Leclerc Jacinthe, Arsenault Marie, Després Jean-Pierre, Brassard Patrice, Gaudreault Valérie, Bergeron Jean, Alméras Natalie, Tremblay Angelo, Auclair Audrey, Ross Marie-Kristelle, Denault-Bissonnette Stéphanie, Poirier Paul
1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .
2 Faculté de Pharmacie, Université Laval , Québec, Canada .
Metab Syndr Relat Disord. 2016 Dec;14(10):483-491. doi: 10.1089/met.2016.0021. Epub 2016 Oct 18.
Abdominal obesity and presence of the metabolic syndrome (MetS) are associated with cardiac abnormalities. Among those, left ventricular diastolic dysfunction (LVDD) is the most frequently encountered in clinical practice. Few studies evaluated the reversibility of LVDD by an approach promoting lifestyle modifications in abdominally obese subjects with MetS.
We assessed the impact of a 1-year lifestyle modification program combining nutritional and physical activity counseling on LVDD and metabolic profile of abdominally obese men with MetS. Echocardiograms, oral glucose tolerance test, lipids profile, dual energy X-ray absorptiometry, computed tomography scans (visceral obesity assessment), heart rate variability (HRV), as well as maximal and submaximal exercise tests were performed in participants before and after a 1-year program combining healthy eating and a physical activity/exercise program.
Fifty-one abdominally obese men participated in this study. At baseline, 86% of the participants had LVDD (n = 44). After the 1-year program, LVDD improved in 57% of participants (n = 29, P < 0.0001). All metabolic, adiposity, and exercise tolerance measures improved from baseline (P < 0.0001), but were not associated with improvement in LVDD. Participants who improved LVDD had better exercise performance at baseline. Exercise tolerance during the submaximal exercise test, parasympathetic cardiac autonomic activity, and fasting insulin predicted 50% of LVDD improvements.
There was a significant improvement in LVDD after a 1-year lifestyle intervention program in abdominally obese men with MetS, such an improvement being associated with increased exercise tolerance, enhanced HRV, and reduced insulin levels.
腹部肥胖和代谢综合征（MetS）与心脏异常有关。其中，左心室舒张功能障碍（LVDD）是临床实践中最常见的。很少有研究通过促进生活方式改变的方法来评估腹型肥胖合并MetS患者LVDD的可逆性。
我们评估了一项为期1年的生活方式改变计划（结合营养咨询和体育活动指导）对腹型肥胖合并MetS男性患者LVDD和代谢状况的影响。在参与者参加为期1年的健康饮食与体育活动/锻炼计划之前和之后，进行了超声心动图、口服葡萄糖耐量试验、血脂谱、双能X线吸收法、计算机断层扫描（内脏肥胖评估）、心率变异性（HRV）以及最大和次最大运动试验。
51名腹型肥胖男性参与了本研究。基线时，86%的参与者存在LVDD（n = 44）。经过1年的计划后，57%的参与者（n = 29，P < 0.0001）的LVDD得到改善。所有代谢、肥胖和运动耐量指标均较基线有所改善（P < 0.0001），但与LVDD的改善无关。LVDD得到改善的参与者在基线时运动表现更好。次最大运动试验期间的运动耐量、心脏副交感神经自主活动和空腹胰岛素可预测LVDD改善的50%。
在腹型肥胖合并MetS的男性中，经过1年的生活方式干预计划后，LVDD有显著改善，这种改善与运动耐量增加、HRV增强和胰岛素水平降低有关。
