摘要
目的 分析不同性别和年龄冠心病患者脂肪氧化能力的差异.方法 多中心、横断面研究.连续纳入2021年5月至2022年12月在北京医院心内科和沧州市中心医院心血管病预防与康复科进行心肺运动试验的冠心病患者400例,平均年龄(61.7±9.6)岁.根据患者性别分为男性组(279例)和女性组(121例);根据年龄分为老年组(≥65岁,166例)和非老年组(＜65岁,234例).收集患者临床资料和心肺运动试验数据.比较不同性别和年龄组间最大脂肪氧化速率(MFO)及MFO时的摄氧量(VO2)、MFO时VO2占最大VO2的百分比(FATmax)、功率、氧脉搏和通气量/二氧化碳排出量(VE/VCO2)的差异.结果 男性组MFO高于女性组(Z=-3.282,P=0.001),FATmax低于女性组(Z=-6.208,P＜0.001).男性组MFO时的VO2、功率和氧脉搏均高于女性组(Z=-3.750、-6.706 和-7.998,均为 P＜0.001).老年组 MFO 低于非老年组(Z=-4.284,P＜0.001),FATmax高于非老年组(Z=-2.603,P=0.009).老年组在MFO时的VO2、功率、氧脉搏和VE/VCO2均低于非老年组(Z=-2.683、-4.304、-4.523和-4.679,均为P＜0.01).亚组分析中,非老年男性组的MFO最大,FATmax最低;老年女性组的MFO最小,FATmax最高(均为P＜0.001).结论 冠心病患者MFO和FATmax存在性别和年龄差异.不同年龄和性别冠心病患者的脂肪氧化能力和峰值出现时间不同,在运动康复优化方案中应考虑患者性别和年龄的影响.
Abstract
Objective To explore the differences in fat oxidation capacity in coronary artery disease(CAD)patients based on sex and age.Methods This was a multi-center,cross-sectional study.A total of 400 CAD patients who underwent cardiopulmonary exercise testing at the Department of Cardiology,Beijing Hospital,and the Cardiovascular Disease Prevention and Rehabilitation Department,Cangzhou Central Hospital,between May 2021 and December 2022 were included,with an average age of 61.7±9.6 years.Clinical data and cardiopulmonary exercise data were collected.Patients were grouped by sex(male group,279 cases;female group,121 cases)and age(≥65 years as the elderly group,166 cases;＜65 years as the non-elderly group,234 cases).Differences in maximal fat oxidation(MFO),oxygen uptahe(VO2)at the time of MFO accounted for predicted maxium VO2(FATmax),VO2,load,oxygen pulse,and ventilation/CO2 output(VE/VCO2)among the groups were compared.Results The MFO of the male group was significantly higher than that of the female group(Z=-3.282,P＜0.001),while FATmax was significantly lower(Z=-6.208,P＜0.001).VO2,load,and oxygen pulse at MFO rate were significantly higher in the male group than those of female group(Z=-3.750,-6.706 and-7.998,all P＜0.001).The elderly group had a significantly lower MFO compared to the non-elderly group(Z=-4.284,P＜0.001),while FATmax was significantly higher(Z=-2.603,P=0.009).VO2,load,and oxygen pulse at MFO rate were significant lower in elderly groups than in non-elderly group(Z=-2.683,-4.304,-4.523 and-4.679,all P＜0.01).In the subgroup analysis,non-elderly men had the highest MFO and the lowest FATmax,while elderly women had the lowest MFO and the highest FATmax(all P＜0.001).Conclusions In CAD patients,MFO and FATmax are significantly influenced by sex and age.Fat oxidation capacity is varied between different sex and age.It is recommended to consider sex and age differences when designing exercise rehabilitation programs.
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