Wilms Britta, Keppler Rahel, Ernst Barbara, Schmid Sebastian M, Thurnheer Martin, Schultes Bernd
Department of Internal Medicine I, University of Lübeck, Lübeck, Germany.
Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Exp Clin Endocrinol Diabetes. 2020 Jan;128(1):15-19. doi: 10.1055/a-0650-4020. Epub 2018 Aug 17.
Even subjects with severe obesity show a wide range of metabolic health states, with some showing marked alterations in glucose and lipid metabolism whereas others do not. In severely obese women, we could recently show that the degree of cardiorespiratory fitness is, independently of body mass and age, associated with several markers of glucose and lipid metabolism.
In our retrospective study on a clinical data set, we questioned whether such an association also exists in severely obese men.
Cardiorespiratory fitness, i. e. workload (W) and oxygen uptake (V̇O) at peak exercise, was assessed by a bicycle spiroergometry in 133 severely obese men (all BMI>35 kg m). The following metabolic blood markers were also measured: Fasting serum glucose, insulin, triglycerides (TG), total, low-, high-density cholesterol (Chol, LDL, HDL), uric acid, and whole blood glycated hemoglobin (HbA1c). The Chol/HDL ratio and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were also calculated.
Multiple stepwise linear regression models including age, body mass, and smoking status as independent variables revealed that W and V̇O, explained 4.5 to 10.7% of variance in HbA1c and TG (all beta<- 0.22; all p<0.02). Including fat free mass instead of body mass in respective models revealed that both W and V̇O were predictors of HbA1c and TG (all beta<- 0.265; all p<0.013), respectively, while W also accounted for variance in glucose and Chol (both beta<- 0.259; both p<0.023).
Similar to previous observations in women, our data indicate that cardiorespiratory fitness assessed by bicycle ergospirometry test is associated with glucose and lipid metabolism in severely obese men. The strength of the found associations suggest a mild to moderate influence of cardiorespiratory fitness on metabolic health in severe obesity.
即使是重度肥胖的个体，其代谢健康状况也存在很大差异，一些人在糖脂代谢方面有明显改变，而另一些人则没有。在重度肥胖女性中，我们最近发现，心肺适能程度与糖脂代谢的多个指标相关，且独立于体重和年龄。
在我们对一个临床数据集的回顾性研究中，我们探讨了这种关联在重度肥胖男性中是否也存在。
通过自行车运动心肺功能测试评估了133名重度肥胖男性（所有BMI>35kg/m²）的心肺适能，即运动峰值时的工作量（W）和摄氧量（V̇O₂）。还测量了以下代谢血液标志物：空腹血清葡萄糖、胰岛素、甘油三酯（TG）、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇（Chol、LDL、HDL）、尿酸和全血糖化血红蛋白（HbA1c）。还计算了Chol/HDL比值和胰岛素抵抗稳态模型评估（HOMA-IR）。
以年龄、体重和吸烟状况作为自变量的多元逐步线性回归模型显示，W和V̇O₂解释了HbA1c和TG变异的4.5%至10.7%（所有β<-0.22；所有p<0.02）。在各自模型中用去脂体重代替体重后发现，W和V̇O₂分别是HbA1c和TG的预测因子（所有β<-0.265；所有p<0.013），而W也解释了葡萄糖和Chol的变异（两者β<-0.259；两者p<0.023）。
与之前在女性中的观察结果相似，我们的数据表明，通过自行车运动心肺功能测试评估的心肺适能与重度肥胖男性的糖脂代谢相关。所发现关联的强度表明心肺适能对重度肥胖患者的代谢健康有轻度至中度影响。
