Groussard Carole, Rouchon-Isnard Myriam, Coutard Céline, Romain Fanny, Malardé Ludivine, Lemoine-Morel Sophie, Martin Brice, Pereira Bruno, Boisseau Nathalie
Laboratory "Movement, Sport and Health Sciences" (M2S), Rennes 2 University-ENS Cachan, Avenue Robert Schuman, Campus de Ker Lann, F-35170 Bruz, France.
Appl Physiol Nutr Metab. 2015 Jun;40(6):550-6. doi: 10.1139/apnm-2014-0357. Epub 2015 May 8.
In chronic kidney disease (CKD), oxidative stress (OS) plays a central role in the development of cardiovascular diseases. This pilot program aimed to determine whether an intradialytic aerobic cycling training protocol, by increasing physical fitness, could reduce OS and improve other CKD-related disorders such as altered body composition and lipid profile. Eighteen hemodialysis patients were randomly assigned to either an intradialytic training (cycling: 30 min, 55%-60% peak power, 3 days/week) group (EX; n = 8) or a control group (CON; n = 10) for 3 months. Body composition (from dual-energy X-ray absorptiometry), physical fitness (peak oxygen uptake and the 6-minute walk test (6MWT)), lipid profile (triglycerides (TG), total cholesterol, high-density lipoprotein, and low-density lipoprotein (LDL)), and pro/antioxidant status (15-F2α-isoprostanes (F2-IsoP) and oxidized LDL in plasma; superoxide dismutase, glutathione peroxidase, and reduced/oxidized glutathione in erythrocytes) were determined at baseline and 3 months later. The intradialytic training protocol did not modify body composition but had significant effects on physical fitness, lipid profile, and pro/antioxidant status. Indeed, at 3 months: (i) performance on the 6MWT was increased in EX (+23.4%, p < 0.001) but did not change in CON, (ii) plasma TG were reduced in EX (-23%, p < 0.03) but were not modified in CON, and (iii) plasma F2-IsoP concentrations were lower in EX than in CON (-35.7%, p = 0.02). In conclusion, our results show that 30 min of intradialytic training, 3 times per week for 3 months, are enough to exert beneficial effects on the most sensitive and reliable marker of lipid peroxidation (IsoP) while improving CKD-associated disorders (lipid profile and physical fitness). Intradialytic aerobic cycling training represents a useful and easy strategy to reduce CKD-associated disorders. These results need to be confirmed with a larger randomized study.
在慢性肾脏病（CKD）中，氧化应激（OS）在心血管疾病的发生发展中起核心作用。本试点项目旨在确定透析期间的有氧骑行训练方案能否通过提高身体素质来降低氧化应激，并改善其他与CKD相关的病症，如身体成分改变和血脂谱异常。18名血液透析患者被随机分为透析期间训练组（骑行：30分钟，峰值功率的55%-60%，每周3天）（EX组；n = 8）或对照组（CON组；n = 10），为期3个月。在基线期和3个月后测定身体成分（采用双能X线吸收法）、身体素质（峰值摄氧量和6分钟步行试验（6MWT））、血脂谱（甘油三酯（TG）、总胆固醇、高密度脂蛋白和低密度脂蛋白（LDL））以及促氧化剂/抗氧化剂状态（血浆中的15-F2α-异前列腺素（F2-IsoP）和氧化型LDL；红细胞中的超氧化物歧化酶、谷胱甘肽过氧化物酶以及还原型/氧化型谷胱甘肽）。透析期间训练方案未改变身体成分，但对身体素质、血脂谱和促氧化剂/抗氧化剂状态有显著影响。事实上，在3个月时：（i）EX组的6MWT表现提高（+23.4%，p < 0.001），而CON组未改变；（ii）EX组的血浆TG降低（-23%，p < 0.03），而CON组未改变；（iii）EX组的血浆F2-IsoP浓度低于CON组（-35.7%，p = 0.02）。总之，我们的结果表明，每周3次、每次30分钟的透析期间训练，持续3个月，足以对脂质过氧化最敏感和可靠的标志物（异前列腺素）产生有益影响，同时改善与CKD相关的病症（血脂谱和身体素质）。透析期间有氧骑行训练是一种有用且简便的策略，可减少与CKD相关的病症。这些结果需要通过更大规模的随机研究来证实。
