Cooper Dan M, Leu Szu-Yun, Taylor-Lucas Candice, Lu Kim, Galassetti Pietro, Radom-Aizik Shlomit
Department of Pediatrics, Pediatric Exercise and Genomic Research Center, University of California-Irvine, Irvine, CA.
Pediatr Exerc Sci. 2016 Feb;28(1):98-108. doi: 10.1123/pes.2015-0107. Epub 2015 Dec 29.
Consensus has yet to be achieved on whether obesity is inexorably tied to poor fitness. We tested the hypothesis that appropriate reference of cardiopulmonary exercise testing (CPET) variables to lean body mass (LBM) would eliminate differences in fitness between high-BMI (≥ 95th percentile, n = 72, 50% female) and normal-BMI (< 85th percentile, n = 142, 49% female), otherwise-healthy children and adolescents typically seen when referencing body weight. We measured body composition with dual x-ray absorptiometry (DXA) and CPET variables from cycle ergometry using both peak values and submaximal exercise slopes (peak VO2, ΔVO2/ΔHR, ΔWR/ΔHR, ΔVO2/ΔWR, and ΔVE/ΔVCO2). In contrast to our hypothesis, referencing to LBM tended to lessen, but did not eliminate, the differences (peak VO2 [p < .004] and ΔVO2/ΔHR [p < .02]) in males and females; ΔWR/ΔHR differed between the two groups in females (p = .041) but not males (p = .1). The mean percent predicted values for all CPET variables were below 100% in the high-BMI group. The pattern of CPET abnormalities suggested a pervasive impairment of O2 delivery in the high-BMI group (ΔVO2/ΔWR was in fact highest in normal-BMI males). Tailoring lifestyle interventions to the specific fitness capabilities of each child (personalized exercise medicine) may be one of the ways to stem what has been an intractable epidemic.
肥胖是否必然与身体不健康相关，目前尚未达成共识。我们检验了这样一个假设：将心肺运动测试（CPET）变量适当参照去脂体重（LBM），会消除高BMI（≥第95百分位数，n = 72，50%为女性）和正常BMI（<第85百分位数，n = 142，49%为女性）的健康儿童和青少年之间的健康差异，而在参照体重时通常会出现这种差异。我们使用双能X线吸收法（DXA）测量身体成分，并通过峰值和次最大运动斜率（峰值VO2、ΔVO2/ΔHR、ΔWR/ΔHR、ΔVO2/ΔWR和ΔVE/ΔVCO2）从自行车测力计测量CPET变量。与我们的假设相反，参照LBM往往会缩小但不会消除男性和女性之间的差异（峰值VO2 [p <.004]和ΔVO2/ΔHR [p <.02]）；两组女性的ΔWR/ΔHR存在差异（p = 0.041），而男性不存在差异（p = 0.1）。高BMI组所有CPET变量的平均预测值百分比均低于100%。CPET异常模式表明高BMI组存在普遍的氧输送受损（实际上，正常BMI男性的ΔVO2/ΔWR最高）。根据每个孩子的特定健康能力量身定制生活方式干预措施（个性化运动医学）可能是遏制这一棘手流行病的方法之一。
