Kelly Karen R, Navaneethan Sankar D, Solomon Thomas P J, Haus Jacob M, Cook Marc, Barkoukis Hope, Kirwan John P
1Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH; 2Department of Nutrition, Case Western Reserve University, School of Medicine, Cleveland, OH; 3Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH; 4Department of Physiology, Case Western Reserve University, School of Medicine, Cleveland, OH; and 5Metabolic Translational Research Center, Cleveland Clinic, Cleveland, OH.
Med Sci Sports Exerc. 2014;46(5):920-6. doi: 10.1249/MSS.0000000000000200.
Several studies have identified relationships between weight loss and adipokine levels; however, none have looked at the combined effect of aerobic exercise training with the consumption of a low- or a high-glycemic diet. We examined the effects of 12 wk of aerobic exercise combined with either a low-glycemic index diet (∼40 U) plus exercise (LoGIX) or a high-glycemic index diet (∼80 U) diet plus exercise (HiGIX) on plasma leptin and adiponectin (total and high molecular weight [HMW]) in 27 older obese adults (age = 65 ± 0.5 yr, body mass index = 34.5 ± 0.7 kg·m).
Insulin sensitivity was calculated from an oral glucose tolerance test. Fasting HMW adiponectin and leptin were quantified from plasma samples obtained before the insulin sensitivity index obtained from the oral glucose tolerance test. Glucose and insulin measures were obtained before and every 30 min during the test. Dual-energy x-ray absorptiometry and computerized tomography were used to determine body composition and to quantify subcutaneous and visceral abdominal adiposity, respectively.
Fasting leptin was significantly decreased in both groups (LoGIX: preintervention = 33.8 ± 4.7, postintervention = 19.2 ± 4.5; HiGIX: preintervention = 27.9 ± 4.2, postintervention = 11.9 ± 2.2 ng·mL; P = 0.004), and HMW adiponectin was significantly increased (LoGIX: preintervention = 1606.9 ± 34.6, postintervention = 3502.3 ± 57; HiGIX: preintervention = 3704.8 ± 38.1, postintervention = 4284.3 ± 52.8 pg·mL; P = 0.003) after the 12-wk intervention. Total body fat was reduced after both interventions. Visceral fat mass was inversely correlated with HMW adiponectin, whereas subcutaneous fat correlated with leptin.
The data suggest that exercise training, independent of dietary glycemic index, favorably alters HMW adiponectin and leptin secretion and that a reduction in visceral fat mass is a key factor regulating HMW adiponectin in older obese persons.
多项研究已确定体重减轻与脂肪因子水平之间的关系；然而，尚无研究探讨有氧运动训练与低升糖指数或高升糖指数饮食相结合的综合效果。我们研究了12周有氧运动结合低升糖指数饮食（约40 U）加运动（LoGIX）或高升糖指数饮食（约80 U）加运动（HiGIX）对27名老年肥胖成年人（年龄 = 65 ± 0.5岁，体重指数 = 34.5 ± 0.7 kg·m²）血浆瘦素和脂联素（总脂联素和高分子量[HMW]脂联素）的影响。
通过口服葡萄糖耐量试验计算胰岛素敏感性。从口服葡萄糖耐量试验获得胰岛素敏感性指数之前采集的血浆样本中定量测定空腹HMW脂联素和瘦素。在试验前及试验期间每30分钟获取葡萄糖和胰岛素测量值。分别使用双能X线吸收法和计算机断层扫描来确定身体成分并量化皮下和内脏腹部脂肪量。
两组的空腹瘦素均显著降低（LoGIX组：干预前 = 33.8 ± 4.7，干预后 = 19.2 ± 4.5；HiGIX组：干预前 = 27.9 ± 4.2，干预后 = 11.9 ± 2.2 ng·mL；P = 0.004），且12周干预后HMW脂联素显著升高（LoGIX组：干预前 = 1606.9 ± 34.6，干预后 = 3502.3 ± 57；HiGIX组：干预前 = 3704.8 ± 38.1，干预后 = 4284.3 ± 52.8 pg·mL；P = 0.003）。两种干预后全身脂肪均减少。内脏脂肪量与HMW脂联素呈负相关，而皮下脂肪与瘦素相关。
数据表明，运动训练，无论饮食升糖指数如何，均可有利地改变HMW脂联素和瘦素分泌，且内脏脂肪量的减少是调节老年肥胖者HMW脂联素的关键因素。
