8周有氧、抗阻和联合运动对年轻肥胖女性血流动力学和动脉硬度的影响

关键词：有氧运动  抗阻运动  联合运动  血流动力学  动脉硬度

Keywords:aerobic exercise  resistance exercise  combined exercise  hemodynamics  arterial stiffness

摘要：

      摘要 目的：对比8周有氧（aerobic exercise， AE）、抗阻（resistance exercise， RE）和联合运动（combined exercise， CE）对肥胖年轻女性心功能、血流动力学和血管硬度的影响，为肥胖年轻女性科学运动提供理论和实践依据。 方法：筛选47名体脂率≥30%的肥胖女性，随机分为AE、RE和CE组，运动干预8周，60min/次，3次/周。AE组在跑台上以70%—75%储备心率运动50min。RE组以75%1次最大重复次数，依次完成深蹲、卧推和硬拉，10次/组，组间间歇2min，变换动作间隙2min。CE组先进行25min抗阻训练，后进行25min有氧训练，训练内容和强度同AE和RE运动组。使用双能X光检测仪、彩色多普勒超声和动脉硬化检测仪检测运动0周、4周和8周后受试者身体成分、心功能、血流动力学和血管硬度的变化。 结果：8周运动后肌肉重量时间×组别交互效应（P＜0.05）和体脂率时间主效应（P＜0.01）出现显著性意义。3组受试者体脂率在8周运动后较运动前均显著下降（P＜0.05），AE组第4周肌肉重量显著下降（P=0.02），而RE和CE组第8周肌肉量较运动前和运动中显著升高（P＜0.05）。除左心室收缩末期容积和心率外，其它心功能指标出现显著时间主效应（P＜0.05）。3组运动后左心室舒张末期容积（P＜0.01）、每搏输出量（P＜0.01）和短轴缩短率（AE：P＜0.01，RE：P=0.01，CE：P=0.047）较运动前均显著增加。峰值血流速度和血流剪切力存在显著时间主效应（P＜0.01）。干预后AE和CE组峰值血流速度（AE：P=0.04，CE：P＜0.01）和血流剪切力（AE：P=0.01，CE：P＜0.01）均显著高于运动前，RE组（P=0.02）只有血流剪切力显著增加。左侧肱踝脉搏波传导速度（brachial-ankle pulse wave conduction velocity， baPWV）（P=0.008）时间×组别效应和左右两侧baPWV时间主效应（P＜0.05）均有显著性意义。8周运动后AE组左、右侧baPWV均显著降低（P＜0.05）。RE组baPWV无显著改变（P＞0.05）。CE组右侧baPWV随运动时长增加逐渐降低，且于第8周降低幅度出现显著性差异（P=0.03）。 结论：8周有氧、抗阻和联合运动均能改善年轻肥胖女生身体成分、心脏泵血功能和血流动力学等指标。有氧和联合运动不仅能降低体脂，也能降低baPWV。联合和抗阻运动均能增加肌肉质量，但抗阻运动不能改变年轻肥胖女性baPWV。

Abstract:

      Abstract Objective： To compare the effects of 8 weeks of aerobic exercise （AE）， resistance exercise （RE） and combined exercise （CE） on cardiac function， hemodynamics and vascular stiffness in young women with obesity， and to provide theoretical and practical basis for exercise prescription in this population. Method： Forty-seven women with obesity (body fat percentage ≥30%) were screened and randomly divided into AE， RE and CE group.Exercise intervention consisted of 8 weeks， 60 min per session， 3 sessions per week. The AE group exercised on a running platform at 70%—75% of the heart rate reserve for 50 min. The RE group completed squats， bench presses and pull-ups sequentially at 75% of the 1 repetition maximum for 10 reps per set， with a 2 min break between sets and 2 min for the change of the movement interval. The CE group performed 25min of resistance training followed by 25min of aerobic training with the same content and intensity as the AE and RE exercise group. Changes in body composition， cardiac function， hemodynamics and vascular stiffness were detected before， during and after exercise using a dual-energy X-ray detector， color Doppler ultrasound and arterial stiffness detector. Result： Body fat percentage decreased significantly in all three groups after 8 weeks of exercise compared to pre-exercise （P<0.05）. Lean mass significantly decreased in the AE group （P=0.02） at week 4， whereas increased significantly in the RE and CE groups at week 8 compared to baseline and exercise （P<0.05）. Left ventricular end-diastolic volume （P<0.01）， stroke volume （P<0.01）， and short-axis foreshortening rate （AE：P<0.01， RE：P=0.01， CE：P=0.047） increased significantly in all three groups after exercise compared to pre-exercise. Peak blood flow velocity （AE：P=0.04， CE：P<0.01） and blood flow shear （AE：P=0.01， CE：P<0.01） were significantly higher in the AE and CE groups than in the pre-exercise period， and only the increase in Wall shear stress was statistically significant in the RE group （P=0.02）. The left and right brachial-ankle pulse wave conduction velocity （baPWV） of the AE group decreased significantly after 8 weeks of exercise（P<0.05）. BaPWV of the RE group did not change significantly （P>0.05）. The right baPWV of the CE group decreased gradually with the increase of the duration of exercise， and the decrease appeared to be statistically significant in the 8 weeks （P=0.03）. Conclusion： Eight weeks of aerobic， resistance and combined exercise all improved body composition， cardiac function and hemodynamic indices in young women with obesity. Aerobic and combined exercise not only reduced body fat but also baPWV. Both combined and resistance exercise increased muscle mass， and resistance exercise had no effect on baPWV in young women with obesity.