运动方式对超重和肥胖青少年胰岛素抵抗和异位脂肪的影响：一项随机临床试验。
Effects of Exercise Modality on Insulin Resistance and Ectopic Fat in Adolescents with Overweight and Obesity: A Randomized Clinical Trial.
机构信息
Division of Sports Medicine, Graduate School of Physical Education, Kyung Hee University, Yongin, Republic of Korea.
Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
出版信息
J Pediatr. 2019 Mar;206:91-98.e1. doi: 10.1016/j.jpeds.2018.10.059. Epub 2018 Dec 13.
OBJECTIVE
To examine whether a combined aerobic exercise and resistance exercise is more effective than either aerobic exercise or resistance exercise alone in improving insulin sensitivity and reducing total adiposity and ectopic fat in adolescents.
STUDY DESIGN
A total of 118 sedentary adolescents with overweight/obesity (body mass index >85th percentile, 12-17 years) were recruited from October 2013 through April 2017 at Children's Hospital of Pittsburgh. Participants were randomized to 1 of the following 6-month exercise groups (3 d/wk, 180 min/wk): aerobic exercise (n = 38), resistance exercise (n = 40), and combined aerobic exercise and resistance exercise (n = 40). The primary outcome was the change in insulin-stimulated glucose disposal by a 3-hour hyperinsulinemic-euglycemic clamp. The secondary outcomes were changes in liver fat by proton magnetic resonance spectroscopy and intermuscular adipose tissue by computed tomography.
RESULTS
Of the 118 participants randomized, 85 participants (72%) completed the study with 90% exercise attendance. Total adiposity reduced similarly in all groups (-2%, P < .05). After adjusting for age and sex, insulin-stimulated glucose disposal increased (P < .05) in all groups, with the increase in the aerobic exercise group being greater than the resistance exercise group (1.7 ± 0.1 vs 0.7 ± 0.1 mg/kg/min, P < .05) but not different from the combined group (1.2 ± 0.1 mg/kg/min). Liver fat was reduced (P < .05) in the aerobic exercise (-0.6%) and combined (-0.6%) groups but not in the resistance exercise group (-0.3%, P > .05). Intermuscular adipose tissue decreased (P < .05) similarly in all groups.
CONCLUSION
Combined aerobic exercise and resistance exercise and aerobic exercise alone are similarly beneficial in improving insulin sensitivity and reducing ectopic fat in adolescents with obesity.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT01938950.
目的
研究有氧运动与抗阻运动相结合是否比单独进行有氧运动或抗阻运动更能有效改善青少年的胰岛素敏感性，减少全身脂肪量和异位脂肪。
研究设计
2013 年 10 月至 2017 年 4 月，匹兹堡儿童医院招募了 118 名久坐超重/肥胖青少年（体重指数>第 85 百分位，12-17 岁）。参与者被随机分为以下 6 个月运动组中的 1 组（每周 3 天，每次 180 分钟）：有氧运动组（n=38）、抗阻运动组（n=40）和有氧与抗阻运动联合组（n=40）。主要结局是通过 3 小时高胰岛素-正葡萄糖钳夹试验评估胰岛素刺激葡萄糖摄取的变化。次要结局是通过质子磁共振波谱（1H-MRS）评估肝脏脂肪和计算机断层扫描（CT）评估肌间脂肪组织的变化。
结果
在随机分组的 118 名参与者中，85 名（72%）完成了研究，且 90%的人坚持了运动。所有组的全身脂肪量均相似减少（-2%，P<.05）。在校正年龄和性别后，所有组的胰岛素刺激葡萄糖摄取均增加（P<.05），其中有氧运动组的增加大于抗阻运动组（1.7±0.1 比 0.7±0.1 mg/kg/min，P<.05），但与联合组无差异（1.2±0.1 mg/kg/min）。肝脏脂肪量减少（P<.05）在有氧运动组（-0.6%）和联合组（-0.6%）中，但在抗阻运动组中无变化（-0.3%，P>.05）。肌间脂肪组织减少（P<.05）在所有组中相似。
结论
有氧运动与抗阻运动相结合以及单纯有氧运动均能有效改善肥胖青少年的胰岛素敏感性和减少异位脂肪。
临床试验注册
ClinicalTrials.gov：NCT01938950。
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