Centro di ricerca Terapia Neurovegetativa e Medicinadell’esercizio, Dipartimento Scienze Cliniche, Università degli Studi di Milano, Milano, Italy.
Heart. 2013 Mar;99(6):376-81. doi: 10.1136/heartjnl-2012-302616. Epub 2012 Oct 19.
Overweight (OW) and obesity in children are important forerunners of cardiovascular risk, possibly through autonomic nervous system (ANS) dysregulation, while physical exercise exerts a beneficial influence. In this observational study we hypothesise that OW might influence ANS profile even in a population performing high volume of supervised exercise. We study 103 young soccer players, homogeneous in terms of gender (all male), cultural background, school, age (11.2 ± 1 years) and exercise routine, since they all belong to the same soccer club, thus guaranteeing equality of supervised training and similar levels of competitiveness. ANS is evaluated by autoregressive spectral analysis of heart rate and systolic arterial pressure (SAP) variabilities. We estimate also the accumulated weekly Metabolic Equivalents and time spent in sedentary activities. We subdivide the entire population in two subgroups (normal weight and OW) based on the International Obesity Task Force criteria. In OW soccer players (10.7% of total group) we observe an altered profile of autonomic cardiovascular regulation, characterised by higher values of SAP (113 ± 4 vs 100 ± 1 mm Hg, 39.7 ± 3 vs 66.2 ± 10%), higher Low Frequency variability power of SAP (an index of vasomotor sympathetic regulation) (12 ± 3 vs 4.5 mm Hg(2)) and smaller spontaneous baroreflex gain (an index of cardiac vagal regulation) (19 ± 3 vs 33 ± 3 ms/mm Hg) (all (p < 0.02)). Moreover Correlation analysis on the entire study population shows a significant link between anthropometric and autonomic indices. These data show that OW is associated to a clear autonomic impairment even in children subjected to an intense aerobic training.
超重(OW)和肥胖是儿童心血管风险的重要前驱因素,可能通过自主神经系统(ANS)失调来实现,而体育锻炼则产生有益的影响。在这项观察性研究中,我们假设 OW 即使在进行大量监督运动的人群中也可能影响 ANS 特征。我们研究了 103 名年轻的足球运动员,他们在性别(全部为男性)、文化背景、学校、年龄(11.2 ± 1 岁)和运动常规方面均具有同质性,因为他们都属于同一个足球俱乐部,从而保证了监督训练的平等性和类似的竞争力水平。通过心率和收缩压(SAP)变异性的自回归谱分析来评估 ANS。我们还估计了每周累积代谢当量和久坐活动时间。我们根据国际肥胖工作组的标准将整个人群分为两个亚组(正常体重和 OW)。在 OW 足球运动员(占总人群的 10.7%)中,我们观察到自主心血管调节的特征发生改变,表现为 SAP 较高(113 ± 4 对 100 ± 1mmHg,39.7 ± 3 对 66.2 ± 10%),SAP 的低频变异性功率较高(血管运动交感调节的指标)(12 ± 3 对 4.5mmHg(2)),自发性血压反射增益较小(心脏迷走神经调节的指标)(19 ± 3 对 33 ± 3ms/mm Hg)(所有指标均为 p < 0.02)。此外,对整个研究人群的相关分析表明,人体测量和自主指标之间存在显著关联。这些数据表明,即使在进行剧烈有氧运动的儿童中,OW 也与明显的自主功能障碍相关。
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