Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program
Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program
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DOI：
10.1016/j.jacc.2006.07.035
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发表时间：
2006-11-07
影响因子：
24
通讯作者：
Kienast, Wolfgang
中科院分区：
文献类型：
--
作者：
Meyer, Andreas A.;Kundt, Guether;Kienast, Wolfgang
目的：本研究旨在评估6个月的运动计划对肥胖儿童血流介导的血管舒张（FMD）、颈动脉内膜-中膜厚度（IMT）和心血管危险因素（RF）的影响。儿童肥胖会导致成人肥胖和随后的心血管疾病。缺乏运动是肥胖、内皮功能障碍和颈动脉IMT升高的主要RF，最终导致早期动脉粥样硬化性疾病。方法67名肥胖受试者（年龄14.7 +/- 2.2岁）随机分为6个月运动组和非运动组。我们检查了运动（1小时，每周3次）对FMD、IMT和心血管风险概况的影响。结果：与苗条对照组相比，肥胖儿童在基线时表现出FMD显著受损（4.09 +/- 1.76% vs. 10.65 +/- 1.95%, p < 0.001）， IMT增加（0.48 +/- 0.08 mm vs. 0.37 +/- 0.05 mm, p < 0.001），以及许多肥胖相关的心血管RF。运动组IMT （0.44 +/- 0.08 mm, p = 0.012, - 6.3%）和FMD （7.71 +/- 2.53%, p < 0.001, + 127%）均有显著改善。这种改善与降低RF相关，如体重指数标准差评分、体脂质量、腰臀比、动态收缩压、空腹胰岛素、甘油三酯、低密度Epoprotein/高密度脂蛋白比率和低程度炎症（c反应蛋白、纤维蛋白原）。结论：本研究表明，在年轻肥胖受试者中，IMT增加，内皮功能受损，各种心血管RF升高。6个月以上的定期运动可恢复内皮功能，改善颈动脉IMT，并改善肥胖儿童心血管风险概况。
OBJECTIVES The present study aimed to assess the effect of a 6-month exercise program in obese children on flow-mediated vasodilation (FMD) carotid intima-media thickness (IMT) and cardiovascular risk factors (RF).BACKGROUND Childhood obesity contributes to adult obesity and subsequent cardiovascular disease. Physical inactivity is a major RF for obesity, endothelial dysfunction, and elevated carotid IMT, culminating in early atherosclerotic disease.METHODS Sixty-seven obese subjects (age 14.7 +/- 2.2 years) were randomly assigned to 6 months' exercise or non-exercise protocol. We examined the influence of exercises (1 h, 3 times/week) on FMD, IMT, and cardiovascular risk profile.RESULTS Compared with lean control subjects, obese children demonstrated at baseline significantly impaired FMD (4.09 +/- 1.76% vs. 10.65 +/- 1.95%, p < 0.001), increased IMT (0.48 +/- 0.08 mm vs. 0.37 +/- 0.05 mm, p < 0.001), and a number of obesity-related cardiovascular RF. Significant improvements were observed in the exercise group for IMT (0.44 +/- 0.08 mm, p = 0.012, - 6.3%) and FMD (7.71 +/- 2.53%, p < 0.001, + 127%). This improvement correlated with reduced RF, such as body mass index standard deviation scores, body fat mass, waist/hip ratio, ambulatory systolic blood pressure, fasting insulin, triglycerides, low-density Epoprotein/high-density lipoprotein ratio, and low-degree inflammation (C-reactive protein, fibrinogen).CONCLUSIONS The present study documented increased IMT, impaired endothetial function, and various elevated cardiovascular RF in young obese subjects. Regular exercise over 6 months restores endothelial function and improves carotid IMT associated with an improved cardiovascular risk profile in obese children.