基于网络的运动与监督运动对中老年中心型肥胖者减少内脏脂肪组织的效果比较：一项随机对照试验。
Web-based exercise versus supervised exercise for decreasing visceral adipose tissue in older adults with central obesity: a randomized controlled trial.
机构信息
Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden.
Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
出版信息
BMC Geriatr. 2020 May 12;20(1):173. doi: 10.1186/s12877-020-01577-w.
BACKGROUND
Visceral adipose tissue (VAT) is a strong risk factor for cardiovascular disease and increases with age. While supervised exercise (SE) may be an effective approach, web-based exercise (WE) have other advantages such as being more readily accessible. Therefore, we evaluated the effects of WE on VAT, body composition and cardiometabolic risk markers in centrally obese older adults and compared the effects of WE to SE. We also explored the feasibility of WE.
METHODS
In a randomized controlled trial conducted in Umeå, Sweden during January 2018 - November 2018, N = 77, 70-year-old men and women with central obesity (> 1 kg VAT for women, > 2 kg for men) were randomized to an intervention group (n = 38) and a wait-list control group (n = 39). The intervention group received 10 weeks of SE while the wait-list control group lived as usual. Following a 10-week wash-out-period, the wait-list control group received 10 weeks of WE. The primary outcome was changes in VAT. Secondary outcomes included changes in fat mass (FM), lean body mass (LBM), blood lipids, fasting blood glucose. Additionally, we explored the feasibility of WE defined as adherence and participant experiences.
RESULTS
WE had no significant effect on VAT (P = 0.5), although it decreased FM by 450 g (95% confidence interval [CI], 37 to 836, P < 0.05). The adherence to WE was 85% and 87-97% of the participants rated aspects of the WE intervention > 4 on a scale of 1-5. Comparing SE to WE, there was no significant difference in decrease of VAT (Cohen's δ effect size [ES], 0.5, 95% CI, - 24 to 223, P = 0.11), although SE decreased FM by 619 g (ES, 0.5, 95% CI, 22 to 1215, P < 0.05) compared to WE.
CONCLUSIONS
Ten weeks of vigorous WE is insufficient to decrease VAT in centrally obese older adults, but sufficient to decrease FM while preserving LBM. The high adherence and positive experiences of the WE intervention implies that it could serve as an alternative exercise strategy for older adults with central obesity, with increased availability for a larger population.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT03450655), retrospectively registered February 28, 2018.
背景
内脏脂肪组织（VAT）是心血管疾病的一个强有力的危险因素，并随着年龄的增长而增加。虽然监督下的运动（SE）可能是一种有效的方法，但基于网络的运动（WE）具有其他优势，例如更容易获得。因此，我们评估了 WE 对中心性肥胖的老年人 VAT、身体成分和心血管代谢风险标志物的影响，并比较了 WE 和 SE 的效果。我们还探讨了 WE 的可行性。
方法
在 2018 年 1 月至 2018 年 11 月期间在瑞典于默奥进行的一项随机对照试验中，我们招募了 N = 77 名年龄在 70 岁的男性和女性，这些人存在中心性肥胖（女性 VAT > 1kg，男性 > 2kg），并将他们随机分配到干预组（n = 38）和候补名单对照组（n = 39）。干预组接受了 10 周的 SE，而候补名单对照组则照常生活。在为期 10 周的洗脱期后，候补名单对照组接受了 10 周的 WE。主要结局是 VAT 的变化。次要结局包括脂肪量（FM）、瘦体重（LBM）、血脂、空腹血糖的变化。此外，我们还探讨了 WE 的可行性，将其定义为依从性和参与者体验。
结果
WE 对 VAT 没有显著影响（P = 0.5），尽管它使 FM 减少了 450g（95%置信区间[CI]，37 至 836，P < 0.05）。WE 的依从率为 85%，87%至 97%的参与者对 WE 干预的各个方面评分 > 4（1 至 5 分）。与 SE 相比，WE 对 VAT 的减少没有显著差异（Cohen 的 δ 效应量[ES]，0.5，95%CI，-24 至 223，P = 0.11），尽管 SE 使 FM 减少了 619g（ES，0.5，95%CI，22 至 1215，P < 0.05），与 WE 相比。
结论
十周的剧烈 WE 不足以减少中心性肥胖老年人的 VAT，但足以减少 FM 而保持 LBM。WE 干预的高依从性和积极体验表明，它可以作为中心性肥胖老年人的另一种运动策略，为更多人提供了更多的可用性。
试验注册
ClinicalTrials.gov（NCT03450655），2018 年 2 月 28 日回顾性注册。
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