中低强度有氧运动结合饮食控制对肥胖青少年血脂和肝脏功能的影响

Aerobic Exercise Combined with Diet Control Improves the Plasma Lipid Profile and Hepatic Function in Obese Adolescents

目的:探讨4周中低强度有氧运动结合饮食控制对肥胖青少年减肥效果以及血脂和肝脏功能的影响。方法:以参加2007年上海巅峰运动减肥中心运动减肥夏令营的56名9～19岁肥胖青少年(男26名,女30名)为对象,测定其身体形态、安静状态心电图、空腹血糖、胰岛素、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、谷氨酸氨基转移酶(ALT)、丙氨酸氨基转移酶(AST)、-谷氨酰转肽酶(GGT),进行肝脏B超检查。根据运动负荷试验结果确定个体运动强度,范围在心率储备的20～40%。选择容易控制强度和长时间持续的运动方式,如游泳、快走、慢跑、健美操、娱乐性球类等。根据年龄、体重和基础代谢率计算个体每日热能需要量,遵循足量蛋白质和低脂的原则,由专业营养师配餐,保证生理需要量营养素供给。4周实验后测定相同指标并进行前后比较。结果:与实验前比较,4周后,(1)实验对象体重、BMI、体脂率明显下降;(2)空腹血脂、血糖和胰岛素均明显下降;(3)肝脏B超检查显示脂肪肝程度减轻,ALT、AST和GGT异常例数明显减少。结论:中低强度长时间运动结合足量蛋白质、低脂饮食是肥胖青少年减肥的有效途径,不仅明显改善体内脂类代谢,降低空腹胰岛素水平,提高组织细胞对胰岛素的敏感性,还可明显减轻肥胖青少年脂肪肝的程度,改善肝功能。

Purpose To investigate the effect of 4-week weight reduction exercise combined with diet control on the plasma lipid and hepatic adipose infiltration.Methods Individualized weight reduction exercise（target HR=20%～40% of HR reserve）and diet control program was formulated for 56 obese adolescents（9~19yrs,26 males and 30 females）.Body shape,blood biochemical indicators（fasting plasma glucose,insulin,plasma lipid）,hepatic function indicators,hepatic adipose infiltration,exercise capacity,and health condition,especially resting ECG and exercise ECG test were measured or examined.Daily calorie intake was calculated according to age,body weight and basal metabolism.The measurements and examinations were carried out before and after 4-week experiment.Results（1）The body weight,BMI,body fat percentage,and fasting plasma lipid,plasma glucose and insulin decreased significantly in the obese adolescents after 4-week weight reduction exercise and diet program.（2）The degree of hepatic adipose infiltration reduced,and the number of cases with abnormal ALT,AST,and GGT decreased significantly.Conclusions Moderate to low intensity exercise in combination with sufficient protein and low fat diet is an effective way to reduce body fat weight in obese adolescents.The program not only improves the lipid metabolism,but also increases the tissue cell sensitivity to insulin,reduces the severity of hepatic adipose infiltration,and thus improves the hepatic function.