Einfluss körperlicher Aktivität auf die Fettoxidation und Endothelfunktion bei Adipösen - eine randomisiert kontrollierte Studie

Zusammenfassung

Fragestellung: Welche Auswirkungen eines moderaten Ausdauertrainings unter Berücksichtigung der Intensität der höchsten Fettoxidation können auf die Fettoxidation und die Körperzusammensetzung sowie die Endothelfunktion bei Adipösen erwartet werden?

Material und Methode: 26 adipöse Probanden mit einem BMI über 30 kg/m² wurden randomisiert einer Trainings- und Kontrollgruppe zugeteilt. Die Probanden der Trainingsgruppe absolvierten für 12 Wochen mit der jeweils individuell bestimmten Intensität ihrer höchsten Fettoxidation drei Trainingseinheiten mit 45 Minuten/Wo. Zur Bestimmung der Fettoxidation diente ein Laufband-Belastungstest, die Beurteilung der Endothelfunktion erfolgte mit der Ultraschallmethode an der A. brachialis. Die Kontrollmessungen wurden in beiden Gruppen zu Beginn und Ende des 12 wöchigen Untersuchungsintervalls vorgenommen.

Ergebnisse: Im Gegensatz zur Kontrollgruppe verbesserte sich in der Trainingsgruppe die Endothelfunktion von 4.3±3.5 auf 6.9±2.7% signifikant (p=0.001). Ebenso erzielte die Trainingsgruppe eine signifikante (p=0.019) Verbesserung der flussmediierten Dilatation (FMD) und eine signifikant (p=0.025) höhere FMD. Die Fettoxidation verbesserte sich während aller drei Belastungsstufen (p=0.006; p=0.023; p=0.007) und die freie Fettmasse nahm signifikant (p=0.009) zu, wobei die Fettmasse gleichzeitig abnahm (p=0.003).

Schlussfolgerung: Ein zwölfwöchiges Ausdauertraining unter Berücksichtigung der individuellen Intensität der höchsten Fettoxidation verbessert auch ohne substantiellen Gewichtsverlust die Endothelfunktion und Fettoxidation bei adipösen Frauen und Männern.

Abstract

Purpose: What are the effects of moderate physical activity based on the intensity of the highest fat oxidation rate on endothelial function, fat oxidation and body composition in obese women and men?

Materials and Methods: 26 subjects with a BMI above 30 kg/m² were randomly assigned to a training and a control group. Subjects of the training group performed three training session per week for 45 minutes for 12 weeks based on their individually determined intensity of highest fat oxidation. Fat oxidation was determined during a treadmill test, the endothelial function was assessed by the ultrasound method on the A. brachialis. In both groups the control measurements were done at the beginning and at the end of the 12 weeks lasting intervention period.

Results: In contrast to the control group the training group improved endothelial function from 4.33.5 to 6.9±2.7% significantly (p=0.001). Furthermore the training group achieved a significantly (p=0.019) improved flow mediated dilatation (FMD) and a significant higher FMD. Fat oxidation rate improved during all three stages significantly (p=0.006; p=0.023; p=0.007) and fat free mass increased significantly (p=0.009) whereas body fat mass was reduced (p=0.003).

Conclusion: A training program of twelve weeks based on the intensity of the highest fat oxidation improves endothelial function and fat oxidation in obese women and men even without reduction in body weight.

