基于学校的有组织的运动干预对肥胖青少年BMI和糖、脂代谢的影响

目的:探讨基于学校的有组织的运动干预对青春期早期肥胖青少年体重指数(BMI)和糖脂代谢的影响及其量效关系。方法:12~14岁肥胖青少年49名,按照BMI和个人意愿分为运动组(25名)和对照组(24名),运动组进行有组织的9个月、运动量两阶段(0~3个月,大运动量;4~9个月,小运动量)递减的运动干预。分别于运动前、3个月末和9个月末进行体格测试和空腹血脂、血糖、胰岛素水平和胰岛素抵抗指数检测。结果:(1)运动组男生和女生BMI在干预期末比干预前分别下降了0.3和0.5,对照组男生和女生BMI分别上升0.2和0.3。(2)运动组血清甘油三酯(TG)水平在第3个月末和9个月末与运动前相比均显著下降(P<0.05),对照组血清TG水平显著上升(P<0.05);运动组血清高密度脂蛋白胆固醇(HDL-C)在整个干预期间无显著性变化,而对照组血清HDL-C水平显著下降(P<0.01),且低于运动组水平(P<0.01)。(3)运动组血糖(P<0.01)、血清胰岛素水平(P<0.05)、胰岛素抵抗指数(HOMA-IR)(P<0.05)在运动干预后均显著下降;对照组血糖显著升高(P<0.05),血清胰岛素水平和HOMA-IR无显著性变化。(4)运动组高甘油三酯血症检出率和空腹血糖受损率在3个月末分别下降了66.7%和100%,并持续维持到9个月运动干预末;对照组则分别上升了2.25倍和1.98倍。结论:基于学校的有组织的运动干预可以有效地预防和延缓肥胖青少年肥胖的进一步发展,改善糖脂代谢,降低高甘油三酯血症和空腹血糖受损发生率。

Effect of School-Based Supervised Exercise Intervention on Body Mass Index and Glucolipid Metabolism in Chinese Obese Adolescents

Objective To study the effect of school based supervised exercise on the body mass index(BMI)and glucolipid metabolism in Chinese obese adolescents.Methods Forty nine obese adolescents(aged 12yrs to 14yrs)were divided into exercise group and control group.There was no difference in BMI between the two groups.The exercise group underwent a 9-month exercise intervention supervised by a PE teacher.The exercise volume in the first 3 months was higher than that in the last 6 months.The control group exercised freely without supervision.Anthropometry and fasting serum lipids,glucose,insulin and HOMA-IR were measured at month 0,3,9 of the intervention.Results (1)The BMI of boys and girls decreased by 0.3 and 0.5 respectively in exercise group as compared with the pre-intervention,whereas the BMI increased by 0.2 and 0.3 respectively in control group.(2)The serum TG level significantly decreased(P<0.05)in exercise group at the end of the 3rd and 9th month,while increased significantly in control group as compared with the pre-intervention(P<0.05).The serum HDL-C level remained unchanged in exercise group during the whole intervention,while decreased significantly in control group(P<0.01),and remained lower than in exercise group even after the intervention(P<0.01).(3)As compared with the pre-intervention,the fasting serum glucose level of post-intervention decreased in exercise group(P<0.01),but increased in control group(P<0.05).The insulin level and HOMA-IR decreased significantly and constantly in exercise group during the intervention(P<0.05),while there was no significant change in control group.(4)The hypertriglyceridemia rate and impaired fasting serum glucose rate in exercise group decreased by 66.7% and 100% respectively by the end of the 3rd month and kept the same level until the 9th month,and those in control group increased by 2.25 and 1.98 times respectively after the intervention.Conclusion School-based supervised exercise intervention could effectively prevent and delay the deterioration of obesity among the over-weighted adolescents and improve their glucolipid metabolism.