Effects of Intense Exercise and Moderate Caloric Restriction on Cardiovascular Risk Factors and Inflammation
Effects of Intense Exercise and Moderate Caloric Restriction on Cardiovascular Risk Factors and Inflammation
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DOI：
10.1016/j.amjmed.2011.02.032
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发表时间：
2011-10-01
影响因子：
5.9
通讯作者：
Siegel, Robert
中科院分区：
文献类型：
--
作者：
Ahmadi, Naser;Eshaghian, Shervin;Siegel, Robert
背景：肥胖与胰岛素抵抗、炎症、代谢功能障碍和动脉粥样硬化有关。本研究探讨了减肥、剧烈运动和适度热量限制对胰岛素抵抗、血脂、炎症生物标志物、颈动脉扩张性指数(CADI)和颈动脉内膜中层厚度(CIMT)的影响。方法：《最大减肥者》电视节目中的17名久坐不动的病态肥胖者完成了为期7个月的剧烈运动和中等热量限制计划；3人因缺乏后续CIMT而被排除在外。分别于治疗前和治疗后7个月检测血清胰岛素水平、血糖、血脂、超敏C反应蛋白(CRP)、糖化血红蛋白(HbA1c)、抵抗素、脂联素、纤溶酶原激活物抑制物-1(PAI-1)、肿瘤坏死因子受体-II(TNFRII)、脂蛋白a(Lp[a])、性激素结合球蛋白(SHBG)、血压、体脂、体重、CADI和CIMT。在舒张期中期测量颈总动脉分叉部下方5~10 mm处的CIMT。CADI定义为：(收缩末期-舒张期末期颈总动脉横截面积)/(舒张末期颈总动脉横截面积×全身脉压)×1000。结果：随访7个月时，体重(-39%)、体脂(-66%)、血清胰岛素(-52%)、血糖(-21%)、高敏C反应蛋白(-81%)、糖化血红蛋白(-11%)、纤溶酶原激活物-1(-49%)、肿瘤坏死因子受体II(-12%)、CIMT(-25%)显著下降，CADI(132%)、抵抗素(344%)、脂联素(94%)、脂联素(94%)、脂联素(73%)、观察到SHBG(94%)。CADI的改善与脂联素、Lp(A)、SBHG和抵抗素的升高呈正相关(R2=0.86，P=0.009)，而与PAI-1、TNFRII、CRP和IR呈负相关(r(2)=-0.64，P=0.01)。CIMT的降低与CADI的升高之间存在明显的负相关(r(2)=0.65，P=.001)。结论：在病态肥胖者中，适度限制热量超过7个月的高强度运动与颈动脉血管功能和动脉粥样硬化危险因素的显著改善以及炎性生物标志物、血脂、胰岛素抵抗和CIMT的减少相关。(C)2011 Elsevier Inc.保留所有权利。《美国医学杂志》(2011)124,978-982
BACKGROUND: Obesity is associated with insulin resistance, inflammation, metabolic dysfunction, and atherosclerosis. This study investigates the effects of weight loss, intense exercise, and moderate caloric restriction on insulin resistance, lipids, inflammatory biomarkers, carotid artery distensibility index (CaDI), and carotid intima media thickness (CIMT).METHODS: Seventeen sedentary morbidly obese contestants in the "Biggest Loser" television program completed the 7-month intense-exercise and moderate-restricting calories program; 3 were excluded due to lack of follow-up CIMT. Serum insulin level, glucose, lipid profile, high-sensitivity C-reactive protein (CRP), hemoglobin A1c (HbA1c), resistin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor receptor-II (TNFRII), lipoprotein a (Lp[a]), sex hormone binding globulin (SHBG), blood pressure, body fat, weight, CaDI, and CIMT were measured at baseline and 7-month follow-up. CIMT was measured 5-10 mm below the common carotid bifurcation during mid-diastolic phase. CaDI was defined as: (End-systole -End-diastole common-carotid cross-sectional area)/(End-diastole common-carotid cross-sectional-area x systemic pulse pressure) x 1000. Insulin resistance was calculated by homeostatic model assessment (HOMA) index.RESULTS: At 7-month follow-up, major reductions in weight (-39%), body fat (-66%), serum insulin level (-52%), glucose (-21%), high-sensitivity CRP (-81%), HbA1c (-11%), PAI-1 (-49%), TNFRII (-12%), and CIMT (-25%), and increases in CaDI (132%), resistin (344%), adiponectin (94%), Lp(a) (73%), and SHBG (94%) were observed. The improvement in CaDI was positively correlated with increases in adiponectin, Lp(a), SBHG, and resistin (r2 = 0.86, P =.009), but inversely with PAI-1, TNFRII, CRP, and IR (r(2) = -0.64, P =.01). Strong inverse correlation was noted between decreases in CIMT and increases in CaDI (r(2) = 0.65, P =.001).CONCLUSION: In morbidly obese individuals, intense exercise with moderate caloric restriction over 7 months is associated with a dramatic improvement in carotid vascular function and atherosclerosis risk factors, as well as a reduction in inflammatory biomarkers, lipids, insulin resistance, and CIMT. (C) 2011 Elsevier Inc. All rights reserved. The American Journal of Medicine (2011) 124, 978-982