Schlüsselwörter

Adipositas - körperliche Aktivität - Fettoxidation - Endothelfunktion

Key words

obesity - physical activity - fat oxidation - endothelial function

Literatur

• 1 Goodpaster BH, Wolfe RR, Kelley DE. Effect of obesity on substrate utilization during exercise.  Obes Res. 2002;  10 575-584
• 2 Perticone F, Ceravolo R, Candigliota M, Ventura G, Iacopino S, Sinopoli F, Mattioli PL. Obesity and body fat distribution induce endothelial dysfunction by oxidative stress.  Diabetes. 2001;  50 150-165
• 3 Baldeweg SE, Pink AM, Yudkin JS, Coppack SW. The relationship between obesity, vascular reactivity and endothelial dysfunction in subjects with non-insulin dependent diabetes mellitus.  Int J Obes Relat Metab Disord. 2000;  24 134-135
• 4 Zurlo F, Lillioja S, Esposito-Del Puente A, Nyomba BL, Raz I, Saad MF, Swinburn BA, Knowler WC, Bogardus C, Ravussin E. Lot ratio of fat to carbohydrate oxidation as predictor of weight gain: study of 24-h RQ.  Am J Physiol. 1990;  159 E650-E657
• 5 Ranneries C, Bülow J, Buemann B, Christensen NJ, Madsen J, Astrup A. Fat metabolism in formerly obese women.  Am J Physiol. 1998;  274 E155-E161
• 6 Schächinger V, Britten MB, Zeiher AM. Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease.  Circulation. 2000;  101 1-8
• 7 Van Aggel-Leijssen DPC, Saris WHM, Wagenmakers AJM, Senden JM, Van Baak MA. Effect of exercise training at different intensities on fat metabolism of obese men.  J Appl Physiol. 2002;  92 1300-1309
• 8 Van Aggel-Leijssen DPC, Saris WHM, Wagenmakers AJM, Hul GB, Van Baak MA. The effect of low-intensity exercise training on fat metabolism of obese women.  Obes Res. 2001;  9 86-96
• 9 Sial S, Coggan AR, Hickner RC, Klein S. Training-induced alterations in fat and carbohydrate metabolism during exercise in elderly subjects.  Am J Physiol Endocrinol Metab. 1998;  274 E785-E790
• 10 Friedlander AL, Casazza GA, Hornig MA, Usaj A, Brooks GA. Endurance training increases fatty acid turnover, but not fat oxidation, in young men.  J Appl Physiol. 1999;  86 2097-2105
• 11 Goto C, Higashi Y, Kimura M, Noma K, Hara K, Nakagawa K, Kawamura M, Chayama K, Yoshizumi M, Nara I. The effect of different intensities of exercise on endothelium-dependent vasodilation in humans: role of endothelium-dependent nitric oxide and oxidative stress.  Circulation. 2003;  108 530-535
• 12 Hambrecht R, Wolf A, Gielen S, Linke A, Hofer J, Erbs S, Schoene N, Schuler G. Effect of exercise on coronary endothelial function in patients with coronary artery disease.  N Engl J Med. 2000;  342 454-460
• 13 Higashi Y, Sasaki S, Sasaki N, Nakagawa K, Ueda T, Yoshimizu A, Kurisu S, Matsuura H, Kajiyama G, Oshima T. Daily aerobic exercise improves reactive hyperemia in patients with essential hypertension.  Hypertension. 1999;  33 591-597
• 14 Walsh JH, Yong G, Cheetham C, Watts GF, OŽDiscoll GJ, Taylor RR, Green DJ. Effects of exercise training on conduit and resistance vessel function in treated and untreated hypercholesterolaemic subjects.  Eur Heart J. 2003;  24 1681-1689
• 15 Friedwald W, Levy R, Fredrickson D. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.  Clin Chem. 1972;  18 499-502
• 16 Frayn KN. Calculation of substrate oxidation rates in vivo form gaseous exchange.  J Appl Physiol. 1983;  55 628-634
• 17 Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JE. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.  Lancet. 1992;  340 1111-1115
• 18 Tanaka H, Monahan KD, Seals DR. Age-predicted heart rate revisited.  J Am Coll Cardiol. 2001;  37 153-156
• 19 Martin 3rd Wh, Dalsky GP, Hurley BF, Matthews DE, Bier DM, Hagberg JM, Rogers MA, King SD, Holloszy JO. Effect of endurance training on plasma free fatty acid turnover and oxidation during exercise.  Am J Physiol Endocrinol Metab. 1993;  265 E708-E714
• 20 Calles-Escandon J, Arcierto PJ, Gardner AW, Bauman C, Poehlman ET. Basal fat oxidation decreases with aging in women.  J Appl Physiol. 1995;  78 266-271
• 21 Saltin B, Gollnick PD. Skeletal muscle adaptability: significance for metabolism and performance. In: Peachey LD, Adrian RH, Geiger SR (Eds). Handbook of Physiology. Section 10: Skeletal muscle. American Society of Physiology, Baltimore: Waverly Press 1983: 112-123
• 22 Kiens B, Kristiansen S, Jensen P, Richter EA, Turcotte LP. Membrane associated fatty acid binding protein (FABPpm) in human skeletal muscle is increased by endurance training.  Biochem Biophys Res Commun. 1997;  231 463-465
• 23 De Glisezinski I, Crampes F, Harant I, Berland M, Hejnova J, Langin D, Rivière D, Stich V. Endurance training changes in lipolytic responsiveness of obese adipose tissue.  Am J Physiol. 1998;  275 E951-E956
• 24 Watts K, Beye P, Siafarikas A, O’Driscoll G, Jones TW, Davis EA, Green DJ. Effects of exercise training on vascular function in obese children.  J Pediatr. 2004;  144 620-625
• 25 Watts K, Beye P, Siafarikas A, Davis EA, Jones TW, O`Driscoll G, Green DJ. Exercise training normalises vascular dysfunction ind improves central adiposity in obese adolescents.  J Am Coll Cardiol. 2004;  43 1823-1827
• 26 Linke A, Schoene N, Gielen S, Hofer J, Erbs S, Schuler G, Hambrecht R. Patients with chronic heart failure: systemic effects of lower-limb exercise training.  J Am Coll Cardiol. 2001;  37 392-397
• 27 Bergholm R, Makimattila S, Valkonen M, Liu ML, Lahdenpera S, Taskinen MR, Sovijarvi A, Malmberg P, Yki-Jarvinen H. Intense physical training decreases circulating antioxidants and endothelium-dependent vasodilation in vivo.  Atherosclerosis. 1999;  145 141-149
• 28 Higashi Y, Sasaki S, Kurisu S, Nakagawa K, Yoshimizu A, Sasaki N, Matsuura H, Kajiyama G, Oshima T. Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects - role of endothelium-derived nitric oxide.  Circulation. 1999;  100 1194-1202
• 29 Brook RD, Bard RL, Glazewski L, Kehrer C, Bodary PR, Eitzman DL, Rajagopalan S. Effect of short-term weight loss on the metabolic syndrome and conduit vascular endothelial function in overweight adults.  Am J Cardiol. 2004;  93 1012-1016
• 30 Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise, or diet plus exercise intervention.  Int J Obes. 1997;  21 941-947
• 31 Ross R, Janssen I. Physical acitivity, total and regional obesity: dose-response considerations.  Med Sci Sports Exerc. 2001;  6 ((Suppl.)) S521-S527
• 32 Watkins LL, Sherwood A, Feinglos M, Hinderliter A, Babyak M, Gullette E, Waugh R, Blumenthal JA. Effects of exercise and weight loss on cardiac risk factors associated with syndrome X.  Ann Intern Med. 2003;  163 1889-1895
• 33 Weltman A, Matter S, Stamford BA. Caloric restriction and/or mild exercise: effects on serum lipids and body composition.  Am J Clin Nutr. 1980;  33 1002-1009

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