| 范洪,张小琴,李竞.儿童肥胖相关血管异常的生活干预研究[J].Chinese journal of Epidemiology,2008,29(7):672-675 |
| 儿童肥胖相关血管异常的生活干预研究 |
| Effects of life style intervention on obesity-related vascular dysfunction in children |
| Received:November 12, 2007 |
| DOI： |
| KeyWord: 超重/肥胖 血管异常 动脉粥样硬化 生活干预 |
| English Key Word: Overweigh t/Obesity Vascular dysfunction Atherosclerosis Life style intervention |
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| Abstract: |
| 目的 通过饮食、运动干预评估与儿童肥胖相关的血管内皮功能障碍及颈动脉内膜中 层厚度增加的可逆性。方法 将78名9~12岁超重、肥胖儿童,随机分配至单纯饮食控制组(A组)、饮食控制加运动组(B组);B组又分为起始的短期运动6周组(SE组)及持续运动1年组(CE组)。用 髙分辨血管外趄声法检测肱动脉内皮功能(内皮依赖性血管舒张,EDD)及颈总动脉内膜中层厚度 (IMT),并测定体脂含量、血脂水平。结果 干预6周后,A组(6.36%±0.81%和5.32%±0.84%, P<0.01)、B组(7.46%±0.91 %和5.20%± 0.87%,P< 0.01)均有内皮功能改善;而B组改善有统 计学意义(P<0.01)。1 年后,SE组(6.38%±1.04%和5.22%±0.96%,P<0.05)、B组(8.29%士 0.78%和5.38%±0.65%,P<0.001)内皮功能均改善,CE组改善更为显著(P<0.05);CE组颈动脉 内膜中层增厚明显减轻(0.57 mm±0.05 mm和0.59 mm±0.07 mm,P<0.001)。结论 通过单纯 控制饮食或同时短期锻炼,肥胖相关的内皮功能障碍可部分逆转;而饮食控制同时持续锻炼1年,内皮功能改善更为持久,可使增厚的颈动脉内膜中层厚度部分恢复。 |
| English Abstract: |
| Objective To evaluate the reversibility of obesity-related arterial dysfunction and thickening carotid intima-media through dietary and/or exercise intervention programs. Methods Seventy- eight 9 to 12 year-old overweight children, were randomly assigned togroup A:only dietary modification,group B：diet plus a supervised structured exercise program for 6 weeks (SE) and subsequently for 1 year (CE). The prospectively defined primary end points were assessed through ultrasound-derived arterial endothelial function (endothelium-dependent dilation) of the brachial artery and intima-media thickness of common carotid artery. Results At 6 weeks, both interventions were associated with improved arterial endothelial function [group A: (6.36±0.81)%vs(5.32土0.84)%，P〈0.01;group B： (7.46土 0,91)%vs. (5.20 土 0.87)%, P< 0.01 ]. A conbination of diet and exercise were associated with a significantlygreater improvement in endothelial function than on diet alone (P<0.01). At 1 year, there appeared significantly less thickening of the carotid wall ingroup CE [(0.57 土 0.05) mm vs. (0.59 土 0.07)mm, P< 0.001). Compared with children ingroup SE [ (6.38 ± 1.04) %vs. (5,22 ± 0.96) %, P<0.05], vascular function appeared significantly better ingroup CE [(8.29 土 0.78)%vs. (5.38土 0.65) %,P< 0.001). Conclusion Obesity-related vascular dysfunction in young children was partially reversible with diet alone but more obvious when combined with exercise training for 6 weeks. Sustained improvements at 1 year was seen in those who persisted in diet program plus regular exercise. |
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