Tremblay Angelo, Bélanger Marie-Pier, Dhaliwal Rupinder, Brauer Paula, Royall Dawna, Mutch David M, Rhéaume Caroline
1Department of Kinesiology, PEPS, Faculty of Medicine, Université Laval, Quebec, G1V 0A6 Canada.
Metabolic Syndrome Canada, Kingston, Ontario Canada.
Arch Public Health. 2020 Apr 15;78:22. doi: 10.1186/s13690-020-0399-0. eCollection 2020.
Metabolic syndrome (MetS) is a health disorder characterized by metabolic abnormalities that predict an increased risk to develop cardiovascular disease (CVD) and type 2 diabetes (T2DM). It can be resolved, and its complications reduced, by lifestyle interventions offered in primary care. The objectives of this study were to evaluate the impact of the exercise program of the CHANGE feasibility study on physical fitness and physical activity habits, and assess associations between changes in MetS components and cardiorespiratory fitness (CRF).
In this analysis of 192 of the 293 adults with MetS in the overall study, the impact on physical fitness [aerobic capacity, muscular fitness and flexibility], and non-supervised physical activities was investigated over 12 months. In the CHANGE program, aerobic capacity, muscular fitness and flexibility were assessed at baseline, after 3 months of weekly supervised exercise, and following 9 additional months during which participants had one monthly session of supervised exercise. Additionally, CRF response was also examined in relation to changes in MetS components [fasting glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, blood pressure, waist circumference (WC)].
Fitness variables were significantly increased at 12 months with most of the improvements reached by 3 months (estimated VO max: 6 and 12%; partial curl-ups: 55 and 80%; push-ups: 50 and 100%; flexibility: 22 and 10% in men and women, respectively, < 0.001). As expected, the duration and intensity of supervised aerobic physical activity increased during the first 3 months of supervision in both men and women, and remained unchanged for the duration of the program. The duration of non-supervised physical activities did not change during the program in men whereas an increase in manual work of moderate intensity was recorded in women between 3 and 12 months. In women, mean changes in WC were significantly greater among high VO max responders than low responders, between 0 and 12 months, as well as between 3 and 12 months (- 3.42 cm and - 4.32 cm, respectively, < 0.05). No associations were seen with MetS components in men. Higher intensity activities were maintained by both sexes at one year.
Patients with MetS participating in the CHANGE lifestyle program improved physical fitness and physical activity habits by three months and maintained these gains over one year. Women who achieved a greater VO max increase had greater reductions in WC compared to low VOmax responders.
代谢综合征（MetS）是一种健康紊乱状态，其特征为代谢异常，预示着患心血管疾病（CVD）和2型糖尿病（T2DM）的风险增加。通过初级保健提供的生活方式干预可以缓解该综合征，并减少其并发症。本研究的目的是评估CHANGE可行性研究中的运动计划对身体素质和身体活动习惯的影响，并评估代谢综合征各组分变化与心肺适能（CRF）之间的关联。
在对总体研究中293名患有代谢综合征的成年人中的192名进行的这项分析中，研究了12个月期间对身体素质[有氧能力、肌肉力量和柔韧性]以及非监督性身体活动的影响。在CHANGE计划中，在基线、每周进行监督运动3个月后以及随后9个月（在此期间参与者每月进行一次监督运动）对有氧能力、肌肉力量和柔韧性进行评估。此外，还研究了心肺适能反应与代谢综合征各组分[空腹血糖、高密度脂蛋白（HDL）胆固醇、甘油三酯、血压、腰围（WC）]变化之间的关系。
12个月时体能变量显著增加，大部分改善在3个月时就已实现（估计最大摄氧量：男性和女性分别增加6%和12%；部分仰卧起坐：分别增加55%和80%；俯卧撑：分别增加50%和100%；柔韧性：分别增加22%和10%，P<0.001）。正如预期的那样，在监督的前3个月中，男性和女性监督性有氧体育活动的持续时间和强度均增加，并且在该计划期间保持不变。男性在该计划期间非监督性身体活动的持续时间没有变化，而女性在3至12个月期间记录到中等强度体力劳动增加。在女性中，0至12个月以及3至12个月期间，高最大摄氧量反应者的腰围平均变化显著大于低反应者（分别为-3.42厘米和-4.32厘米，P<0.05）。在男性中未发现与代谢综合征各组分有关联。一年时男女均保持了较高强度的活动。
参与CHANGE生活方式计划的代谢综合征患者在3个月时改善了身体素质和身体活动习惯，并在一年中维持了这些改善。与低最大摄氧量反应者相比，最大摄氧量增加幅度更大的女性腰围减少幅度更大。
