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高强度抗阻运动对患有骨质疏松症的老年男性心脏代谢健康的影响:随机对照的弗兰肯骨质疏松症和肌肉减少症试验(FrOST)。

Effect of high-intensity resistance exercise on cardiometabolic health in older men with osteosarcopenia: the randomised controlled Franconian Osteopenia and Sarcopenia Trial (FrOST).

作者信息

Kemmler Wolfgang, Kohl Matthias, von Stengel Simon, Schoene Daniel

机构信息

Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.

Faculty Medical and Life Sciences, Furtwangen University of Applied Sciences, Furtwangen, Germany.

出版信息

BMJ Open Sport Exerc Med. 2020 Dec 24;6(1):e000846. doi: 10.1136/bmjsem-2020-000846. eCollection 2020.

Abstract

OBJECTIVES

Sarcopenia is related to the metabolic syndrome (MetS), a cluster of cardiometabolic risk-factors (CRF). Most exercise trials apply aerobic rather than resistance exercise to address CRF, while the strategy for maintaining muscle and bone is the opposite. However, there is considerable evidence that resistance exercise positively affects CRF. In the present study, we determined the effect of high-intensity resistance exercise training (HIT-RT) on CRF represented by the MetS in older men.

METHODS

Forty-three osteosarcopenic and predominately obese older men (>72 years) living independently in Erlangen-Nürnberg, Germany were randomly assigned to two study arms. The HIT-RT group (n=21) conducted a periodised high intensity/effort protocol dedicated to muscle and bone mass and function two times per week, while the control group (CG: n=22) maintained their habitual physical activities. Both groups were supplemented with protein, cholecalciferol and calcium. Study outcomes presented here were the MetS-Z (MetSZ) score and its underlying risk-factors.

RESULTS

After 18 months of intervention, we observed significant effects for the MetSZ score (p<0.001), with significant improvements in the HIT-RT and significant worsening in the CG. In detail, all parameters constituting the MetS contributed to this result, however, only waist-circumference, HDL-cholesterol and mean arterial blood pressure revealed significant effects. No adverse events were reported and high adherence was determined for the HIT-RT-protocol.

CONCLUSION

Continuously supervised HIT-RT is an effective, attractive, feasible and safe method to address cardiometabolic risk factors in community-dwelling men aged 72 years and older. Further, considering the proven effects on musculoskeletal risk factors, the present results indicate a more prominent role for HIT-RT within non-pharmacological prevention strategies of older adults.

TRIAL REGISTRATION NUMBER

NCT03453463.

摘要

目的

肌肉减少症与代谢综合征(MetS)相关,代谢综合征是一组心血管代谢危险因素(CRF)。大多数运动试验采用有氧运动而非抗阻运动来解决心血管代谢危险因素问题,而维持肌肉和骨骼的策略则相反。然而,有大量证据表明抗阻运动对心血管代谢危险因素有积极影响。在本研究中,我们确定了高强度抗阻运动训练(HIT-RT)对老年男性中以代谢综合征为代表的心血管代谢危险因素的影响。

方法

43名生活在德国埃尔朗根-纽伦堡、独立生活的骨质疏松性肌肉减少症且主要为肥胖的老年男性(>72岁)被随机分配到两个研究组。高强度抗阻运动训练组(n = 21)每周进行两次专门针对肌肉和骨骼质量及功能的周期性高强度/高强度训练方案,而对照组(CG:n = 22)维持其习惯性身体活动。两组均补充蛋白质、胆钙化醇和钙。此处呈现的研究结果是代谢综合征-Z(MetSZ)评分及其潜在危险因素。

结果

干预18个月后,我们观察到MetSZ评分有显著影响(p < 0.001),高强度抗阻运动训练组有显著改善,而对照组则显著恶化。详细而言,构成代谢综合征的所有参数都促成了这一结果,然而,只有腰围、高密度脂蛋白胆固醇和平均动脉血压显示出显著影响。未报告不良事件,且确定高强度抗阻运动训练方案的依从性很高。

结论

持续监督的高强度抗阻运动训练是解决72岁及以上社区居住男性心血管代谢危险因素的一种有效、有吸引力、可行且安全的方法。此外,考虑到对肌肉骨骼危险因素已证实的影响,目前的结果表明高强度抗阻运动训练在老年人非药物预防策略中发挥着更突出的作用。

试验注册号

NCT03453463。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b74/7768961/8fb7c1949015/bmjsem-2020-000846f01.jpg

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