Horváth Judit, Seres Ildikó, Paragh György, Fülöp Péter, Jenei Zoltán
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Debrecen, 4026 Debrecen, Hungary.
Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
Nutrients. 2024 Dec 9;16(23):4251. doi: 10.3390/nu16234251.
Obesity poses an enormous public health and economic burden worldwide. Visceral fat accumulation is associated with various metabolic and cardiovascular consequences, resulting in an increased prevalence of atherosclerotic conditions. We aimed to examine the impact of low-and moderate-intensity aerobic training on several anthropometric and cardiorespiratory parameters and markers of atherosclerosis, including inflammation, serum levels of lipoproteins and adipokines of extremely obese patients in poor condition.
Forty severely obese patients were recruited and randomized into two groups, Group 1 and Group 2, for a six-week inpatient study. Group 1 received moderate-intensity (40-60% heart rate reserve) and Group 2 received low-intensity (30-39% of heart rate reserve) aerobic training combined with resistance training. The patients' cardiorespiratory functions were assessed by ergospirometry. Anthropometric data were recorded, body composition was analyzed and functional tests were performed. We also investigated serum lipids and high-sensitive C-reactive protein levels and calculated the homeostatic model assessment-insulin resistance indices and adipokine levels as predictive biomarkers.
Functional abilities and some biochemical parameters, such as homeostatic model assessment-insulin resistance, serum lipids, apolipoprotein A and apolipoprotein-B improved in both groups in a positive direction. However, cardiorespiratory capacity and the serum levels of high-sensitive C-reactive protein and Lipocalin-2 decreased, while irisin and paraoxonase 1 increased significantly, but only in Group 1.
Six weeks of aerobic training, regardless of its intensity, could induce favorable changes in functional tests, body composition and serum lipids, even in severely obese, extremely unconditioned patients in both groups. However, moderate-intensity aerobic training should at least increase cardiorespiratory capacity and yield a better lipid profile oxidative status and inflammation profile.
肥胖在全球范围内构成了巨大的公共卫生和经济负担。内脏脂肪堆积与各种代谢和心血管后果相关，导致动脉粥样硬化疾病的患病率增加。我们旨在研究低强度和中等强度有氧运动训练对一些人体测量学、心肺参数以及动脉粥样硬化标志物的影响，这些标志物包括炎症、脂蛋白血清水平以及身体状况较差的极度肥胖患者的脂肪因子。
招募了40名严重肥胖患者，并将其随机分为两组，即第1组和第2组，进行为期六周的住院研究。第1组接受中等强度（心率储备的40 - 60%）的有氧运动训练，第2组接受低强度（心率储备的30 - 39%）的有氧运动训练，并结合抗阻训练。通过运动肺量计评估患者的心肺功能。记录人体测量数据，分析身体成分并进行功能测试。我们还研究了血脂和高敏C反应蛋白水平，并计算了稳态模型评估 - 胰岛素抵抗指数和脂肪因子水平作为预测生物标志物。
两组患者的功能能力以及一些生化参数，如稳态模型评估 - 胰岛素抵抗、血脂、载脂蛋白A和载脂蛋白B均呈正向改善。然而，心肺功能以及高敏C反应蛋白和lipocalin - 2的血清水平下降，而鸢尾素和对氧磷酶1显著增加，但仅在第1组中出现。
六周的有氧运动训练，无论强度如何，即使对于两组中严重肥胖、身体状况极差的患者，也能在功能测试、身体成分和血脂方面诱导出有利变化。然而，中等强度的有氧运动训练至少应提高心肺功能，并产生更好的脂质谱氧化状态和炎症谱。
