Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, England, UK.
Am J Obstet Gynecol. 2014 Nov;211(5):516.e1-516.e11. doi: 10.1016/j.ajog.2014.04.025. Epub 2014 Apr 23.
Women who have had preeclampsia demonstrate higher prevalence of metabolic syndrome (MetS), impaired vascular function, and increased sympathetic activity and are at increased risk of cardiovascular disease. The aim of this study was to assess the effects of 12 weeks of exercise training (70-80% maximum volume of oxygen utilization) in women who had had preeclampsia on physical fitness, components of MetS, vasculature, and autonomic functions compared with healthy control subjects.
Our prospective case-control study included 24 normotensive women who had had preeclampsia and 20 control subjects who were matched for age and postpartum interval (all 6-12 months after delivery). Before and after training, we measured all components of MetS (ie, BP, lipids, glucose/insulin, and albuminuria), carotid intima media thickness (IMT) and brachial and superficial femoral artery endothelial function that used flow-mediated dilation (FMD). Autonomic activity was quantified with power spectral analysis (low-frequency/high-frequency power [LF/HF] ratio).
At baseline, women who had had preeclampsia demonstrated higher values of most components of MetS. Compared with the control subjects, women who had had preeclampsia had increased IMT (580 ± 92 μm vs 477 ± 65 μm, respectively), impaired endothelial function (FMD brachial artery, 5.3% ± 2.2% vs 10.8% ± 3.5%, respectively; FMD superficial femoral artery, 4.9% ± 2.1% vs 8.7% ± 3.2%, respectively) and increased LF/HF power ratio (2.2 ± 1.0 vs 1.3 ± 0.4, respectively; all P < .05). In both groups, exercise training decreased values of most components of MetS and IMT, improved FMD, and concurrently reduced LF/HF. Despite these improvements, vascular and autonomic variables did not normalize by 12 weeks of training in women who had had preeclampsia.
This study demonstrates that exercise training in women who had had preeclampsia and control subjects improves components of MetS, endothelial function, vascular wall thickness, and autonomic control. Nonetheless, trained women who had had preeclampsia only reached a cardiovascular status that is comparable with sedentary healthy control subjects.
患有先兆子痫的女性表现出更高的代谢综合征（MetS）患病率、血管功能受损、交感神经活动增加，并且心血管疾病风险增加。本研究旨在评估 12 周的运动训练（最大氧利用率的 70-80%）对患有先兆子痫的女性的身体适应性、MetS 成分、血管和自主功能的影响，并与健康对照组进行比较。
我们前瞻性的病例对照研究纳入了 24 名血压正常的患有先兆子痫的女性和 20 名年龄和产后间隔相匹配的健康对照组（均为产后 6-12 个月）。在训练前后，我们测量了所有 MetS 成分（即血压、血脂、血糖/胰岛素和白蛋白尿）、颈动脉内膜中层厚度（IMT）和肱动脉及浅表股动脉内皮功能，使用血流介导的扩张（FMD）。自主活动通过功率谱分析（低频/高频功率比[LF/HF]比值）来量化。
在基线时，患有先兆子痫的女性表现出更高的 MetS 成分值。与对照组相比，患有先兆子痫的女性 IMT 更高（580±92μm 与 477±65μm，分别），内皮功能受损（肱动脉 FMD，5.3%±2.2%与 10.8%±3.5%，分别；股浅动脉 FMD，4.9%±2.1%与 8.7%±3.2%，分别），LF/HF 比值更高（2.2±1.0 与 1.3±0.4，分别；所有 P<0.05）。在两组中，运动训练都降低了 MetS 成分和 IMT 值，改善了 FMD，同时降低了 LF/HF。尽管有这些改善，但在 12 周的训练后，患有先兆子痫的女性的血管和自主功能变量仍未恢复正常。
本研究表明，运动训练可改善患有先兆子痫的女性和对照组的 MetS 成分、内皮功能、血管壁厚度和自主控制。尽管如此，经过训练的患有先兆子痫的女性仅达到了与久坐不动的健康对照组相当的心血管状态。
