Особенности окисления жиров при физических нагрузках различной интенсивности у больных абдоминальным ожирением

Цель исследования - изучить характер окисления жиров при физической нагрузке различной интенсивности и выявить факторы, влияющие на этот процесс у больных абдоминальным ожирением. В исследование включены 90 пациентов в возрасте от 30 до 55 лет с абдоминальным ожирением (АО). Окисление жиров (ОЖ) во время физической нагрузки (ФН) определяли методом непрямой калориметрии с оценкой максимального потребления кислорода (VO2peak), анаэробного порога (АП), дыхательного коэффициента (RQ). Оценивали уровень физической активности (ФА) и состав тела. У больных АО максимальное ОЖ происходит при ФН низкой интенсивности и снижается по мере ее увеличения. Установлена связь между ОЖ и уровнем АП (r=0,6; р=0,0001), резервом частоты сердечных сокращений на пике ФН (r=0,8; p=0,001), расходом энергии во время физических тренировок (r=0,98; p=0,016) и общим расходом энергии при ФА (r=0,3; p=0,035), тощей массой тела (r=0,3; p=0,04) и давностью ожирения (r=0,6; p=0,04).

абдоминальное ожирение, окисление жиров, непрямая калориметрия, физическая нагрузка, физическая активность

1. Spataro J., Dyer A., Stameer J. Measures of adiposity and coronary heart disease mortality in the Chicago Western Electric Company Study. J Clin Epidemiol 1996; 49: 8: 849-857.

2. Kershaw E.E., Fllier J.S. Adipose Tissue as an Endocrine Organ. J Clin Endocrinol Metab 2004; 89: 2548-2556.

3. Haffner S. Waist circumference and body mass index are both independently associated with cardiovascular disease. The International Day for the Evaluation of Abdominal Obesity (IDEA) survey. 2006.

4. Solomon C.G., Manson J.E. Obesity and mortality: a review of the epidemiologic data. Am J Clin Nutr 1997; 66: Suppl 4: 1044S-1050S.

5. Flatt J.P. Important of nutrient balance in body weight regulation. Diabetes Metab Rev 1988; 6: 571-581.

6. Buscemi S., Maggio O., Blunda G. et al. A low resting metabolic rate is associated to body weight gain in adult Caucasian subjects: preliminary results of a 8-10 year longitudinal study. Ins J Obes 1998; 22: Suppl 1: S75.

7. Zurlo F., Lillioja S., Puente AE-D. et al. Low ratio of fat to carbohydrate oxidation as predictor of weight gain: Study of 24-h RQ. Am J Physiol 1990; 259: E650-E657.

8. Ranneries C., Bulow J., Buemann B. et al. Fat metabolism in formerly obese women. Am J Physiol Endocrinol Metab 1998; 274: E155-E161.

9. Blaak E.E., Van Baak M.A., Kemerink G.J. et al. β-Adrenergic stimulation of energy expenditure and forearm skeletal muscle metabolism in lean and obese men. Am J Physiol Endocrinol Metab 1994; 267: E306-E315.

10. Ferraro R.T., Eckel R.H., Larson D.E. et al. Relationship between skeletal muscle lipoprotein lipase activity and 24-hour macronutrient oxidation. J Clin Invest 1993; 92: 441-445.

11. Zurlo F., Nemeth P., Choksi R. et al. Whole-body energy metabolism and skeletal muscle biochemical characteristics. Metabolism 1994; 43: 481-486.

12. Alberti G. Introduction to the metabolic syndrome. Eur Heart J 2005; 7: Suppl D: D3-D5.

13. Armstrong L., Balady G.J., Berry M.J. et al. ACSM's Guidelines for Exercise Testing and Prescription. 7th ed. Baltimore, Maryland: Lippincott Williams &Wilkins 2006; 3-5.

14. Jakson A.S., Pollock M.L. Practical assessment of body composition. Physiol Sport Med 1985; 13: 3: 76-90.

15. Coyle E.F., Jeukendrup A.E., Oseto M.C. et al. Low-fat diet alter intramuscular substrates and reduces lipolysis and fat oxidation during exercise. Am J Physiol Endocrinol Metab 2001; 280: E391-398.

16. Weltan S.M., Bosch A.N., Dennis S.C., Noakes T.D. Influence of muscle glycogen content on metabolic regulation Am J Physiol 1998; 274: E72082.

17. Van Loon L.J., Jeukendrup A.E., Saris W.H., Wagenmakers A.J. Effect of training status on fuel selection during submaximal exercise with glucose ingestion. J Appl Physiol 1999; 87: 1413-1420.

18. Achten J., Jeukendrup A. Relation between plasma lactate concentration and fat oxidation rates over a wide range of exercise intensities. Int J Sports Med 2004; 25: 32-37.

19. Romijn J.A., Coyle E.F., Sidossis L.S. et al. Substrate metabolism during different exercise intensities in endurance-trained women. J Appl Physiol 2000; 88: 1707-1714.

20. Romijn J.A., Coyle E.F., Sidossis L.S. et al. Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity and duration. Am J Physiol Endocrinol Metab 1993; 265: E380-E391.

21. Deriaz O., Dumont M., Bergeron N. et al. Skeletal muscle low attenuation area and maximal fat oxidation rate during submaximal exercise in male obese individuals. Intern J Obes 2001; 25: 1579-1584.

22. Petez-Martin A., Dumortier M., Raynaud E. et al. Balance of substrate oxidation during submaximal exercise in lean and obese people. Diabetes Metab 2001; 27: 466-474.

23. Bircher S., Knechtle B. Relationship between FO and LT in athletes and obese women and men. J Sports Science Med 2004; 3: 174-181.

24. Randle P.J., Garland P.B., Hales C.N., Newsholme E.A. The glucose fatty-acid cycle. Its role in insulin sensitivity and metabolic disturbances of diabetes mellitus. Lancet 1963; 1: 785-789.

25. Horowitz J., Mora-Rodriguez R., Byerley L., Coyle E. Lipolitic suppression following carbohydrate ingestion limits fat oxidation during exercise. Am J Physiol 1997; 273: E768-775.

26. Venables M., Achten J., Jeukendrup A. Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study. J Appl Physiol 2004; 98: 160-167.

27. Hansen K., Shiver T., Schoeller D. The effects of exercise on the storage and oxidation fat. Sports Med 2005; 35: 5: 363-373.

28. Dorien P.C., Van Aggel-Leijssen, Wim H.M. Saris, Anton J.M. Wagenmakers et al. Effect of exercise training at different intensities on fat metabolism of obese men. J Appl Physiol 2002; 92: 1300-1309.

29. Astrup A., Buemann B., Western P. et al. Obesity as an adaptation to a high-fat diet: evidence from a cross-sectional study. Am L Clin Nutr 1994; 59: 350-355.

30. Weyer C., Pratley R., Sable A. et al. Energy Expenditure, FO, and body weight regulation: A study of metabolic adaptation to long-term Weight change J Clin Endocrin Metab 2000; 85: 1087-1094.