Baria Flavia, Kamimura Maria Ayako, Aoike Danilo Takashi, Ammirati Adriano, Rocha Mariana Leister, de Mello Marco Túlio, Cuppari Lilian
Nutrition Graduation Program, Federal University of São Paulo, São Paulo, Brazil.
Nephrol Dial Transplant. 2014 Apr;29(4):857-64. doi: 10.1093/ndt/gft529. Epub 2014 Jan 20.
The prevalence of obesity has markedly increased in patients with chronic kidney disease (CKD). Studies on the impact of exercise focusing on obese CKD patients are scarce. Therefore, we aimed to investigate the effect of aerobic exercise performed either in an exercise centre or at home on visceral fat in overweight non-dialysed CKD patients.
Twenty-seven sedentary men (52.1 ± 9.5 years, body mass index 30.4 ± 3.8 kg/m(2), estimated glomerular filtration rate (eGFR) 27.5 ± 11.6 mL/min) were randomly assigned to a centre-based exercise group (n = 10), home-based exercise group (n = 8) or control group (n = 9). The aerobic training was prescribed according to ventilatory threshold and performed three times per week during 12 weeks. Body composition was assessed by dual energy X-ray absorptiometry (DEXA) and the distribution of abdominal fat by computed tomography.
In the centre-based group, visceral fat and waist circumference decreased 6.4 ± 6.4 mm (P < 0.01) and 2.0 ± 2.3 cm (P = 0.03) and leg lean mass increased 0.5 ± 0.4 kg (P < 0.01). No significant changes were observed in the home-based group. Visceral fat increased 5.0 ± 4.4 mm in the control group (P = 0.01). In relation to the control, a group-by-time interaction was significant for visceral fat and waist circumference for both exercise groups and for leg lean mass for the centre-based group. Mean blood pressure decreased in both exercise groups (centre-based 13%, P < 0.01 and home-based 10%, P = 0.03) and eGFR increased 3.6 ± 4.6 mL/min (P = 0.03) in the centre-based group. These parameters remained unchanged in the control group.
Centre-based aerobic exercise is an effective approach to reduce visceral fat besides promoting relevant clinical benefits in male overweight CKD patients.
慢性肾脏病(CKD)患者中肥胖的患病率显著增加。针对肥胖CKD患者运动影响的研究较少。因此,我们旨在研究在运动中心或家中进行有氧运动对超重非透析CKD患者内脏脂肪的影响。
27名久坐不动的男性(年龄52.1±9.5岁,体重指数30.4±3.8kg/m²,估计肾小球滤过率(eGFR)27.5±11.6mL/min)被随机分配至中心运动组(n=10)、家庭运动组(n=8)或对照组(n=9)。根据通气阈值制定有氧运动方案,每周进行3次,共12周。通过双能X线吸收法(DEXA)评估身体成分,通过计算机断层扫描评估腹部脂肪分布。
在中心运动组中,内脏脂肪和腰围分别减少了6.4±6.4mm(P<0.01)和2.0±2.3cm(P=0.03),腿部瘦体重增加了0.5±0.4kg(P<0.01)。家庭运动组未观察到显著变化。对照组内脏脂肪增加了5.0±4.4mm(P=0.01)。与对照组相比,两个运动组的内脏脂肪和腰围以及中心运动组的腿部瘦体重在组间与时间交互作用方面均有显著差异。两个运动组的平均血压均下降(中心运动组下降13%,P<0.01;家庭运动组下降10%,P=0.03),中心运动组的eGFR增加了3.6±4.6mL/min(P=0.03)。对照组这些参数保持不变。
对于男性超重CKD患者,除了带来相关临床益处外,在运动中心进行有氧运动是减少内脏脂肪的有效方法。