The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Radiology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
JAMA Cardiol. 2019 Aug 1;4(8):778-787. doi: 10.1001/jamacardio.2019.2074.
Epicardial and pericardial adipose tissues are emerging as important risk factors for cardiovascular disease, and there is a growing interest in discovering strategies to reduce the accumulation of fat in these depots.
To investigate whether a 12-week endurance or resistance training intervention regulates epicardial and pericardial adipose tissue mass.
DESIGN, SETTING, AND PARTICIPANTS: Secondary analysis of a randomized, assessor-blinded clinical trial initiated on August 2016 and completed April 2018. This single-center, community-based study included 50 physically inactive participants with abdominal obesity.
Participants were randomized to a supervised high-intensity interval endurance training (3 times a week for 45 minutes), resistance training (3 times a week for 45 minutes), or no exercise (control group).
Change in epicardial and pericardial adipose tissue mass assessed by magnetic resonance imaging, based on a prespecified secondary analysis plan including 3 of 5 parallel groups.
Of 50 participants (mean [SD] age, 41 [14] years, 10 men [26%]; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 32 [5]), 39 [78%] completed the study. Endurance training and resistance training reduced epicardial adipose tissue mass by 32% (95% CI, 10%-53%) and 24% (95% CI, 1%-46%), respectively, compared with the no exercise control group (56% [95% CI, 24%-88%]; P = .001 and 48% [95% CI, 15%-81%]; P < .001, respectively). While there was a nonsignificant reduction in pericardial adipose tissue mass after endurance training (11% [95% CI, -5% to 27%]; P = .17), resistance training significantly reduced pericardial adipose tissue mass by 31% (95% CI, 16%-47%; P < .001) when compared with the no exercise control group. Compared with the no exercise control group, there was an increase in left ventricular mass by endurance (20 g [95% CI, 11%-30%]; P < .001) and resistance training (18 g [95% CI, 8%-28%]; P < .001). Other cardiometabolic outcomes remained unchanged after the 12-week trial period.
In individuals with abdominal obesity, both endurance and resistance training reduced epicardial adipose tissue mass, while only resistance training reduced pericardial adipose tissue mass. These data highlight the potential preventive importance of different exercise modalities as means to reduce cardiac fat in individuals with abdominal obesity.
ClinicalTrials.gov identifier: NCT02901496.
心外膜和心包脂肪组织正逐渐成为心血管疾病的重要危险因素，人们越来越关注发现减少这些脂肪沉积的策略。
研究 12 周的耐力或抗阻力训练干预是否能调节心外膜和心包脂肪组织的质量。
设计、设置和参与者：这是一项于 2016 年 8 月启动并于 2018 年 4 月完成的随机、评估者盲法临床试验的二次分析。这项单中心、社区为基础的研究纳入了 50 名身体不活跃的腹型肥胖参与者。
参与者被随机分配到高强度间歇耐力训练组（每周 3 次，每次 45 分钟）、抗阻力训练组（每周 3 次，每次 45 分钟）或不运动对照组（无锻炼组）。
采用磁共振成像评估心外膜和心包脂肪组织质量的变化，这是基于包括 5 个平行组中的 3 个组的预设二次分析方案。
在 50 名参与者（平均[标准差]年龄 41[14]岁，10 名男性[26%]；平均[标准差]体重指数[按千克体重除以米平方计算]32[5]）中，有 39 名（78%）完成了研究。与无运动对照组相比，耐力训练和抗阻力训练分别使心外膜脂肪组织质量减少了 32%（95%置信区间，10%-53%）和 24%（95%置信区间，1%-46%）（P=0.001 和 48%[95%置信区间，15%-81%]；P<0.001）。尽管耐力训练后心包脂肪组织质量有一定程度的非显著减少（11%[95%置信区间，-5%至 27%]；P=0.17），但与无运动对照组相比，抗阻力训练可显著减少 31%的心包脂肪组织质量（95%置信区间，16%-47%；P<0.001）。与无运动对照组相比，耐力训练和抗阻力训练分别使左心室质量增加 20 克（95%置信区间，11%-30%）和 18 克（95%置信区间，8%-28%）（P<0.001）。12 周试验期后，其他心血管代谢结局保持不变。
在腹型肥胖者中，耐力和抗阻力训练均可减少心外膜脂肪组织质量，而只有抗阻力训练可减少心包脂肪组织质量。这些数据突出了不同运动方式作为减少腹型肥胖者心脏脂肪的潜在预防作用。
ClinicalTrials.gov 标识符：NCT02901496。
