基于心肺运动试验的精准有氧运动处方对中心型肥胖患者体成分及代谢指标的影响

关键词：心肺运动试验  运动处方  中心型肥胖  体成分  代谢指标

Keywords:cardiopulmonary exercise test  exercise prescription  central obesity  body composition  metabolic index

摘要：

      摘要 目的：探讨基于心肺运动试验精准制定个体化有氧运动处方减轻中心型肥胖患者体重、改善体成分及代谢指标的疗效。 方法：选取2019年6月至2020年10月在南京医科大学附属无锡人民医院内分泌科就诊的中心型肥胖患者60例，以是否进行心肺运动试验分为两组，每组各30例，分为心肺运动试验组（CPET组，30例）和对照组（CON组，30例），两组均进行标准化饮食指导，执行相同的力量运动处方，CON组进行每周5—7次的常规有氧运动训练，CPET组根据心肺运动试验测试结果制定精准有氧运动处方，对两组患者基线及干预12周后的体重、身体质量指数（body mass index， BMI）、腰围、人体成分（体脂肪、骨骼肌、体脂百分比、内脏脂肪面积）、静息收缩压、静息舒张压和代谢指标（糖化血红蛋白，Glycosylated hemoglobin， type A1C，HbA1c）、低密度脂蛋白胆固醇（Low-density lipoprotein cholesterol，LDL-C）、高密度脂蛋白胆固醇（High density liptein cholesterol，HDL-C）、甘油三酯、总胆固醇、空腹血糖、尿酸、谷丙转氨酶、谷草转氨酶）进行检测和比较分析。 结果：两组患者一般情况及各指标基线值无显著性差异（P>0.05）。两组患者治疗12周后体重、BMI、腰围、静息血压、体成分及代谢指标与治疗前相比均有显著改善（P<0.05），较CON组相比，这些指标在CPET组改善更明显，其中体重、BMI、腰围、静息舒张压、体脂肪、体脂百分比及内脏脂肪等指标有显著性差异（P<0.05）。 结论：以心肺运动试验为依据的个体化有氧运动处方能更精准地改善中心型肥胖患者的代谢指标及人体成分，增强减重效果，重塑代谢健康，值得推广。

Abstract:

      Abstract Objective： To explore the efficacy of accurately formulating individualized aerobic exercise prescription based on cardiopulmonary exercise test to reduce body weight and improve body composition and metabolic indexes in patients with central obesity. Method： Sixty patients with central obesity treated in the department of endocrinology of Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2019 to October 2020 were selected. They were divided into two groups with 30 cases in each according to whether to carry out cardiopulmonary exercise test. They were divided into cardiopulmonary exercise test group （CPET group， 30 cases） and control group （CON group， 30 cases）. Both groups were given standardized diet guidance and performed the same strength exercise prescription， CON group received routine aerobic exercise training 5—7 times a week. CPET group formulated accurate aerobic exercise prescription according to the results of cardiopulmonary exercise test. The body weight， body mass index （BMI）， waist circumference， body composition （body fat， skeletal muscle， body fat percentage， visceral fat area）， resting systolic blood pressure，resting diastolic blood pressure and metabolic indexes （Glycosylated Hemoglobin， Type A1C，HbA1c）， low density lipoprotein cholesterol （LDL-C）， high density lipoprotein cholesterol （HDL-C）， triglycerides， total cholesterol， fasting blood glucose， uric acid， alanine aminotransferase and aspartate aminotransferase） were detected and compared. Result： There was no statistical difference in general conditions and baseline values of each index between the two groups（P>0.05）. After 12 weeks of treatment， body weight， BMI， waist circumference， resting blood pressure， body composition and metabolic indexes in two groups were significantly improved compared with those before treatment（P<0.05）. These indicators in the CPET group were improved more obviously than those in the control group， and there were statistical differences in body weight， BMI， waist circumference，resting diastolic blood pressure， body fat， body fat percentage and visceral fat between the two groups（P<0.05）. Conclusion： Accurate aerobic exercise prescriptions based on cardiopulmonary exercise tests can more accurately improve the metabolic indexes of central obesity patients by reducing body fat， enhance the effect of weight loss， and rebuild metabolic health. It is worthy of promotion.