北欧式持杖健步走对糖尿病前期非酒精性脂肪肝绝经后女性腹部、肝脏脂肪及血脂的影响

发布时间：2018-03-09 23:31

本文选题：糖尿病前期　切入点：非酒精性脂肪肝　出处：《上海体育学院》2016年博士论文　论文类型：学位论文

【摘要】：研究目的本研究以糖尿病前期非酒精性脂肪肝的绝经后女性为研究对象,在不改变受试者其他任何生活方式的条件下,对其进行北欧式持杖健步走有氧运动干预,观察此干预方案对受试者身体成分、腹部脂肪组织质量、肝脏脂肪含量以及血脂相关生化指标的效果。探索有效的科学的运动干预方案,为防治T2DM、NAFLD提供参考。研究方法1.研究对象:根据排纳标准纳入45名上海市杨浦区糖尿病前期非酒精性脂肪肝病人为受试者,随机分成运动组(NW)和对照组(CON)共2组。35周干预后(去除流失人员)NW组17人,CON组14人。受试者均自愿参与研究,签署知情同意书。2.运动干预方案:运动干预以北欧式持杖健步走为运动方式。受试者在社区运动场地以群练的形式进行运动。运动强度从最大摄氧量的60%逐步提升至75%,运动时间由每次45分钟逐步提升至每次60分钟,次数由每周3次逐步提升至每周5次,共持续35周。3.测试指标:通过DXA定量评估受试者干预前后的身体成分;MRI定量评估其腹部脂肪质量(皮下脂肪、腹膜后脂肪和腹膜内脂肪);1H MRS定量评估其肝脏脂肪含量;检测血清空腹FFA、LDL、TC及TG水平。研究结果1.北欧式持杖健步走干预组35周干预后心肺功能加强;体重、上腹部、下腹部及全身脂肪含量下降显著(p0.05);对照组的去脂体重和瘦体重下降显著。2.北欧式持杖健步走干预组腹部SAT、RAT、IAT、VAT总质量;T10水平SAT、RAT、IAT和VAT的质量;L4-L5水平IAT和VAT的质量明显减少。与CON组相比,NW组腹部SAT总质量、T10水平的SAT和RAT质量组间差异显著(p0.05)。3.干预35周后,与对照组肝脏脂肪含量相比,NW组的肝脏脂肪堆积下降显著(p0.05)。NW组血清FFA、LDL、TC水平明显降低(p0.05);TG水平在35周干预后有下降趋势,但差异不具有统计学意义。4.全身脂肪含量与肝脏脂肪含量的干预后变化率呈高度相关(R0.7,p0.05);腰腹部脂肪含量、腹臀部脂肪含量、L2-L3水平IAT质量、L4-L5水平IAT质量、L4-L5水平VAT质量、TC水平、TG水平与肝脏脂肪含量的干预后变化率呈中度相关(0.4≤R0.7,p0.05)。研究结论1.35周北欧式持杖健步走有氧运动干预有效降低糖尿病前期非酒精性脂肪肝绝经后女性的体重、脂肪含量,包括上腹部(腰腹部)、下腹部(腹臀部)及全身脂肪含量,而且可以延缓去脂体重和瘦体重的下降趋势。2.北欧式持杖健步走干预可以降低糖尿病前期非酒精性脂肪肝绝经后女性人群的腹部SAT、RAT、IAT、VAT总质量;T10水平SAT、RAT、IAT和VAT的质量;L4-L5水平IAT和VAT的质量。北欧健走有效防止脂肪在肝脏外周部位的堆积,但对L2-L3水平SAT、RAT、IAT、VAT的质量的干预效果并不理想。3.北欧式持杖健步走干预可以降低糖尿病前期非酒精性脂肪肝绝经后女性的HFC且可以产生降低糖尿病前期非酒精性脂肪肝绝经女性的FFA、LDL、TC水平的效果。4.北欧式持杖健步走有氧运动干预对全身及局部的脂肪含量、血脂TC及TG水平与肝脏脂肪含量的干预效果之间密切相关。
[Abstract]:Purpose of this study is to pre diabetic non alcoholic fatty liver after menopause women as the research object, does not change in the subjects of any other way of life under the condition of the North European crutch walking aerobic exercise intervention, observe the intervention on subjects of body composition, abdominal adipose tissue quality the liver fat content, blood lipid and related biochemical effect. To explore the effective scientific exercise intervention program, to provide reference for prevention and therapy of T2DM, NAFLD. Methods 1. subjects: according to the inclusion criteria into the 45 Shanghai Yangpu District pre diabetes patients with nonalcoholic fatty liver as subjects and randomly divided into exercise group (NW) and control group (CON) 2 weeks after the intervention group.35 (removal of personnel loss) NW group 17, CON group of 14 people. The subjects were willing to participate in the study, informed consent.2. exercise intervention program: exercise intervention in the North European holding The rod was walking motion. Subjects in the exercise of community sports venues in the form of group practice. The exercise intensity from 60% VO2max increased gradually to 75%, the exercise time every 45 minutes up to 60 minutes each time, 3 times a week by the number of up to 5 times a week, a total of 35 weeks.3. through the DXA test index: quantitative assessment of body composition before and after the