Exercise training and insulin resistance in overweight children and adolescents

超重儿童和青少年的运动训练和胰岛素抵抗

• 批准号: 8201812
• 负责人: SHANA ERIN MCCORMACK
• 金额: $ 4.01万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-12-15 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8201812
• 关键词: ATP Synthesis Pathway; Adherence; Adolescent; Affect; Alanine; Amino Acids; Biological; Biological Markers; Biological Process; Blood Pressure; Body Weight; Cardiovascular system; Child; Childhood; Citric Acid Cycle; Clinical Trials; Complex; Creatinine; Development; Eating; Educational Intervention; Endocrinology; Epidemic; Exercise; Future; Generations; Glutamates; Glycerol; HDL-triglyceride; Health Benefit; Home environment; Homeostasis; Insulin; Insulin Resistance; Lead; Life Expectancy; Light; Link; Lipids; Lower Extremity; Magnetic Resonance Spectroscopy; Measures; Mediating; Metabolic; Mitochondria; Modeling; Modification; Molecular Weight; Monitor; Obesity; Overnutrition; Overweight; Oxidative Phosphorylation; Oxygen; Parents; Pathogenesis; Pathway interactions; Patients; Phenotype; Phosphocreatine; Physicians; Physiological; Physiology; Population; Public Health; Randomized Controlled Trials; Recovery; Regimen; Research Personnel; Risk; Skeletal Muscle; Technology; Testing; Training; United States; Vulnerable Populations; Work; fitness; improved; indexing; insight; insulin sensitivity; lipid metabolism; muscle form; novel; nutrition; skills; sugar; uptake; waist circumference

DESCRIPTION (provided by applicant): Children and adolescents in the United States continue to eat more and exercise less than their parents did a generation ago; this combination of overnutrition and inactivity is partly to blame for an epidemic of obesity that threatens to shorten life expectancy of young people. Many of the adverse sequelae of obesity are mediated by insulin resistance. Understanding how to reverse obesity-associated insulin resistance in this vulnerable population is of critical public health importance. The proposed study is a randomized controlled trial to evaluate the impact of a supervised in-home 8-week exercise training intervention on insulin resistance in overweight children and adolescents, and to explore the mechanisms by which fitness-related amelioration of insulin resistance may occur. Specifically, we hypothesize that exercise will produce alterations in skeletal muscle physiology that will improve insulin sensitivity. The amount of lean mass, mitochondrial function, and intramyocellular lipid content are candidate modulators of insulin resistance at the level of the skeletal muscle that may be affected by exercise; we will investigate the potential contribution of each of these to exercise- related changes in insulin sensitivity. Finally, to support and extend our findings, we propose to simultaneously measure the concentrations of many metabolites (amino acids, sugars, low molecular weight lipids). We hope to identify other biological pathways modifiable by exercise and associated with better insulin sensitivity that can be the focus of future work. A better understanding of how exercise may ameliorate insulin resistance could shed light on pathogenesis of this condition and lead to more effective exercise prescriptions for patients. PUBLIC HEALTH RELEVANCE: Children and adolescents in the United States continue to eat more and exercise less than their parents did a generation ago; this combination of excess nutrition and inactivity is partly to blame for an epidemic of obesity that threatens to shorten life expectancy of young people. We propose a study to evaluate whether exercise can reverse some of the harmful effects of obesity in this important population, and if so, how it might work. We hope that a better understanding of how exercise helps will lead to insights into obesity and its consequences in children and adolescents, as well as more effective exercise prescriptions for our pediatric patients.

描述（由申请人提供）：美国的儿童和青少年继续比他们的父母一代人吃得更多，锻炼得更少;这种营养过剩和缺乏运动的结合是肥胖流行的部分原因，肥胖可能会缩短年轻人的预期寿命。肥胖的许多不良后遗症是由胰岛素抵抗介导的。了解如何扭转肥胖相关的胰岛素抵抗在这个脆弱的人群是至关重要的公共卫生重要性。这项研究是一项随机对照试验，旨在评估为期8周的监督性家庭运动训练干预对超重儿童和青少年胰岛素抵抗的影响，并探讨与健身相关的胰岛素抵抗改善可能发生的机制。具体来说，我们假设运动会改变骨骼肌的生理机能，从而改善胰岛素敏感性。瘦体重、线粒体功能和肌细胞内脂质含量是可能受运动影响的骨骼肌水平的胰岛素抵抗的候选调节剂;我们将研究这些因素中的每一个对运动相关的胰岛素敏感性变化的潜在贡献。最后，为了支持和扩展我们的发现，我们建议同时测量许多代谢物（氨基酸，糖，低分子量脂质）的浓度。我们希望确定其他可通过运动改变的生物途径，并与更好的胰岛素敏感性相关，这可能是未来工作的重点。更好地了解运动如何改善胰岛素抵抗可以揭示这种情况的发病机制，并为患者提供更有效的运动处方。 公共卫生相关性：美国的儿童和青少年仍然比上一代人吃得更多，锻炼得更少;这种营养过剩和缺乏运动的结合是肥胖流行的部分原因，肥胖可能会缩短年轻人的预期寿命。我们提出了一项研究来评估运动是否可以扭转肥胖对这一重要人群的一些有害影响，如果可以，它可能如何发挥作用。我们希望更好地了解运动如何帮助将导致对肥胖及其对儿童和青少年的影响的深入了解，以及为我们的儿科患者提供更有效的运动处方。