全天体力活动对代谢异常型肥胖青少年健康改善效果评价

刘付娴; 朱琳

doi:10.16835/j.cnki.1000-9817.2023.04.007

全天体力活动对代谢异常型肥胖青少年健康改善效果评价

doi: 10.16835/j.cnki.1000-9817.2023.04.007

刘付娴¹,
朱琳^2, ,

1.
广州体育学院研究生院，广东 510075
2.
广州体育学院运动与健康学院

基金项目:

国家社科基金一般项目 18BTY075

广东省珠江学者岗位计划资助项目 2019

详细信息

作者简介:
刘付娴(1996-)，女，广东湛江人，硕士，主要研究方向为青少年运动与健康促进

通讯作者:
朱琳，E-mail：11251@gzsport.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R723.14 G804.49 R179
计量
- 文章访问数: 229
- HTML全文浏览量: 135
- PDF下载量: 15
- 被引次数: 0
出版历程
- 收稿日期: 2022-10-08
- 修回日期: 2022-12-29
- 网络出版日期: 2023-04-26
- 刊出日期: 2023-04-25

Effects of total daily physical activity on health improving among adolescents with metabolically unhealthy obesity

LIU Fuxian¹,
ZHU Lin^{2
, ,}

1.
Graduate Department of Guangzhou Sport University, Guangzhou(510075), China

摘要

摘要: 目的探讨4周封闭训练营的全天体力活动对代谢异常型肥胖(MUO)青少年身体成分、心血管代谢风险的改善作用，为不同代谢状态的肥胖青少年健康促进提供证据支撑。方法于2019年7—8月招募深圳某封闭训练营10~17岁肥胖青少年58名，测量受试者入营前的身体成分、血压、血脂4项和空腹血糖等指标，分为MUO组(31名)和代谢健康型肥胖(MHO)组(27名)。采用Actigraph w-GT3x BT三轴运动加速度计记录两组4周在封闭训练营中9：00—19：00的全天体力活动情况。结营后比较两组干预前后上述指标的差异及组内的变化。结果 51.6%的MUO青少年过渡为MHO青少年；体重、体质量指数(BMI)-Z评分、体脂肪量、收缩压(SBP)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和空腹血糖(FPG)的时间与组别交互作用有统计学意义(F值分别为11.25，11.25，11.04，4.89，16.75，5.92，5.57，P值均＜0.05)。组别的主效应显示，入营前MUO组的BMI-Z评分、SBP、TG和FPG高于MHO组，HDL-C低于MHO组(F值分别为5.60，6.62，20.21，10.17，31.04，P值均＜0.05)；时间的主效应显示，两组的体重、BMI-Z评分、体脂肪量、SBP、TG均下降(P值均＜0.05)，HDL-C仅在MUO组中上升(P＜0.01)，两组的FPG干预前后差异无统计学意义(P＞0.05)。体脂率、DBP、TC和LDL-C的交互作用无统计学意义(P值均＞0.05)，组别的主效应无统计学意义(P值均＞0.05)，时间的主效应有统计学意义(P值均＜0.01)。结论以封闭训练营形式增加的体力活动可以帮助MUO青少年减脂；MUO青少年在日常生活中应增加体力活动量，以降低发生心血管代谢疾病的风险。
- 运动活动 /
- 肥胖症 /
- 代谢疾病 /
- 干预性研究 /
- 青少年
Abstract: Objective To explore the effect of all-day physical activity in a 4-week closed training camp on the improvement of body composition and cardiovascular metabolic risk in metabolic unhealthy obese adolescents (MUO), so as to provide stronger evidence for the health promotion of obese adolescents with different metabolic states. Methods From July to August 2019, 58 obese adolescents aged 10-17 years from a closed training camp in Shenzhen were recruited and their body composition, blood pressure, lipid profile, and fasting blood glucose before admission were measured. They were divided into MUO group(n=31) and metabolic healthy obese (MHO) group(n=27). Using an Actigraphw GT3xBT triaxial accelerometer, the physical activity of the two groups during the whole day from 9:00 to 19:00 in a closed training camp for four weeks was recorded. After the conclusion of the camp, the above indicators were detected to compare the differences between the two groups before and after the intervention and the changes within the group. Results A total of 51.6% of MUO adolescents transitioned to MHO adolescents; Body weight, BMI-Z score, body fat mass, SBP, TG, HDL-C, and FPG had time×group significant interactions(F=11.25, 11.25, 11.04, 4.89, 16.75, 5.92, 5.57, P < 0.05). The main effect of the group showed that before entering the camp, the BMI-Z score, SBP, TG, and FPG in the MUO group were higher than those in the MHO group, while the HDL-C was lower than those in the MHO group(F=5.60, 6.62, 20.21, 10.17, 31.04, P < 0.05). The main effect of time showed that the body weight, BMI-Z score, body fat mass, SBP, and TG of both groups decreased significantly(P < 0.05), and HDL-C only showed a significant increase in the MUO group(P < 0.01). There was no significant change in FPG in both groups before and after intervention(P>0.05). The time×group interactions of body fat ratio, DBP, TC, and LDL-C was not significant(P>0.05), and the main effect of the group was not significant(P>0.05), the main effect of time was significant(P < 0.01). Conclusion Increased physical activity in the form of closed training camps can help MUO adolescents reduce fat, MUO adolescents should increase physical activity in their daily life to reduce the risk of cardiovascular metabolic diseases.
- Motor activity /
- Obesity /
- Metabolic diseases /
- Intervention studies /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 MUO组和MHO组青少年入营前后身体成分变化情况比较

