综合干预对肥胖青少年糖脂代谢肝肾和心血管功能的影响

Effects of comprehensive intervention on glucose and lipid metabolism, liver and kidney function and cardiovascular function in obese adolescents

目的探讨运动结合饮食控制对肥胖青少年基本形态功能、糖脂代谢、肝肾功能和心血管功能的影响,为学校和家庭青少年肥胖的防治提供依据。方法以71名肥胖青少年为研究对象,对其进行6周运动结合饮食控制的综合干预,测定干预前后的形态功能、糖脂代谢水平、肝肾功能和心血管功能水平。结果综合干预后,在基本形态功能显著改善的基础上,肥胖青少年的胰岛素水平(FINS)[(18.76±11.46)(11.32±6.54)uU/L]、低密度脂蛋白胆固醇(LDL-C)[(2.96±0.69)(2.22±0.62)mmol/L]、三酰甘油(TG)[(1.57±0.82)(0.89±0.37)mmol/L]和总胆固醇(TC)[(4.52±0.76)(3.53±0.62)mmol/L]下降,胰岛素抵抗指数(3.92±2.54,2.40±1.63)改善(P值均<0.01);谷草转氨酶(AST)[(36.10±32.28)(22.89±7.27)U/L]、谷丙转氨酶(ALT)[(57.42±61.25)(27.86±22.12)U/L]、血清尿素(BUN)[(4.78±0.89)(3.44±0.79)mmol/L]和血清尿酸(UA)[(498.83±120.60)(471.07±120.96)mmol/L]降低(P值均<0.05);反应性充血指数(RHI)(1.34±0.28,1.69±0.45)和NO/ET-1(1.69±0.41,2.67±0.86)升高,动脉粥样硬化指数(AI)(3.06±0.96,2.58±0.80)降低(P值均<0.01)。结论 6周运动结合饮食控制的综合干预方案能够在降低肥胖青少年肥胖程度基础上,有效改善其糖脂代谢状态、肝肾功能和心血管功能。

Objective To investigate the effects of exercise combined with dietary intervention on glucose and lipid metabolism, liver and kidney function and cardiovascular function in obese adolescents. Methods Seventy-one obese adolescents were enrolled in this study. Six weeks of exercise combined with dietary intervention were performed to determine anthropometry, glucose and lipid metabolism, liver and kidney function and cardiovascular function before and after intervention. Results After 6 weeks of comprehensive intervention, in addition to significant improvement in anthropometry indicators, fasting insulin [(18.76±11.46 vs 11.32±6.54)uU/L], LDL-C [(2.96±0.69 vs 2.22±0.62)mmol/L], TG [(1.57±0.82 vs 0.89±0.37)mmol/L] and TC [(4.52±0.76 vs 3.53±0.62)mmol/L] decreased significantly and insulin resistance improved significantly. AST [(36.1±32.28 vs 22.89±7.27)U/L], ALT [(57.42±61.25 vs 27.86±22.12)U/L], blood urea nitrogen [(4.78±0.89 vs 3.44±0.79)mmol/L] and uric acid [(498.83±120.6 vs 471.07±120.96)mmol/L] were significantly decreased and the detection rates of fatty liver and kidney were significantly decreased(P<0.05), RHI(1.34±0.28 vs 1.69±0.45) and nitric oxide/endothelin-1(ET-1)(1.69±0.41 vs 2.67±0.86) significantly increased and atherogenic index(3.06±0.96 vs 2.58±0.80) significantly decreased(P<0.01). Conclusion The comprehensive intervention of exercise combined with diet can effectively improve anthropometry indicators, glycolipid metabolism, liver and kidney function as well as cardiovascular function of obese adolescents.