Physical Activity Following Surgery-Induced Weight Loss

手术引起的减肥后的体力活动

基本信息

批准号：
8018185
负责人：
Bret H Goodpaster
金额：
$ 57.52万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-03-01 至 2013-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8018185
关键词：
Abdomen Address Adipose tissue Bariatrics Body Composition Body Weight decreased Caloric Restriction Cardiovascular Diseases Ceramides Characteristics Data Development Exercise Fatty Acids Fatty acid glycerol esters Functional disorder Health Individual Insulin Insulin Resistance Intervention Trial Life Style Link Lipids Measures Metabolic Metabolic syndrome Mitochondria Morbidity - disease rate Muscle Non-Insulin-Dependent Diabetes Mellitus Obesity Operative Surgical Procedures Outcome Patients Physical activity Populations at Risk Prevention Randomized Regulation Research Risk Risk Factors Role Skeletal Muscle Stimulus Triglycerides Weight Weight Gain Weight maintenance regimen abdominal fat bariatric surgery cardiovascular disorder risk effective therapy experience fatty acid metabolism fatty acid oxidation improved insulin sensitivity mitochondrial dysfunction moderate obesity mortality novel oxidation prevent sedentary

项目摘要

DESCRIPTION (provided by applicant): Obesity and physical inactivity are both related to increased mortality and morbidity in conjunction with increased risk for the development of type 2 diabetes, the metabolic syndrome and cardiovascular disease. We propose to examine if physical activity will provide an additive effect of reducing risk factors for CVD in an extremely at risk population (very obese individuals) following bariatric weight loss surgery. Preliminary data from each of our research groups has indicated that an inefficient use of fatty acids and diminished oxidative capacity is strongly associated with the pathophysiology of insulin resistance of obesity. Thus impaired fatty acid utilization and insulin resistance are both characteristic of the metabolic inflexibility in obesity. The prevailing paradigm is that mitochondrial dysfunction underpins metabolic inflexibility and thus directly contributes to the pathophysiology of skeletal muscle insulin resistance. While this hypothesis is attractive, it has not been experimentally proven. Although weight loss itself can improve insulin resistance, it does little, if anything to improve mitochondria function or to promote more efficient utilization of fatty acids in obesity. Moreover, physical activity may promote positive effects on mitochondria function, fatty acid metabolism and insulin resistance independent of weight loss. We propose to employ a randomized controlled physical activity intervention trial in a group of patients following their weight loss surgery. Our primary hypotheses are that the combination of weight loss + physical activity will provide additive (and thus independent) positive effects on: 1) weight loss and body composition; 2) metabolic risk factors such as insulin action and other markers of the metabolic syndrome; and 3) markers of mitochondria function and the capacity for efficient fat utilization by muscle. These findings will be novel and relevant to treating obesity, as morbidly obese individuals are likely genetically and environmentally predisposed towards a negative metabolic status and a sedentary lifestyle; it is not evident if physical activity can provide an additional positive stimulus to dramatic weight loss in these patients. Investigating the role of increased physical activity following surgery-induced weight loss is critical to our understanding of the most effective strategies to treat obesity and its associated conditions. Information emanating from this study would thus help to determine the most effective treatments to prevent weight regain and to improve outcomes of these patients following surgery.

描述（由申请人提供）：肥胖和身体不活跃既与死亡率和发病率的增加有关，同时增加了2型糖尿病，代谢综合征和心血管疾病的风险增加。我们建议检查体育锻炼是否会在减肥手术后，在极端危险人群（非常肥胖的个体）中减少CVD的危险因素是否会提供添加作用。来自我们每个研究小组的初步数据表明，脂肪酸和氧化能力的效率低下与肥胖症胰岛素抵抗的病理生理学密切相关。因此，脂肪酸的利用率受损和胰岛素抵抗都是肥胖中代谢不灵活性的特征。盛行的范式是线粒体功能障碍基于代谢不灵活性，因此直接有助于骨骼肌胰岛素抵抗的病理生理学。尽管该假设很有吸引力，但尚未经过实验证明。尽管体重减轻本身可以提高胰岛素抵抗，但它几乎没有什么作用，即使有任何改善线粒体功能或促进肥胖症中脂肪酸更有效利用的情况。此外，体育活动可能会促进对线粒体功能，脂肪酸代谢和胰岛素抵抗的积极影响，而不是体重减轻。我们建议在减肥手术后在一组患者中采用随机对照的身体活动干预试验。我们的主要假设是，体重减轻 +体育锻炼的组合将为以下方面提供添加剂（因此独立）的积极影响：1）体重减轻和身体组成； 2）代谢危险因素，例如胰岛素作用和代谢综合征的其他标志物； 3）线粒体功能的标记和肌肉有效利用脂肪的能力。这些发现将是新颖的，并且与治疗肥胖有关，因为病态肥胖的个体可能在遗传和环境上倾向于倾向于负面的代谢状况和久坐的生活方式。如果体育锻炼可以为这些患者的急剧体重减轻提供额外的阳性刺激，这一点并不明显。研究手术引起的体重减轻后体育活动增加的作用对于我们对治疗肥胖症及其相关状况的最有效策略的理解至关重要。因此，从这项研究中发出的信息将有助于确定最有效的治疗方法，以防止体重恢复并改善手术后这些患者的预后。