Table 1. Comparison of pre and post camp changes in body composition between MUO and MHO adolescents

组别	入营前后	体重/kg	BMI-Z评分	体脂率/%	体脂肪量/kg
MUO(n=31)	入营前	84.04±15.44	3.06±0.66	35.05±4.40	29.71±7.52
	结营后	73.25±13.94	2.38±0.60	30.07±5.43	22.35±7.02
MHO(n=27)	入营前	81.83±16.34	2.69±0.52	32.89±4.39	27.31±8.50
	结营后	73.34±14.63	2.16±0.53	28.86±5.51	21.61±7.82
P(η²)_时间值		< 0.01(0.72)	< 0.01(0.93)	< 0.01(0.58)	< 0.01(0.70)
P(η²)_组别值		0.83(< 0.01)	0.06(0.06)	0.08(0.03)	0.50(0.01)
P(η²)_交互作用值		< 0.01(0.17)	< 0.01(0.17)	0.06(0.06)	< 0.01(0.17)
注：除BMI-Z评分外，其余指标均将性别作为协变量进行调整。

下载: 导出CSV

表 2 MUO组和MHO组青少年入营前后心血管代谢风险指标比较

Table 2. Comparison of pre and post camp cardiometabolic risk markers between MUO and MHO adolescents

组别	入营前后	SBP/mmHg	DBP/mmHg	TC/ (mmol·L^-1)	TG/ (mmol·L^-1)	HDL-C/ (mmol·L^-1)	LDL-C/ (mmol·L^-1)	FPG/ (mmol·L^-1)
MUO(n=31)	入营前	116.68±12.38	70.71±8.16	4.48±0.86	1.51±0.50	1.02±0.19	2.89±0.69	5.40±0.78
	结营后	103.74±10.25	63.42±7.40	3.56±0.72	0.76±0.27	1.12±0.21	2.00±0.58	5.13±0.62
MHO(n=27)	入营前	109.78±6.66	69.11±7.26	4.46±0.87	1.00±0.33	1.26±0.16	2.63±0.75	4.82±0.56
	结营后	101.19±7.80	62.93±7.60	3.63±0.67	0.70±0.33	1.23±0.22	1.90±0.65	5.17±0.74
P(η²)_时间值		< 0.01(0.26)	< 0.01(0.28)	< 0.01(0.29)	< 0.01(0.17)	0.45(0.01)	< 0.01(0.32)	0.16(0.04)
P(η²)_组别值		0.05(0.07)	0.60(< 0.01)	0.85(< 0.01)	< 0.01(0.19)	< 0.01(0.24)	0.28(0.02)	0.03(0.08)
P(η²)_交互作用值		0.03(0.08)	0.38(< 0.01)	0.67(< 0.01)	< 0.01(0.23)	0.02(0.10)	0.23(0.03)	0.02(0.09)
注：除BMI-Z评分外，其余指标均将性别作为协变量进行调整。

下载: 导出CSV

参考文献(30)

