摘要
目的 探讨心肺适能(CRF)在肥胖青少年体力活动与心血管代谢健康间的作用,以期为肥胖青少年的健康促进提供科学依据.方法 分别于2021年与2022年的7-8月,招募封闭式减肥训练营中的140名10～17岁肥胖青少年为研究对象,采用ActiGraphGT3X+三轴运动加速度计测量肥胖青少年久坐行为(SB)、低强度体力活动(LPA)、总身体活动(TPA)及中高强度体力活动(MVPA)时间,使用20 m折返跑测定CRF水平.测量肥胖青少年包括腰围(WC)、矢状腹径(SAD)、收缩压(SBP)、舒张压(DBP)、平均血压(ABP)、空腹胰岛素(FINs)、空腹血糖(FPG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)在内的心血管代谢健康指标构建心血管代谢风险Z评分(CMR-Z),采用SPSS Process插件进行中介效应分析.结果 肥胖青少年的心血管健康指标中,WC、SAD、SBP、DBP、ABP、FINs、FPG、TC、HDL-C、CMR-Z分别为(93.21±11.51)cm、(21.77±2.71)cm、(111.24±11.86)mmHg、(66.08±9.03)mmHg、(88.66±8.97)mmHg、(8.98±6.42)μU/mL、(4.42±0.62)mmol/L、(4.43±0.97)mmol/L、(1.29±0.28)mmol/L、-0.43(-1.83,1.78)分;每日体力活动行为指标中,SB、LPA、MVPA、TPA 时长分别为(345.16±78.47,267.35±62.65,64.77±39.52,677.30±57.63)min,SB、LPA、MVPA 占比分别为50.96％,39.47％和 9.56％;CRF 指标 VO2max为(37.95±4.96)mL/(kg·min).中介分析结果显示,肥胖青少年 CRF 在 LPA和腰高比(WHtR)间起完全中介作用,占比为44.2％;在LPA和ABP间起遮掩效应,占比为31.5％;在MVPA和SAD间起遮掩效应,占比为43.2％;在MVPA和CMR-Z间起遮掩效应,占比为96.0％.结论 CRF可能是体力活动与肥胖青少年心血管代谢健康间的重要影响因素,提高CRF水平有利于促进肥胖青少年心血管代谢健康.
Abstract
Objective To explore the effect of cardiorespiratory fitness(CRF)on cardiometabolic health and physical activity a-mong obese adolescents,in order to provide a scientific basis for health promotion of obese adolescents.Methods From July to August 2021 and 2022,140 obese adolescents aged 10-17 were recruited in a residential weight-loss camp.Sedentary behavior(SB),low intensity physical activity(LPA),total physical activity(TPA)and moderate-to-vigorous physical activity(MVPA)were measured by ActiGraph GT3X+triaxial motion accelerometer,and CRF levels were measured by 20-meter shuttle run test.Cardiometabolic risk Z score(CMR-Z)was constructed by measuring the cardiometabolic health indicators of obese adolescents,including waist circumference(WC),sagittal abdominal diameter(SAD),systolic blood pressure(SBP),diastolic blood pressure(DBP),average blood pressure(ABP),fasting insulin(FINs),fasting plasma glucose(FPG),total cholesterol(TC),and high-density lipoprotein cholesterol(HDL-C).The mediating effect analysis was conducted by using the SPSS Process plug-in compiled.Results Cardiovascular health indicators WC,SAD,SBP,DBP,ABP,FINs,FPG,TC,HDL-C and CMR-Z were(93.21±11.51)cm,(21.77±2.71)cm,(111.24±11.86)mmHg,(66.08±9.03)mmHg and(88.66±8.97)mmHg,(8.98±6.42)μU/mL,(4.42±0.62)mmol/L,(4.43±0.97)mmol/L,(1.29±0.28)mmol/L,-0.43(-1.83,1.78)min,respectively.In the daily activity be-havior indicators,the duration of SB,LPA,MVPA and TPA were(345.16±78.47,267.35±62.65,64.77±39.52,677.30±57.63)min,respectively.SB,LPA and MVPA accounted for 50.96％,39.47％and 9.56％,respectively.The indicator VO2max of CRF was(37.95±4.96)mL/(kg·min).Mediation analysis showed that CRF played a fully mediating role between LPA and waist-to-height ratio(WHtR),accounting for 44.2％.It exhibited a suppressing effect between LPA and ABP accounting for 31.5％,with a sup-pressing effect between MVPA and SAD accounting for 43.2％and a suppressing effect between MVPA and CMR-Z accounting for 96.0％.Conclusions CRF may be an important factor in the relationship between physical activity and cardiometabolic health of obese adolescents.Improving CRF level may be conducive to promoting cardiometabolic health of obese adolescents.
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