Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, USA.
Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
J Gerontol A Biol Sci Med Sci. 2022 Jan 7;77(1):131-139. doi: 10.1093/gerona/glab111.
Obesity exacerbates age-related effects on body composition and physical and metabolic function. Which exercise mode is most effective in mitigating these deleterious changes in dieting older adults with obesity is unknown.
In a randomized controlled trial, we performed a head-to-head comparison of aerobic (AEX), resistance (REX), or combination (COMB) exercise during matched ~10% weight loss in 160 obese older adults. Prespecified analyses compared 6-month changes in intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) assessed using MRI, insulin sensitivity index (ISI) by oral glucose tolerance test, physical function using Modified Physical Performance Test (PPT), VO2peak, gait speed, and knee strength by dynamometry.
IMAT and VAT decreased more in COMB than AEX and REX groups (IMAT; -41% vs -28% and -23% and VAT: -36% vs -19% and -21%; p = .003 to .01); IMAT and VAT decreased in all groups more than control (between-group p < .001). ISI increased more in COMB than AEX and REX groups (86% vs 50% and 39%; p = .005 to .03). PPT improved more in COMB than AEX and REX groups, while VO2peak improved more in COMB and AEX than REX group (all p < .05). Knee strength improved more in COMB and REX than AEX group (all p < .05). Changes in IMAT and VAT correlated with PPT (r = -0.28 and -0.39), VO2peak (r = -0.49 and -0.52), gait speed (r = -0.25 and -0.36), and ISI (r = -0.49 and -0.52; all p < .05).
Weight loss plus combination aerobic and resistance exercise was most effective in improving ectopic fat deposition and physical and metabolic function in older adults with obesity.
肥胖加剧了与年龄相关的身体成分和身体及代谢功能的变化。在肥胖的老年节食者中，哪种运动模式最能有效减轻这些有害变化尚不清楚。
在一项随机对照试验中，我们在 160 名肥胖的老年患者中进行了头对头比较，比较了有氧运动（AEX）、抗阻运动（REX）或联合运动（COMB）在 10%体重减轻期间的效果。预先设定的分析比较了使用 MRI 评估的肌肉间脂肪组织（IMAT）和内脏脂肪组织（VAT）、口服葡萄糖耐量试验的胰岛素敏感指数（ISI）、改良体能测试（PPT）的身体功能、VO2peak、步态速度和测力计的膝关节力量的 6 个月变化。
COMB 组的 IMAT 和 VAT 减少量多于 AEX 和 REX 组（IMAT：-41% vs -28% 和 -23%；VAT：-36% vs -19% 和 -21%；p =.003 至.01）；与对照组相比，所有组的 IMAT 和 VAT 均减少（组间 p <.001）。与 AEX 和 REX 组相比，COMB 组的 ISI 增加更多（86% vs 50% 和 39%；p =.005 至.03）。与 AEX 和 REX 组相比，COMB 组的 PPT 改善更多，而 COMB 和 AEX 组的 VO2peak 改善更多（均 p <.05）。COMB 和 REX 组的膝关节力量改善更多（均 p <.05）。IMAT 和 VAT 的变化与 PPT（r = -0.28 和 -0.39）、VO2peak（r = -0.49 和 -0.52）、步态速度（r = -0.25 和 -0.36）和 ISI（r = -0.49 和 -0.52；均 p <.05）相关。
在肥胖的老年节食者中，体重减轻加上有氧和抗阻运动联合治疗最能有效改善异位脂肪沉积和身体及代谢功能。
