Ramos Joyce S, Dalleck Lance C, Fennell Mackenzie, Martini Alex, Welmans Talita, Stennett Rebecca, Keating Shelley E, Fassett Robert G, Coombes Jeff S
Caring Futures Institute & SHAPE Research Centre, Exercise Science and Clinical Exercise Physiology, College of Nursing and Health Sciences, Flinders University, Room 268, Sturt South, Sturt Building, Bedford Park, Adelaide, SA, 5042, Australia.
Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
Sports Med Open. 2021 Dec 24;7(1):100. doi: 10.1186/s40798-021-00395-7.
Cardiorespiratory fitness and fatness (notably central obesity) are mediating factors of the metabolic syndrome (MetS) and consequent cardiovascular disease (CVD)/mortality risk. The fitness-fatness index (FFI) combines these factors and has been reported to be a better indicator of CVD and all-cause mortality risk, beyond the capacity of either fitness or fatness alone.
This study sought to investigate the effects of different exercise intensities on FFI in adults with MetS.
This was a sub-study of the 'Exercise in the prevention of Metabolic Syndrome' (EX-MET) multicentre trial. Ninety-nine adults diagnosed with MetS according to the International Diabetes Federation criteria were randomized to one of the following 16-week exercise interventions: i) moderate-intensity continuous training (MICT) at 60-70% HRpeak for 30 min/session (n = 34, 150 min/week); ii) 4 × 4 min bouts of high-intensity interval training at 85-95% HRpeak, interspersed with 3-min active recovery at 50-70% HRpeak (n = 34, 38 min/session, 114 min/week); and iii) 1 × 4 min bout of HIIT at 85-95% HRpeak (n = 31, 17 min/session, 51 min/week). Cardiorespiratory fitness (peak oxygen uptake, V̇Opeak) was determined via indirect calorimetry during maximal exercise testing and fatness was the ratio of waist circumference-to-height (WtHR). FFI was calculated as V̇Opeak in metabolic equivalents (METs) divided by WtHR. A clinically meaningful response to the exercise intervention was taken as a 1 FFI unit increase.
Seventy-seven participants completed pre and post testing to determine FFI. While there was no significant between group difference (p = 0.30), there was a small group x time interaction effect on FFI [F(2, 73) = 1.226; η = 0.01], with numerically greater improvements following HIIT (4HIIT, + 16%; 1HIIT, + 11%) relative to MICT (+ 7%). There was a greater proportion of participants who had a clinically meaningful change in FFI following high-volume HIIT (60%, 15/25) and low-volume HIIT (65%, 17/26) compared to MICT (38%, 10/26), but with no significant between-group difference (p = 0.12). A similar trend was found when a sub-analysis comparing the FFI between those with type 2 diabetes (MICT, 33%, 3/9; high-volume HIIT, 64%, 7/11; and low-volume HIIT, 58%, 7/12) and without type 2 diabetes (MICT, 41%, 7/17; high-volume HIIT, 57%, 8/14; low-volume HIIT, 71%, 10/14).
Although there were no statistically significant differences detected between groups, this study suggests that the response to changes in FFI in adults with MetS may be affected by exercise intensity, when numerical differences between exercise groups are considered. Further research is warranted. Trial registration number and date of registration: ClinicalTrials.gov NCT01676870; 31/08/2012.
心肺适能和肥胖（尤其是中心性肥胖）是代谢综合征（MetS）以及随之而来的心血管疾病（CVD）/死亡风险的中介因素。适能-肥胖指数（FFI）综合了这些因素，据报道，它是CVD和全因死亡风险的一个更好指标，其预测能力超过了单独的适能或肥胖指标。
本研究旨在调查不同运动强度对患有MetS的成年人的FFI的影响。
这是“运动预防代谢综合征”（EX-MET）多中心试验的一项子研究。根据国际糖尿病联盟标准，99名被诊断患有MetS的成年人被随机分配到以下16周运动干预方案之一：i）中等强度持续训练（MICT），心率峰值的60-70%，每次训练30分钟（n = 34，每周150分钟）；ii）4组，每组4分钟的高强度间歇训练，心率峰值的85-95%，每组间穿插3分钟心率峰值50-70%的主动恢复（n = 34，每次训练38分钟，每周114分钟）；iii）1组，每组4分钟的高强度间歇训练，心率峰值的85-95%（n = 31，每次训练17分钟，每周51分钟）。通过最大运动测试期间的间接量热法测定心肺适能（峰值摄氧量，V̇Opeak），肥胖程度以腰围与身高之比（WtHR）表示。FFI的计算方法是代谢当量（METs）表示的V̇Opeak除以WtHR。将运动干预后FFI增加1个单位视为具有临床意义的反应。
77名参与者完成了FFI的前后测试。虽然组间没有显著差异（p = 0.30），但在FFI上存在较小的组×时间交互效应[F(2, 73) = 1.226；η = 0.01]，相对于MICT组（+7%），高强度间歇训练组（4组高强度间歇训练，+16%；1组高强度间歇训练，+11%）在数值上有更大的改善。与MICT组（38%，10/26）相比，大量高强度间歇训练组（60%，15/25）和少量高强度间歇训练组（65%，17/26）中FFI发生具有临床意义变化的参与者比例更高，但组间无显著差异（p = 0.12）。在对2型糖尿病患者（MICT组，33%，3/9；大量高强度间歇训练组，64%，7/11；少量高强度间歇训练组，58%，7/12）和非2型糖尿病患者（MICT组，41%，7/17；大量高强度间歇训练组，57%，8/14；少量高强度间歇训练组，71%，10/14）的FFI进行亚组分析时也发现了类似趋势。
尽管各组之间未检测到统计学上的显著差异，但本研究表明，考虑运动组之间的数值差异时，患有MetS的成年人对FFI变化的反应可能受运动强度影响。有必要进行进一步研究。试验注册号和注册日期：ClinicalTrials.gov NCT01676870；2012年8月31日。