intervention of the subjects; the abdominal fat quality assessment MRI (Quantitative subcutaneous fat, retroperitoneal fat and intraperitoneal fat); the 1H MRS quantitative assessment of liver fat content; serum fasting FFA, LDL, TC and TG level. Results of the 1. North European crutch walking intervention group 35 weeks after the prognosis of cardiopulmonary function strengthened; weight, upper abdomen, lower abdomen and body fat content decreased significantly (P0.05); the control group lean body weight and lean body mass decreased significantly.2. Nordic crutch walking intervention group abdominal SAT, RAT, IAT VAT, total quality; T10 level SAT, RAT, IAT and VAT quality; quality level of L4-L5 IAT and VAT decreased significantly. Compared with the CON group, NW group, SAT total abdominal quality, SAT and RAT quality differences between groups T10 level was.3. (P0.05) 35 weeks after intervention, compared with the control content fatty liver group, NW group of fatty liver was significantly decreased (P0.05) in.NW group serum FFA, LDL, TC were significantly decreased (P0.05); TG level at 35 weeks after intervention decreased, but the difference was not statistically significant.4. body fat content and fat content in the liver after intervention were highly correlated (rate of change R0.7, P0.05); abdominal fat, abdominal fat buttocks, the level of L2-L3 IAT L4-L5 IAT the level of quality, quality, quality level of L4-L5 VAT, TC level, TG level and liver fat content after the intervention rate showed a moderate correlation (0.4 R0.7, P0.05). The research conclusion 1.35 week North European crutch walking Aerobics Dynamic intervention effectively reduce pre diabetes non weight, female alcoholic fatty liver fat content in postmenopausal women, including upper abdominal (abdomen), lower abdomen (belly hips) and body fat content, but also can delay the body fat and lean body mass decreased.2. Nordic crutch walking intervention can reduce pre diabetes non alcohol fatty liver in postmenopausal women's abdominal SAT, RAT, IAT, VAT total quality; T10 level of SAT, RAT, IAT and VAT quality; quality level of L4-L5 IAT and VAT. Nordic walking effectively prevent fat in the liver of peripheral parts of the heap, but on the level of L2-L3 SAT, RAT, IAT. The quality of the VAT intervention effect is not ideal.3. Nordic crutch walking intervention can reduce pre diabetes in nonalcoholic fatty liver disease in postmenopausal women with HFC and can reduce pre diabetes in nonalcoholic fatty liver disease in postmenopausal women FFA, LDL, TC level. Fruit.4. Nordic crutch walking aerobic exercise intervention on systemic and local fat content, closely related between the intervention effect of TC and TG levels of blood lipid and liver fat content.

【学位授予单位】：上海体育学院
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R587.1;R575.5

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