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中等强度有氧运动对肥胖成人体成分及糖脂代谢的干预效果

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目的 探讨中等强度有氧运动对肥胖成人体成分及糖脂代谢的干预效果.方法 本研究为自身对照研究,于2017年11月至2018年3月在解放军总医院健康管理研究院招募接受减重治疗的280例肥胖成人,依托自主研发的慢性病精准运动干预系统实施为期12周的中等强度(40%~60%储备心率)有氧运动干预,要求有效运动时间≥40 min/次,运动总时间≤100min/d,有效运动时间≥200 min/周;运动频率≥4次/周,两次运动间隔≤48 h.研究过程中77例受试者由于疾病、运动损伤、工作原因等出组,最终203例纳入分析.根据周运动时长<300min、300~400min和>400 min将受试者分为短时组(97例)、中时组(63例)和长时组(43例),采用配对t检验比较干预前后指标差异,采用协方差分析比较3组间指标差异,分析中等强度有氧运动对肥胖成人体成分及糖脂代谢的干预效果.结果 受试者干预后静息心率、体重、体重指数、体脂率、体脂肪量、肌肉量、内脏脂肪面积、皮下脂肪面积、空腹胰岛素、胰岛素抵抗指数、总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均显著低于干预前[(66.67±9.38)比(71.48±10.13)次/min、(86.02±13.13)比(90.16±13.93)kg、(30.33±3.08)比(31.80± 3.27)kg/m2、35.64%±7.19%比37.87%±7.21%、(30.78±8.14)比(34.30±8.73)kg、(52.06±10.30)比(52.74± 10.61)kg、(100.82±38.63)比(119.53±43.08)cm2、(270.14±74.19)比(305.24±77.12)cm2、(12.33±6.92)比(17.86±14.23)mmol/L、3.08±2.22 比4.52±4.09、(4.42±0.78)比(4.62±0.89)mmol/L、(1.46±0.82)比(1.71± 1.11)mmol/L、(2.93±0.70)比(3.08±0.80)mmol/L](均 P<0.05).长时组干预前后体重、体重指数、体脂率、体脂肪量的下降差值均显著高于中时组和短时组[(5.56±0.62)比(3.97±0.51)、(3.63±0.41)kg,(1.98±0.21)比(1.39±0.17)、(1.31±0.14)kg/m2,3.38%±0.40%比 2.27%±0.33%、1.69%±0.27%,(4.90± 0.53)比(3.54±0.43)、(2.89±0.35)kg],空腹胰岛素下降差值、高密度脂蛋白胆固醇升高差值均显著高于短时组[(7.38±0.94)比(4.54±0.62)mmol/L、(0.07±0.02)比(0.01±0.02)mmol/L],内脏脂肪面积下降差值显著高于中时组[(28.45±4.53)比(12.55±3.67)cm2](均P<0.05).结论 中等强度有氧运动可作为肥胖成人体成分和糖脂代谢的干预手段,当运动时长>400 min/周时,其改善效果可能更明显.
Intervention effect of moderate intensity aerobic exercise on body composition and glycolipid metabolism in obese adults
Objective To explore the intervention effect of moderate intensity aerobic exercise on body composition and glycolipid metabolism in obese adults.Methods This was a self-controlled study,which enrolled 280 obese adults who received weight loss treatment in the Health Management Institute of the Chinese PLA General Hospital from November 2017 to March 2018 and performed a 12-week precise aerobic exercise intervention(40%-60%of heart reserved rate)based on an independently developed aerobic exercise intervention system for chronic diseases.The following requirements also need to be met as effective exercise time of ≥40 minutes every time,total exercise time of ≤100 minutes per day,effective exercise time of ≥200 minutes per week,exercise frequency of ≥4 times per week,and an interval of ≤48 hours between two exercises.During the research,77 subjects were excluded due to illness,sports injuries,work reasons,etc.,and 203 subjects were included in the analysis.These patients were divided into three groups based on weekly exercise duration,including 97 cases in short-term group(weekly exercise time<300 minutes),63 cases in medium-term group(weekly exercise time of 300-400 minutes),and 43 cases in long-term group(weekly exercise time>400 minutes).Paired t-tests were used to compare the differences in indicators before and after intervention,and covariance analysis was used to compare the differences in indicators among three groups.The intervention effect of moderate intensity aerobic exercise on the body composition and glucose and lipid metabolism in obese adults was analyzed.Results The resting heart rate,body weight,body mass index,body fat rate,body fat mass,muscle mass,visceral fat area,subcutaneous fat area,fasting insulin,insulin resistance index,total cholesterol,triglycerides,and low-density lipoprotein cholesterol were all decreased significantly in the 203 patients after the intervention[(66.67±9.38)vs(71.48±10.13)/min,(86.02± 13.13)vs(90.16±13.93)kg,(30.33±3.08)vs(31.80±3.27)kg/m2,35.64%±7.19%vs 37.87%±7.21%,(30.78±8.14)vs(34.30±8.73)kg,(52±10.30)vs(52.74±10.61)kg,(100.82±38.63)vs(119.53± 43.08)cm2,(270.14±74.19)vs(305.24±77.12)cm2,(12.33±6.92)vs(17.86±14.23)mmol/L,3.08± 2.22 vs 4.52±4.09,(4.42±0.78)vs(4.62±0.89)mmol/L,(1.46±0.82)vs(1.71±1.11)mmol/L,(2.93± 0.70)vs(3.08±0.80)mmol/L](all P<0.05).The reduction degree of indicators including body weight,body mass rate,body fat rate,and body fat mass were all significantly higher in long-term group when compared with those in medium-term and short-term group[(5.56±0.62)vs(3.97± 0.51)vs(3.63±0.41)kg,(1.98±0.21)vs(1.39±0.17)vs(1.31±0.14)kg/m2,3.38%±0.40%vs 2.27%± 0.33%vs 1.69%±0.27%,(4.90±0.53)vs(3.54±0.43)vs(2.89±0.35)kg].Besides,patients in long-term group had significantly higher reduction degree of fasting insulin and higher rising degree of high-density lipoprotein cholesterol[(7.38±0.94)vs(4.54±0.62)mmol/L,(0.07±0.02)vs(0.01± 0.02)mmol/L]and higher reduction degree of visceral fat area[(28.45±4.53)vs(12.55±3.67)cm2]than medium-term group(all P<0.05).Conclusions Moderate intensity aerobic exercise can be an effective intervention for the body composition and glycolipid metabolism in obese adults.If the weekly exercise time is greater than 400 minutes,the potential benefits of improvement may be more evident.

ObesityModerate intensity aerobic exerciseBody compositionGlycolipid metabolism

马靖、张敬炟、李巧、王维民

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解放军总医院第二医学中心健康医学科,北京 100089

海南医学院公共卫生与全健康国际学院,海口 570100

肥胖症 中等强度有氧运动 身体成分 糖脂代谢

中国科学院科技服务网络计划(STS计划项目)

KFJ-STS-ZDTP-033

2024

中华健康管理学杂志
中华医学会

中华健康管理学杂志

CSTPCD北大核心
影响因子:1.004
ISSN:1674-0815
年,卷(期):2024.18(1)
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