Ross Leanna M, Slentz Cris A, Kraus William E
Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States.
Division of Cardiology, School of Medicine, Duke University, Durham, NC, United States.
Front Physiol. 2019 Nov 14;10:1401. doi: 10.3389/fphys.2019.01401. eCollection 2019.
Understanding group responses to a given exercise exposure is becoming better developed; however, understanding of individual responses to specific exercise exposures is significantly underdeveloped and must advance before personalized exercise medicine can become a functional reality. Herein, utilizing data from the STRRIDE studies, we address some of the key issues surrounding our efforts to develop better understanding of individual exercise responsiveness.
We assessed individual cardiometabolic and cardiorespiratory fitness responses in subjects successfully completing STRRIDE I ( = 227) and STRRIDE II ( = 155). Subjects were previously sedentary, overweight or obese men and women with mild-to-moderate dyslipidemia. Subjects were randomized to either an inactive control group or to an exercise training program. Training groups varied to test the differential effects of exercise amount, intensity, and mode on cardiometabolic health outcomes. Measures included fasting plasma glucose, insulin, and lipids; blood pressure, minimal waist circumference, visceral adipose tissue, and peak VO. Absolute change scores were calculated for each subject as post-intervention minus pre-intervention values in order to evaluate the heterogeneity of health factor responsiveness to exercise training.
For subjects completing one of the aerobic training programs, change in peak VO ranged from a loss of 37% to a gain of 77%. When ranked by magnitude of change, we observed discordant responses among changes in peak VO with changes in visceral adipose tissue, HDL-C, triglycerides, and fasting plasma insulin. There was also not a clear, direct relationship observed between magnitudes of individual response in the aforementioned variables with aerobic training adherence levels. This same pattern of highly variable and discordant responses was displayed even when considering subjects with adherence levels greater than 70%.
Our findings illustrate the unclear relationship between magnitude of individual response for a given outcome with training adherence and specific exercise exposure. These discordant and heterogeneous responses highlight the difficult nature of developing understanding for how individuals will respond to any given exposure. Further investigation into the biological, physiological, and genetics factors affecting individual responsiveness is vital to making personalized exercise medicine a reality.
对给定运动暴露的群体反应的理解正在不断完善；然而，对个体对特定运动暴露的反应的理解仍严重不足，在个性化运动医学成为现实之前，这方面必须取得进展。在此，我们利用STRRIDE研究的数据，探讨了围绕我们更好地理解个体运动反应性所做努力的一些关键问题。
我们评估了成功完成STRRIDE I（n = 227）和STRRIDE II（n = 155）的受试者的个体心脏代谢和心肺适能反应。受试者先前久坐不动，为超重或肥胖的男性和女性，伴有轻度至中度血脂异常。受试者被随机分为非运动对照组或运动训练组。训练组有所不同，以测试运动量、强度和模式对心脏代谢健康结果的不同影响。测量指标包括空腹血糖、胰岛素和血脂；血压、最小腰围、内脏脂肪组织和峰值摄氧量。为每个受试者计算绝对变化分数，即干预后值减去干预前值，以评估健康因素对运动训练反应性的异质性。
对于完成其中一项有氧训练计划的受试者，峰值摄氧量的变化范围为下降37%至上升77%。按变化幅度排序时，我们观察到峰值摄氧量的变化与内脏脂肪组织、高密度脂蛋白胆固醇、甘油三酯和空腹血浆胰岛素的变化之间存在不一致的反应。在上述变量的个体反应幅度与有氧训练依从水平之间也未观察到明确的直接关系。即使考虑依从水平大于70%的受试者，也呈现出这种高度可变和不一致反应的相同模式。
我们的研究结果表明，对于给定结果的个体反应幅度与训练依从性和特定运动暴露之间的关系尚不清楚。这些不一致和异质性反应凸显了了解个体对任何给定暴露将如何反应的困难性质。进一步研究影响个体反应性的生物学、生理学和遗传学因素对于使个性化运动医学成为现实至关重要。
