16周有氧运动结合饮食干预对重度肥胖症患者血液脂肪酸成分的影响

Impact of 16-week Combined Intervention of Aerobic Exercise and Diet Control on Serum Fatty Acid Composition in Severe Obese Patients

目的:探讨16周中小强度有氧运动结合饮食控制对重度肥胖症患者血清脂肪酸、身体形态和血脂的影响。方法:以2012年参加上海巅峰全封闭长期减肥班的12名BMI≥36且体脂率≥40%的重度肥胖症患者为研究对象。入营前,经运动负荷试验、体格检查,制定个性化运动处方,以个体心率储备为参考确立运动强度。选择强度易于控制、且能长时间坚持的运动项目如游泳、椭圆机、快走等。根据研究对象的年龄、体重和基础代谢率计算其每天热能生理需要量,由专业营养师配餐。每4周测试身体形态指标和进行运动负荷试验,并据此调整运动强度。分别于入营时、第8周和第16周采集空腹肘静脉血,测定血清总脂肪酸种类和含量、血糖(GLU)、胰岛素(INS)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),计算HDL-C/LDL-C比值。结果:16周后,肥胖症患者体重、BMI、体脂率、腰围、臀围、腰臀比与入营时比较均显著下降(P<0.01);TG、TC、INS、LDL-C均不同程度降低,HDL-C/LDL-C比值升高;总脂肪酸(TFA)、不饱和脂肪酸(UFA)、单不饱和脂肪酸(MUFA)、多不饱和脂肪酸(PUFA)、n-6多不饱和脂肪酸(n-6 PUFA)含量降低,各脂肪酸含量均呈明显下降趋势。结论:16周有氧运动与饮食干预明显降低肥胖症患者肥胖程度,其身体形态、血脂代谢明显得以改善,血清各脂肪酸含量明显降低。

Objective To observe the effect of combined 16-week intervention of aerobic exercise and diet control on serum fatty acid composition, body shape and blood lipid of obese patients. Methods 12 severe obese patients （BMI ≥ 38,F%≥ 40%） took part in ＂2012 Shanghai Weight Loss Camp＂ . The subjects underwent exercise test and physical examination before taking part in the camp,and their individualized exercise prescription were determined based on the individual HR reserve. Their daily intakes of calories and nutrition were offered based on the age,weight and BMR. The exercise intensity was adjusted every 4 weeks according to the results from the new exercise test and physical examination. The anthropometric data,serum fatty acid composition,blood glucose （GLU）and insulin （INS）,total cholesterol （TC）, triglyceride （TG）, HDL, LDL, HDL/LDL, total fatty acid （TFA）, unsaturated fatty acid （UFA）,monounsaturated fatty acid （MUFA）,polyunsaturated fatty acid （PUFA）,and n-6 PUFA were obtained before intervention,and at the 8th week and 16th week of intervention. Results Body weight, BMI,body fat percentage,waistline,hip circumference,waist/hip ratio of the, subjects reduced significantly（P 〈 0.01 ）after 16-week intervention. The fasting blood TG,TC ,INS, LDH-C decreased and HDL/LDL raised in certain degree. Contents of TFA,UFA,MUFA,PUFA,and n-6 PUFA tended to decrease. Conclusion 16-week aerobic exercise in combination with diet control could effectively reduce the body weight and improve the body morphology and lipid metabolism of severe obese patients.