Erfahrungsheilkunde 2021; 70(05): 287-291
DOI: 10.1055/a-1606-8310
Praxis

Bewegungstherapie und Sport bei Fettstoffwechselstörungen

Karsten Krüger

Zusammenfassung

Zahlreiche Studien belegen den starken Zusammenhang zwischen Veränderungen des Plasma-Lipidprofils und dem kardiovaskulären Risiko. Körperliche Aktivität stellt eine wirksame Präventions- und Therapiestrategie der Fettstoffwechselstörungen dar und wirkt gleichzeitig gegen zahlreiche Komorbiditäten, die oftmals das Krankheitsbild begleiten. Mechanistische Grundlagen der Sport- und Bewegungstherapie liegen im erhöhten Energieumsatz, den funktionellen und strukturellen Adaptationen an die metabolische Beanspruchung sowie in den immunregulierenden Effekten der Bewegung. Als besonders wirksam auf das Lipidprofil haben sich moderate Ausdauerbelastungen herausgestellt, die jedoch im Sinne einer umfassenden Gesundheitsförderung durch Sport optimiert werden können. Empfohlen werden ein aktiver Alltag sowie ein polarisiertes Training aus aerobem sowie Intervalltraining.

Abstract

Numerous studies demonstrated the strong link between dyslipidemia and the cardiovascular risk. Physical activity and exerise represent effective prevention and therapy strategies for dyslipidemia and at the same time counteract numerous comorbidities,that often accompany the disease. The mechanistic basis of sport and exercise therapy is represented by an increased energy metabolism, the functional and structural adaptations to the metabolic demand, and in the immune-regulating effects of exercise. Moderate endurance loads have proven to be particularly effective on the lipid profile, which can be optimized through sport in the sense of comprehensive health promotion. Recommended are an increased level of daily activities as well as a polarized training, aerobic as well as interval training.



Publication History

Article published online:
12 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Pressler A. A run a day keeps lipids at bay? Regular exercise as a treatment of dyslipidaemias. Dtsch Z Sportmed 2017; 68: 253-260
  • 2 Goldstein JL, Brown MS. A century of cholesterol and coronaries: From plaques to genes to statins. Cell 2015; 161 (01) 161-172
  • 3 van Diepen JA, Berbee JF, Havekes LM. et al. Interactions between inflammation and lipid metabolism: Relevance for efficacy of anti-inflammatory drugs in the treatment of atherosclerosis. Atherosclerosis 2013; 228: 306-315
  • 4 Sorci-Thomas MG, Thomas MJ. Microdomains, inflammation, and atherosclerosis. Circ Res 2016; 118: 679-691
  • 5 Grebe A, Latz E. Cholesterol crystals and inflammation. Curr Rheumatol Rep 2013; 15: 313
  • 6 Alack K, Pilat C, Krüger K. Current knowledge and new challenges in exercise immunology. Dtsch Z Sportmed 2019; 70: 250-260
  • 7 Khovidhunkit W, Kim MS, Memon RA. et al. Effects of infection and inflammation on lipid and lipoprotein metabolism: Mechanisms and consequences to the host. J Lipid Res 2004; 45: 1169-1196
  • 8 Garcia-Gomez C, Bianchi M, de la Fuente D. et al. Inflammation, lipid metabolism and cardiovascular risk in rheumatoid arthritis: A qualitative relationship?. World J Orthop 2014; 5: 304-311
  • 9 Roma P, Bernini F, Fogliatto R. et al. Defective catabolism of oxidized LDL by J774 murine macrophages. J Lipid Res 1992; 33: 819-829
  • 10 Hubler MJ, Kennedy AJ. Role of lipids in the metabolism and activation of immune cells. J Nutr Biochem 2016; 34: 1-7
  • 11 Franceschi C. Inflammaging as a major characteristic of old people: Can it be prevented or cured?. Nutr Rev 2007; 65 (12) 173-176
  • 12 Davalos AR, Coppe JP, Campisi J. et al. Senescent cells as a source of inflammatory factors for tumor progression. Cancer Metastasis Rev 2010; 29 (02) 273-283
  • 13 Nakajima T, Schulte S, Warrington KJ. et al. T-cell-mediated lysis of endothelial cells in acute coronary syndromes. Circulation 2002; 105 (05) 570-575
  • 14 Boßlau TK, Wasserfurth P, Krüger B. et al. Abdominal obesity-related disturbance of insulin sensitivity is associated with CD8 + EMRA cells in the elderly. Cells 2021; 10 (05) 998
  • 15 Proto JD, Doran AC, Subramanian M. et al. Hypercholesterolemia induces T-cell expansion in humanized immune mice. J Clin Invest 2018; 128 (06) 2370-2375
  • 16 Albarrati AM, Alghamdi MSM, Nazer RI. et al. Effectiveness of low to moderate physical exercise training on the level of low-density lipoproteins: A systematic review. Biomed Res Int 2018; 2018: 5982980
  • 17 Rhee EJ, Kim HC, Kim JH. et al. 2018 Guidelines for the management of dyslipidemia. Korean J Int Med 2019; 34 (04) 723-771 [published correction appears in Korean J Int Med 2019; 34(5): 1171].
  • 18 Kelley GA, Kelley KS. Aerobic exercise and HDL2-C: A meta-analysis of randomized controlled trials. Atherosclerosis 2006; 184 (01) 207-215
  • 19 Varady KA, St-Pierre AC, Lamarche B. et al. Effect of plant sterols and endurance training on LDL particle size and distribution in previously sedentary hypercholesterolemic adults. Eur J Clin Nutr 2005; 59: 518-525
  • 20 Watt MJ, Heigenhauser GJ, Dyck DJ. et al. Intramuscular triacylglycerol, glycogen and acetyl group metabolism during 4 h of moderate exercise in man. J Physiol 2002; 541: 969-978
  • 21 Ringseis R, Mooren FC, Keller J. et al. Regular endurance exercise improves the diminished hepatic carnitine status in mice fed a high-fat diet. Mol Nutr Food Res 2011; 55 (02) 193-202
  • 22 Greene NP, Fluckey JD, Lambert BS. et al. Regulators of blood lipids and lipoproteins? PPARdelta and AMPK, induced by exercise, are correlated with lipids and lipoproteins in overweight/obese men and women. Am J Physiol Endocrinol Metab 2012; 303: E1212-E1221
  • 23 Couillard C, Despres JP, Lamarche B. et al. Effects of endurance exercise training on plasma HDL cholesterol levels depend on levels of triglyzerides: Evidence from men of the health, risk factors, exercise training and genetics (HERITAGE) family study. Arterioscler Thromb Vasc Biol 2001; 21: 1226-1232
  • 24 Lee J, Lee Y, LaVoy EC. et al. Physical activity protects NLRP3 inflammasome-associated coronary vascular dysfunction in obese mice. Physiol Rep 2018; 6 (12) e13738
  • 25 Philippe M, Gatterer H, Burtscher M. et al. Concentric and eccentric endurance exercise reverse hallmarks of t-cell senescence in pre-diabetic subjects. Front Physiol 2019; 10: 684
  • 26 Sun L, Li FH, Li T. et al. Effects of high-intensity interval training on adipose tissue lipolysis, inflammation, and metabolomics in aged rats. Pflugers Arch 2020; 472 (02) 245-258
  • 27 Barajas-Galindo DE, González Arnáiz E, Ferrero Vicente P. et al. Effects of physical exercise in sarcopenia. A systematic review. Endocrinol Diabetes Nutr (Engl Ed) 2021; 68 (03) 159-169