[1]	OHLSSON C, BYGDELL M, SONDÉN A, et al. Association between excessive BMI increase during puberty and risk of cardiovascular mortality in adult men: a population-based cohort study[J]. Lancet Diabetes Endocrinol, 2016, 4(12): 1017-1024. doi: 10.1016/S2213-8587(16)30273-X
[2]	STEFAN N, HÄRING H U, HU F B, et al. Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications[J]. Lancet Diabetes Endocrinol, 2013, 1(2): 152-162. doi: 10.1016/S2213-8587(13)70062-7
[3]	SMITH G I, MITTENDORFER B, KLEIN S. Metabolically healthy obesity: facts and fantasies[J]. J Clin Invest, 2019, 129(10): 3978-3989. doi: 10.1172/JCI129186
[4]	GUO F, GARVEY W T. Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: stability of metabolic health status in adults[J]. Obesity (Silver Spring), 2016, 24(2): 516-525. doi: 10.1002/oby.21344
[5]	张云婷, 马生霞, 陈畅, 等. 中国儿童青少年身体活动指南[J]. 中国循证儿科杂志, 2017, 12(6): 401-409. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK201706001.htm ZHANG Y T, MA S X, CHEN C, et al. Physical activity guide for children and adolescents in China[J]. Chin J Evid Based Pediatr, 2017, 12(6): 401-409. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK201706001.htm
[6]	FAROOQ A, MARTIN A, JANSSEN X, et al. Longitudinal changes in moderate-to-vigorous-intensity physical activity in children and adolescents: a systematic review and Meta-analysis[J]. Obes Rev, 2020, 21(1): e12953.
[7]	BARNETT T A, KELLY A S, YOUNG D R, et al. Sedentary behaviors in today's youth: approaches to the prevention and management of childhood obesity: a scientific statement from the American heart association[J]. Circulation, 2018, 138(11): e142-e159.
[8]	周慧敏, 向政. 6周有氧运动结合饮食控制对肥胖青少年身体形态及血液指标的影响[J]. 中国应用生理学杂志, 2017, 33(2): 166-168. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSL201702019.htm ZHOU H M, XIANG Z. The influence of 6-week aerobic exercise combined with dietary control for body shape and blood indexe of obese adolescent[J]. Chin J Appl Physiol, 2017, 33(2): 166-168. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSL201702019.htm
[9]	叶莉, 封飞虎, 李春艳, 等. 运动减肥夏令营对男性肥胖青少年体成分及血清生化指标的影响[J]. 中国康复理论与实践, 2016, 22(2): 198-202. doi: 10.3969/j.issn.1006-9771.2016.02.016 YE L, FENG F H, LI C Y, et al. Effects of exercise for weight loss summer camp on body composition and serum biochemical markers in male obese adolescents[J]. Chin J Rehabilit Theory Pract, 2016, 22(2): 198-202. (in Chinese) doi: 10.3969/j.issn.1006-9771.2016.02.016
[10]	国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 北京: 人民卫生出版社, 2018. National Health and Family Planning Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018[S]. Beijing: People's Medical Publishing House, 2018. (in Chinese)
[11]	王永慧, 高珊, 黎明. 中国儿童代谢健康型肥胖定义与筛查专家共识[J]. 中国妇幼健康研究, 2019, 30(12): 1487-1490. https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201912003.htm WANG Y H, GAO S, LI M. The expert consensus on definition of metabolically healthy obesity and screening metabolically healthy obesity in Chinese children[J]. Chin J Woman Child Health Res, 2019, 30(12): 1487-1490. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201912003.htm
[12]	CAIN K L, SALLIS J F, CONWAY T L, et al. Using accelerometers in youth physical activity studies: a review of methods[J]. J Phys Act Health, 2013, 10(3): 437-450. doi: 10.1123/jpah.10.3.437
[13]	刘景新, 朱琳, 徐佶, 等. 肥胖儿童青少年运动强度的多指标联合诊断标准及价值[J]. 上海体育学院学报, 2021, 45(10): 54-61. https://www.cnki.com.cn/Article/CJFDTOTAL-STYB202110006.htm LIU J X, ZHU L, XU J, et al. Diagnostic criteria and value of multiple-index joint diagnosis of exercise intensity in obese children and adolescents[J]. J Shanghai Univ Sport, 2021, 45(10): 54-61. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-STYB202110006.htm
[14]	DE ONIS M, ONYANGO A W, BORGHI E, et al. Development of a WHO growth reference for school-aged children and adolescents[J]. Bull World Health Organ, 2007, 85(9): 660-667. doi: 10.2471/BLT.07.043497
