Dose-response relationship between daily steps counts and fat loss in obese children and adolescents
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摘要:
目的 探究肥胖儿童青少年每日不同步数与减脂效果间是否存在非线性关系和阈值效应, 以期为肥胖儿童青少年的运动减脂提供科学精准的理论依据。 方法 2021年7—8月, 在深圳减肥达人训练营招募48名10~17岁肥胖儿童青少年进行4周封闭式运动训练, 使用ActiGraph GT3X+监控每日步数, 通过干预前后身体成分指标的变化评价减脂效果。干预前后指标的比较使用配对样本t检验; 每日步数与减脂效果间的剂量-效应关系使用线性回归及分段回归分析, 非线性关系的分析使用限制性立方样条(RCS)分析。 结果 干预后体脂肪量(27.50±7.33)kg、体脂百分比(36.17±5.59)%、瘦体重(47.55±6.48)kg、骨骼肌量(26.14±3.84)kg较干预前均下降(t值分别为21.04, 13.32, 7.65, 8.35, P值均<0.05), 每日步数与以上指标的变化量间存在非线性剂量-效应关系(P值均<0.05);分段回归结果显示, 校正年龄、性别和基线BMI后, 每日步数每增加1 000步, 体脂肪量增加0.44(95%CI=0.03~0.84)kg、体脂百分比增加0.61%(95%CI=0.17%~1.04%)。在校正了年龄、性别、基线BMI后, 当每日步数8 300~11 400时, 每日步数每增加1 000步, 瘦体重增加0.58(95%CI=0.11~1.04)kg、骨骼肌量增加0.29(95%CI=0.03~0.54)kg。 结论 肥胖儿童青少年每日步数与减脂效果间存在非线性的剂量-效应关系, 为了达到最佳减脂效率, 每日步数以8 300~1 1400步为宜。 Abstract:Objective To investigate whether there is a nonlinear relationship and threshold effect between the number of daily steps counts and fat loss in obese children and adolescents. Methods Forty-eight obese children and adolescents were randomly recruited to undergo 4-week closed exercise training during July to August 2021. Actigraphy GT3X+ was used to monitor the daily steps, and fat loss effect was evaluated by changes of body composition indicators before and after the intervention. Paired samples t test was used to compare the indicators before and after the intervention; the dose-response relationship between daily steps counts and fat loss was analyzed by linear regression and piecewise regression, and the nonlinear relationship was analyzed by restricted cubic spline (RCS). Results Body fat mass, percentage of body fat, lean body mass and skeletal muscle mass decreased (27.50±7.33)kg, (36.17±5.59)%, (47.55±6.48)kg, (26.14±3.84)kg, respectively compared with those before intervention (t=21.04, 13.32, 7.65, 8.35, P < 0.05). There was a significant nonlinear dose-response relationship between daily steps counts and the change of these indicators (P < 0.05). After adjusting for age, sex and baseline BMI, each 1 000-step increase in daily walking number, BMI increased by 0.44(95%CI=0.03-0.84)kg and body fat percentage by 0.61%(95%CI=0.17%-1.04%). After adjusting for age, sex, and baseline BMI, each 1 000 step increased in daily number of steps occurred when the daily number of steps ranged from 8 300 to 11 400, lean body weight increased by 0.58(95%CI=0.11-1.04)kg, skeletal muscle mass increased by 0.29(95%CI=0.03-0.54)kg. Conclusion There is a non-linear dose-response relationship between daily steps and fat loss in obese children and adolescents, for optimal fat loss efficiency, daily steps to 8 300-11 400 appropriate. -
Key words:
- Obesity /
- Walking /
- Adipose tissue /
- Intervention studies /
- Child /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 肥胖儿童青少年干预前后身体成分比较(x±s)
Table 1. Comparison of body composition changes before and after intervention among obese children and adolescents(x±s)
干预前后 人数 体重/kg BMI/(kg·m-2) 体脂肪量/kg 体脂百分比/% 瘦体重/kg 骨骼肌量/kg 干预前 48 81.04±12.80 30.27±3.80 31.97±7.82 39.06±5.12 49.08±6.93 27.08±4.15 干预后 48 75.04±11.75 28.04±3.52 27.50±7.33 36.17±5.59 47.55±6.48 26.14±3.84 t值 23.73 26.29 21.04 13.32 7.65 8.35 P值 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 表 2 肥胖儿童青少年每日步数与减脂效果的剂量-效应关系分析[β值(β值95%CI),n=48]
Table 2. Analysis of dose-response relationship between daily steps counts and fat loss effect among obese children and adolescents[β(β 95%CI), n=48]
指标 模型1 模型2 体重/kg -0.19(-0.50~0.12) -0.15(-0.40~0.11) BMI/(kg·m-2) -0.07(-0.18~0.03) -0.06(-0.15~0.03) 体脂肪量/kg -0.23(-0.48~0.03) -0.13(-0.38~0.11) 体脂百分比/% -0.28(-0.54~-0.03)* -0.12(-0.39~0.15) 瘦体重/kg 0.04(-0.21~0.29) -0.02(-0.28~0.25) 骨骼肌量/kg 0.01(-0.13~0.15) -0.02(-0.17~0.12) 注:模型1无校正;模型2校正年龄、性别、基线BMI;*P<0.05。 -
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