韓國成人中央肥胖與心血管疾病風險因子的關聯:運動的保護作用✔

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本研究探討了韓國健康成人的內臟脂肪與運動參與對C-反應蛋白、胰島素抗性和內皮功能障礙的影響。結果顯示,高內臟脂肪與心血管疾病標誌物顯著相關,而規律運動則有助於降低這些健康風險,即便體型無顯著差異。

Associations of visceral adiposity and exercise participation with C-reactive protein, insulin resistance, and endothelial dysfunction in Korean healthy adults

內臟脂肪和運動參與與C反應蛋白、胰島素抗性和內皮功能障礙在韓國健康成人中的關聯

Kim K, Valentine RJ, Shin Y, Gong K. Associations of visceral adiposity and exercise participation with C-reactive protein, insulin resistance, and endothelial dysfunction in Korean healthy adults. Metabolism. 2008 Sep;57(9):1181-9. doi: 10.1016/j.metabol.2008.04.009. PMID: 18702942.

https://pubmed.ncbi.nlm.nih.gov/18702942/

Abstract

The aim of the current study was to examine the associations of visceral adiposity and exercise participation with C-reactive protein (CRP), insulin resistance, and endothelial dysfunction in Korean adults selected from the general population. We studied 160 Korean adults (aged 41.3 +/- 13.0 years; n = 38 men and n = 122 women) who volunteered in a health promotion program. Subjects were divided into 2 groups based upon spontaneous exercise participation for using a cross-sectional approach. We measured anthropometric factors (body mass index [BMI], percentage body fat, waist-hip ratio [WHR], and abdominal fat area by computed tomographic scanning), blood pressure (BP), blood levels of glucose, lipids, fibrinogen, CRP, leptin, hemoglobin A(1c), homeostasis model assessment (HOMA), and carotid intima media thickness (IMT; via ultrasonography). Associations among the variables were assessed by Pearson partial correlation and linear regression, controlling for age and sex. Independent t tests were used to assess differences between exercise participants and nonparticipants. Significance was accepted at P < .05. As expected, the measures of adiposity (BMI, percentage body fat, WHR, abdominal fat area) were highly correlated with each other (r = .49-.86, P < .01). Blood levels of high-sensitivity CRP (hsCRP), leptin, and HOMA were modestly correlated with all measures of adiposity. Visceral fat area was the most important predictor of hsCRP, explaining 19.6% of the variance using stepwise linear regression analysis (P < .01). As visceral fat area tertiles increased from low to high, a significant stepwise increment in blood levels of CRP (P < .001), HOMA (P = .005), and left carotid IMT (P = .035) was observed. However, hsCRP and HOMA were not significantly different when compared across whole-body fat tertiles. Systolic BP, diastolic BP, and left carotid IMT were modestly correlated with WHR and visceral fat area (P < .05); but systolic BP and diastolic BP were also correlated with BMI and percentage body fat (P < .05). Therefore, the relative importance of central adiposity as opposed to total body fatness in endothelial dysfunction is unclear. Compared with the nonexercise group, exercise participants had significantly lower (P < .05) WHR, visceral fat area, ratio of visceral fat area to subcutaneous area, hsCRP, hemoglobin A(1c), and HOMA, with no significant differences in BMI, percentage body fat, and physical fitness. Central obesity with high visceral fat is strongly associated with blood level of hsCRP, insulin resistance, and endothelial dysfunction-related factors in healthy Korean adults. In addition, exercise participation, even in the absence of difference in physical fitness, may be protective against development of central obesity and insulin resistance in this understudied Korean population.

摘要

本研究的目的是檢驗韓國一般人口中內臟脂肪量和運動參與與C-反應蛋白(CRP)、胰島素抵抗和內皮功能障礙之間的關聯。我們研究了160名韓國成年人(年齡為41.3 +/- 13.0歲;男性38人,女性122人),他們自願參加了健康促進計劃。根據自發性運動參與情況,將受試者分為兩組,使用橫斷面方法進行研究。我們測量了人體測量指標(身體質量指數[BMI]、百分比體脂肪、腰臀比[WHR]和通過計算機斷層掃描測量的腹部脂肪面積)、血壓(BP)、血液中的葡萄糖、脂質、纖維蛋白、CRP、瘦素、血紅蛋白A(1c)、家庭內平衡模型評估(HOMA)和頸動脈內膜中層厚度(IMT;通過超聲波測定)。通過皮爾森偏相關和線性迴歸,控制年齡和性別,評估變量之間的關聯。使用獨立t檢驗評估運動參與者和非參與者之間的差異。在P < 0.05水平上接受顯著性。預期的是,脂肪量測(BMI、百分比體脂肪、WHR、腹部脂肪面積)彼此之間高度相關(r = 0.49-0.86,P < 0.01)。高敏感性CRP(hsCRP)、瘦素和HOMA的血液水平與所有脂肪量測有適度相關。內臟脂肪面積是hsCRP的最重要預測因子,在逐步線性迴歸分析中解釋了19.6%的變異(P < 0.01)。隨著內臟脂肪面積三分位數從低到高,CRP(P < 0.001)、HOMA(P = 0.005)和左側頸動脈IMT(P = 0.035)的血液水平顯著逐步增加。然而,當整體脂肪三分位數比較時,hsCRP和HOMA沒有顯著差異。收縮壓、舒張壓和左側頸動脈IMT與WHR和內臟脂肪面積適度相關(P < 0.05);但收縮壓和舒張壓還與BMI和百分比體脂肪相關(P < 0.05)。因此,相對於全身脂肪含量,中心性脂肪在內皮功能障礙中的相對重要性尚不清楚。與不參加運動的組相比,參與運動的人的WHR、內臟脂肪面積、內臟脂肪面積與皮下脂肪面積的比率、hsCRP、血紅蛋白A(1c)和HOMA顯著降低(P < 0.05),但BMI、百分比體脂肪和身體健康狀況沒有顯著差異。在韓國健康成年人中,高內臟脂肪的中心性肥胖與血液中hsCRP、胰島素抵抗和內皮功能障礙相關因子強烈相關。此外,即使在身體健康狀況無差異的情況下,參與運動可能也有助於預防中心性肥胖和胰島素抵抗在這個未研究的韓國人口中的發展。