Weight loss, exercise or both and cardiometabolic risk factors in obese older adults: results of a randomized controlled trial.
Weight loss, exercise or both and cardiometabolic risk factors in obese older adults: results of a randomized controlled trial.
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DOI：
10.1038/ijo.2013.122
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发表时间：
2014-03
影响因子：
4.9
通讯作者：
Villareal, D. T.
中科院分区：
文献类型：
--
作者：
Bouchonville, M.;Armamento-Villareal, R.;Shah, K.;Napoli, N.;Sinacore, D. R.;Qualls, C.;Villareal, D. T.
肥胖会加剧与年龄相关的胰岛素敏感性下降，并与老年人患心脏代谢综合征的风险相关；然而，对于肥胖老年人的适当治疗仍存在争议。确定减肥和运动对肥胖老年人心脏代谢危险因素的独立和综合影响。将 177 名身体虚弱的肥胖（BMI≥30 kg/m2）老年人（≥65 岁）随机分为对照组、饮食组、运动组和饮食运动组，为期 1 年。这项研究的结果包括胰岛素敏感性指数 (ISI)、葡萄糖耐量、向心性肥胖、脂肪细胞因子和心脏代谢综合征的变化。尽管 6 个月时饮食运动组和节食组的 ISI 出现类似的增加，但 12 个月时饮食运动组的 ISI 比饮食组改善更多（2.4 对比 1.2；组间差异，1.2；95% CI，0.2-2.1）；运动组和对照组的 ISI 均未发生变化。饮食-运动组和饮食组在胰岛素曲线下面积（AUC）（-2.9和-2.9×103mg.min/dl）、葡萄糖AUC（-1.4和-2.2×103mg.min/dl）、内脏脂肪（-787和-561 cm3）、肿瘤坏死因子（-17.0和-17.0 -12.8 pg/mL）、脂联素（5.0和4.0 ng/mL）、腰围（-8.2和-8.4 cm）、甘油三酯（-30.7和-24.3 g/dL）以及收缩压/舒张压（-15.9和-13.1/-4.9和-6.7 mmHg），而这些没有变化 运动组和对照组均出现参数。饮食-运动组的心脏代谢综合征患病率下降了 40%，节食组则下降了 15%。饮食-运动组和节食组的体重下降相似（-8.6 和 -9.7 公斤），但运动组和对照组的体重没有类似下降。在体弱、肥胖的老年人中，与减肥相关的生活方式干预可以改善胰岛素敏感性和其他心脏代谢危险因素，但只有在减肥的同时加上运动训练才能实现胰岛素敏感性的持续改善。
Obesity exacerbates the age-related decline in insulin sensitivity and is associated with risk for cardiometabolic syndrome in older adults; however, the appropriate treatment for obese older adults is controversial. To determine the independent and combined effects of weight loss and exercise on cardiometabolic risk factors in obese older adults. One-hundred-seven obese (BMI≥30 kg/m2) older (≥65 yrs) adults with physical frailty were randomized to control group, diet group, exercise group, and diet-exercise group for 1 year. Outcomes for this study included change in insulin sensitivity index (ISI), glucose tolerance, central obesity, adipocytokines, and cardiometabolic syndrome. Although similar increases in ISI occurred in the diet-exercise and diet groups at 6 months, the ISI improved more in the diet-exercise than in the diet group at 12 months (2.4 vs. 1.2; between-group difference, 1.2; 95% CI, 0.2-2.1); no changes in ISI occurred in both exercise and control groups. The diet-exercise and diet groups had similar improvements in insulin area under the curve (AUC) (−2.9 and −2.9 ×103mg.min/dl), glucose AUC (−1.4 and −2.2×103mg.min/dl), visceral fat (−787 and −561 cm3), tumor-necrosis factor (−17.0 and −12.8 pg/mL), adiponectin (5.0 and 4.0 ng/mL), waist circumference (−8.2 and −8.4 cm), triglyceride (−30.7 and −24.3 g/dL), and systolic/diastolic BP (−15.9 and −13.1/−4.9 and −6.7 mmHg), while no changes in these parameters occurred in both exercise and control groups. The cardiometabolic syndrome prevalence decreased by 40% in the diet-exercise and by 15% in the diet group. Body weight decreased similarly in the diet-exercise and diet groups (−8.6 and −9.7kg) but not in the exercise and control groups. In frail, obese older adults, lifestyle interventions associated with weight loss improve insulin sensitivity and other cardiometabolic risk factors, but continued improvement in insulin sensitivity is only achieved when exercise training is added to weight loss.
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影响因子：
16.2
作者：
Isomaa, B;Almgren, P;Groop, L
通讯作者：
Groop, L
DOI：
10.1111/j.1559-4572.2009.00054.x
发表时间：
2009-12
期刊：
Journal of clinical hypertension (Greenwich, Conn.)
影响因子：
--
作者：
Kirk EP;Klein S
通讯作者：
Klein S
影响因子：
16.2
作者：
Hojbjerre, Lise;Sonne, Mette Paulli;Stallknecht, Bente
通讯作者：
Stallknecht, Bente
影响因子：
5.8
作者：
Christiansen, Tore;Paulsen, Soren K.;Richelsen, Bjorn
通讯作者：
Richelsen, Bjorn
影响因子：
7.7
作者：
Alexander, CM;Landsman, PB;Haffner, SM
通讯作者：
Haffner, SM