健身走运动对老年人血清脂蛋白（a）的影响

Influence of fitness walking on serum lipoprotein （ a ） and lipid levels in seniors

目的通过对健身走运动与老年人血清脂蛋白（a）[Lp（a）]、血脂的相关性研究，观察长期规律性的中等强度健身走运动是否具有防治动脉粥样硬化（AS）和心血管疾病（CVD）的作用。方法经体检选定江苏省徐州市区60～79岁的老年人216名，随机分为对照组（C组）和健走组（S组）。对照组不进行锻炼；健走组进行12个月健身走锻炼，运动强度：以60％～80％最大心率（HRmax）对应的运动负荷为训练强度，运动时间：40～60min／次，频率：3～4次／周。实验期间研究对象的饮食和其他生活习惯无明显变化。实验前后分别抽晨血测定血清Lp（a）、总胆同醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—c）及低密度脂蛋白胆固醇（LDL-c）的浓度。结果与对照组实验后（C2组）和健走组实验前（S1组）相比，健走组实验后（S2组）TC水平分别降低8．3％和9．4％，差异有统计学意义（P〈0．05）；TG水平分别降低21．6％和20．3％，差异有统计学意义（P〈0．05）；血清LDL—c水平分别降低14．5％和15％，差异有统计学意义（P〈0．05）；HDL—c浓度分别升高20．7％和17．2％，差异具有高度统计学意义（P〈0．01）；Lp（a）中位数水平轻度上升，但差异无统计学意义。结论长期规律性的中等强度健身走运动可降低血清TC、TG及LDL-c水平，升高HDL—c含量，增强机体逆向转运胆固醇的能力，促进外周组织和血管中胆周醇的代谢，减少胆固醇在血管壁上的沉积，这对预防AS和CVD的发生发展具有重要的意义。血清Lp（a）中位数水平轻度升高，有利于血管微小损伤的修复。这种变化与其他血脂、脂蛋白的变化一起，对预防AS和CVD具有积极作用。

Objective This experiment was to study correlation between fitness walking and serum lipid and lipoprotein （a） （Lp （a）） in seniors, and see whether long-term regular medium-intensity fitness walking had any effect of preventing atherosclerosis [AS] and cardiovascular disease （CVD） from occurring. Methods 216 people aged 60-79 years were selected from Xuzhou, Jiangsu province after a medical examination, and randomly divided into control group （group C） and fitness walking group （group S）. The subjects in group C had no exercise habit, while those in the group S liked exercise, with a mean intensity of 60 % - 80 % HRmax for 40-60 min/time at a frequency of 3-4 times/week. The experimental cycle lasted 12 months. The subjects were advised not change their diets and other habits significantly during the experiment period. Blood samples were taken before and after the experiment for determination of Lp （a）, serum total cholesterol （TC）, triglycerides （TG）, high-densitylipoprotein-cholesterol （HDL-c） and low-densitylipoprotein-cholesterol （LDL-c）. Results Compared with group C2and group S1, TC in group S2 decreased by 8.3% and 9.4%, TG decreased by 21.6 % and 20.3 %, and LDL-c decreased by 14.5 % and 15 % respectively. The differences were statistically significant （P〈0.05）. HDL-c increased by 20.7% and 17.2%, andthe difference was very significant （P〈0.01）. Lp （a） increased insignificantly （P〉0.05）. Conclusions： Long-term regular moderate-intensity fitness walking can decrease TC, TGand LDL-c levels, significantly increase HDL-c, enhance the body＇ s ability to reverse cholesterol transport, promote peripheral tissue and blood vessels in cholesterol metabolism, and reduce deposition of cholesterol in the vessel wall. In addition, it may play a very important role in the prevention and treatment of CVD. After 12-month fitness walking, Lp （a） level slightly increased, which is beneficial to repair of minor vascular injuries. Working with other blood lipids and lipoprotein changes, it may have a positive impact on the prevention and treatment of AS and CVD.