Lind Lars, Carlsson Axel C, Siegbahn Agneta, Sundström Johan, Ärnlöv Johan
Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Eur J Clin Invest. 2017 Feb;47(2):167-175. doi: 10.1111/eci.12722.
We have recently shown that being physically active (PA) counteracts, but not eliminates the increased risk of future cardiovascular disease in overweight and obese subjects. To investigate this further, we studied the impact of being normal weight, overweight and obese on multiple markers of subclinical cardiovascular disease in relation to physical activity.
At age 70, 1016 subjects were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Being PA was defined as performing regular heavy exercise (self-reported). According to body mass index (BMI)/PA groups, the participants were categorized as PA/normal weight (BMI < 25 kg/m , n = 104), non-PA/normal weight (n = 234), PA/overweight (BMI 25-29·9 kg/m , n = 133), non-PA/overweight (n = 295), PA/obese (BMI ≥ 30 kg/m , n = 54) and non-PA/obese (n = 169). Several different measurements of endothelial reactivity and arterial compliance (plethysmography and ultrasound), cartotid artery atherosclerosis and echocardiography were performed, and seven markers of coagulation/fibrinolysis were measured.
Physically active subjects with obesity showed impaired vasoreactivity in the forearm resistance vessels, increased left ventricular mass and impaired left ventricular systolic and diastolic functions, together with impaired coagulation/fibrinolysis when compared to PA/normal-weight subjects (P < 0·05 to <0·001). The majority of these disturbances were seen also in PA/overweight subjects when compared to PA/normal-weight subjects (P < 0·05 to <0·001).
Our data provide additional support for the notion that an increased level of self-reported physical activity does not fully eliminate the deleterious cardiovascular consequences associated with overweight and obesity.
我们最近发现，进行体育活动（PA）可抵消但不能消除超重和肥胖受试者未来患心血管疾病风险的增加。为了进一步研究这一问题，我们研究了正常体重、超重和肥胖对与体育活动相关的亚临床心血管疾病多种标志物的影响。
在乌普萨拉老年人血管前瞻性研究（PIVUS）中，对1016名70岁的受试者进行了调查。体育活动被定义为进行有规律的剧烈运动（自我报告）。根据体重指数（BMI）/体育活动组，参与者被分为体育活动/正常体重（BMI<25kg/m²，n = 104）、非体育活动/正常体重（n = 234）、体育活动/超重（BMI 25-29.9kg/m²，n = 133）、非体育活动/超重（n = 295）、体育活动/肥胖（BMI≥30kg/m²，n = 54）和非体育活动/肥胖（n = 169）。进行了几种不同的内皮反应性和动脉顺应性测量（体积描记法和超声检查）、颈动脉粥样硬化和超声心动图检查，并测量了七种凝血/纤维蛋白溶解标志物。
与体育活动/正常体重的受试者相比，肥胖的体育活动受试者在前臂阻力血管中表现出血管反应性受损、左心室质量增加、左心室收缩和舒张功能受损，以及凝血/纤维蛋白溶解功能受损（P<0.05至<0.001）。与体育活动/正常体重的受试者相比，这些干扰中的大多数在体育活动/超重的受试者中也可见（P<0.05至<0.001）。
我们的数据为以下观点提供了额外支持，即自我报告的体育活动水平增加并不能完全消除与超重和肥胖相关的有害心血管后果。
