功能障碍的参与仍部分是假设的。

方法

共招募了 16 名中年肥胖男性(BMI≥30 kg m(-2)) 和 16 名体重正常的男性(BMI<25 kg m(-2))),年龄匹配。我们使用超声比较了颈动脉内膜中层厚度(IMT)和弹性、血流介导的扩张(FMD)、硝酸盐依赖性扩张(NDD)和肱动脉缺血后充血期间的峰值 BF(代表大的导血管),以及股四头肌运动时腿部 BF(提示阻力血管功能)在肥胖男性和正常体重男性中的情况。此外,10 名肥胖男性参加了 8 周的个体化低强度训练计划。

结果

与体重正常的男性相比,肥胖男性的颈动脉 IMT 更高(0.50 ± 0.01 比 0.62 ± 0.04mm,P <0.05),但颈动脉弹性更低(0.26 ± 0.03 比 0.11 ± 0.03mm Hg(-1) 10(-2),P <0.05)、FMD(5.7 ± 0.4 比 3.3 ± 0.5%,P <0.05)和缺血后充血期间的峰值 BF(398 ± 52 比 229 ± 24%,P <0.05),尽管最大切变率相似,但没有 NDD 差异。两组下肢 BF(ml min(-1) 100 g(-1))从休息到最大运动都显著增加,但肥胖男性的数值较低(在最大功率时,36.9 ± 1.6 比 31.5+2.2 ml min(-1) 100 g(-1),P <0.05)。运动训练使颈动脉弹性正常化(训练前 0.14 ± 0.04,训练后 0.23 ± 0.03mm Hg(-1) 10(-2),P = 0.09)和 FMD(训练前 2.7 ± 0.4,训练后 4.8 ± 0.5%,P <0.05),但不能改善缺血后充血期间的肱动脉峰值 BF 或运动时腿部 BF。

结论

在肥胖男性中,大导血管和阻力血管的反应性降低,但短期低强度运动训练可改善大导血管的弹性和内皮依赖性血管扩张,但不能改善缺血后或运动肌肉的 BF。

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