[15]	尚延侠, 侯希贺, 潘珊珊, 等. 有氧运动对不同肥胖亚型儿童心血管危险因素的干预效果[J]. 中国运动医学杂志, 2022, 41(4): 266-273. https://www.cnki.com.cn/Article/CJFDTOTAL-YDYX202204003.htm SHANG Y X, HOU X H, PAN S S, et al. Effects of aerobic exercise on cardiovascular risk factors among children with different obesity subtypes[J]. Chin J Sports Med, 2022, 41(4): 266-273. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YDYX202204003.htm
[16]	ORTEGA F B, CADENAS-SANCHEZ C, MIGUELES J H, et al. Role of physical activity and fitness in the characterization and prognosis of the metabolically healthy obesity phenotype: a systematic review and Meta-analysis[J]. Prog Cardiovasc Dis, 2018, 61(2): 190-205.
[17]	MARTINEZ-GOMEZ D, ORTEGA F B, HAMER M, et al. Physical activity and risk of metabolic phenotypes of obesity: a prospective taiwanese cohort study in more than 200, 000 adults[J]. Mayo Clin Proc, 2019, 94(11): 2209-2219.
[18]	JUNG U, CHOI M S. Obesity and its metabolic complications: the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease[J]. Int J Mol Sci, 2014, 15(4): 6184-6223.
[19]	LEE S, ARSLANIAN S. Body composition and cardiorespiratory fitness between metabolically healthy versus metabolically unhealthy obese black and white adolescents[J]. J Adolesc Health, 2019, 64(3): 327-332.
[20]	COLLABORATION G B M, DI ANGELANTONIO E, SHN B, et al. Body-mass index and all-cause mortality: individual-participant-data Meta-analysis of 239 prospective studies in four continents[J]. Lancet, 2016, 388(10046): 776-786.
[21]	DAGPO T D, NOLAN C J, DELGHINGARO-AUGUSTO V. Exploring therapeutic targets to reverse or prevent the transition from metabolically healthy to unhealthy obesity[J]. Cells, 2020, 9(7): 1596.
[22]	LIAO C C, SHEU W H, LIN S Y, et al. The relationship between abdominal body composition and metabolic syndrome after a weight reduction program in adult men with obesity[J]. Diabetes Metab Syndr Obes, 2020, 13: 1-8.
[23]	MAGKOS F, FRATERRIGO G, YOSHINO J, et al. Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity[J]. Cell Metab, 2016, 23(4): 591-601.
[24]	朱显贵, 石旅畅, 张海峰. 不同强度运动对脂解激素的影响及在减肥机制中的作用研究进展[J]. 中国运动医学杂志, 2020, 39(7): 569-576. https://www.cnki.com.cn/Article/CJFDTOTAL-YDYX202007011.htm ZHU X G, SHI L C, ZHANG H F. Research progress on the effects of different intensity exercise on lipolytic hormones and its role in weight loss mechanism[J]. Chin J Sports Med, 2020, 39(7): 569-576. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YDYX202007011.htm
[25]	SONG P, ZHANG Y, YU J, et al. Global prevalence of hypertension in children: a systematic review and Meta-analysis[J]. JAMA Pediatr, 2019, 173(12): 1154-1163.
[26]	CADENAS-SANCHEZ C, RUIZ J R, LABAYEN I, et al. Prevalence of metabolically healthy but overweight/obese phenotype and its association with sedentary time, physical activity, and fitness[J]. J Adolesc Health, 2017, 61(1): 107-114.
[27]	LACEY B, LEWINGTON S, CLARKE R, et al. Age-specific association between blood pressure and vascular and non-vascular chronic diseases in 0.5 million adults in China: a prospective cohort study[J]. Lancet Glob Health, 2018, 6(6): e641-e649.
[28]	潘杭雨, 刘丹, 郎吉萍, 等. 高密度脂蛋白在动脉粥样硬化免疫反应中的作用机制研究进展[J]. 解放军医学杂志, 2021, 46(6): 609-615. https://www.cnki.com.cn/Article/CJFDTOTAL-JFJY202106013.htm PAN H Y, LIU D, LANG J P, et al. Research progress of the mechanism of HDL-C involved in the immune responses of atherosclerosis[J]. Med J Chin PLA, 2021, 46(6): 609-615. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JFJY202106013.htm
[29]	LIN X, ZHANG X, GUO J, et al. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and Meta-analysis of randomized controlled trials[J]. J Am Heart Assoc, 2015, 4(7): e002014.
[30]	KEATING S E, MACHAN E A, O'CONNOR H T, et al. Continuous exercise but not high intensity interval training improves fat distribution in overweight adults[J]. J Obes, 2014, 2014: 834865.