Mechanism of Action of 10-week Aerobic Exercise versus Combined Aerobic and Resistance Exercise in Improving the Microcirculation in Obese College Students

doi:10.12114/j.issn.1007-9572.2022.0118

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (19): 2349-2355.DOI: 10.12114/j.issn.1007-9572.2022.0118

Special Issue: 运动相关研究最新文章合辑；肥胖最新文章合辑

• Original Research·Clinical Quality Improvement • Previous Articles Next Articles

Mechanism of Action of 10-week Aerobic Exercise versus Combined Aerobic and Resistance Exercise in Improving the Microcirculation in Obese College Students

1. School of Physical Education, Hubei Minzu University, Enshi 445000, China
2. School of Physical Education, Guangxi Normal University for Nationalities, Chongzuo 532200, China
3. School of Music and Physical Education, Hubei Enshi College, Enshi 445000, China

Received:2022-02-25 Revised:2022-05-24 Published:2022-07-05 Online:2022-06-02
Contact: Huan ZHU
About author:
XIAO Z, ZHU H, HU J P, et al. Mechanism of action of 10-week aerobic exercise versus combined aerobic and resistance exercise in improving the microcirculation in obese college students[J]. Chinese General Practice, 2022, 25 (19) : 2349-2355, 2362.

10周有氧运动和有氧结合抗阻运动对肥胖大学生微循环功能的影响及机制研究

1．445000　湖北省恩施市，湖北民族大学体育学院
2．532200　广西壮族自治区崇左市，广西民族师范学院体育学院
3．445000　湖北省恩施市，湖北恩施学院音乐与体育学院

通讯作者: 朱欢
作者简介:
肖哲，朱欢，胡江平，等. 10周有氧运动和有氧结合抗阻运动对肥胖大学生微循环功能的影响及机制研究[J].中国全科医学，2022，25（19）：2349-2355，2362. [www.chinagp.net] 作者贡献：肖哲是本研究试验的执行者，负责试验实施、数据整理分析及论文撰写；朱欢、胡江平负责试验设计，并提出修改意见；杨梅、彭永、周慧敏参与试验的运动干预。
基金资助:
2020年湖北省高等学校省级教学研究项目(2020550); 2021年国家民委高等教育教学改革项目(21064); 2020年湖北省教育厅科学研究计划项目(Q20201905); 2021年湖北省教育厅科学研究计划项目(B2021445)

Abstract

Abstract:

Background

Microcirculation dysfunction is closely associated with the development of obesity. Exercise intervention could effectively improve the microcirculation in obese people, but the intensity of an exercise intervention schemes often lacks of individualization and precision. FATmax is a precise and individualized exercise intensity determined on the basis of individual fat oxidation rate.

Objective

To compare the effects of aerobic exercise and combined aerobic and resistance exercise at FATmax intensity on improving the microcirculation in obese college students, and to explore the mechanism of action by analyzing the changes in nitric oxide (NO) , endogenous NO synthase (eNOS) , endothelin-1 (ET-1) and endothelial growth factor (VEGF) .

Methods

In March, 2021, Sixty-six obese college students were recruited from Hubei University for Nationalities, and equally randomized into sex-matched three groups with different 10-week interventions: aerobic exercise group (performing aerobic exercise at the FATmax intensity, 4 times a week, 60 minutes each time) , combined aerobic and resistance exercise group〔performing combined aerobic and resistance exercise at FATmax intensity, 4 times a week, 60 minutes each time (40 minutes for aerobic exercise and 20 minutes for resistance exercise) 〕, and control group (maintaining their normal living habits) . Body weight, body fat percentage, BMI, microvascular reactivity, transcutaneous oxygen pressure (TcPO₂) , muscle oxygen saturation (SmO₂) , NO, eNOS, ET-1, VEGF and HOMA-IR were tested on March 18 and June 2, 2021, respectively.

Results

The intervention modality and duration had significant interactive effects on body weight, BMI and body fat percentage of three groups (P<0.05) . In particular, the average body weight, BMI and body fat percentage decreased significantly in both aerobic exercise group and combined aerobic and resistance exercise group after the intervention (P<0.05) . What's more, the average post-intervention levels of the above-mentioned three indicators in the two groups were significantly lower than those of the control group (P<0.05) . The intervention modality and duration had significant interactive effects on microvascular reactivity, TcPO₂ and SmO₂ of three groups (P<0.05) . In particular, the average microvascular reactivity, TcPO₂ and SmO₂ increased significantly in both aerobic exercise group and combined aerobic and resistance exercise group after the intervention (P<0.05) . In addition, the average post-intervention levels of the average microvascular reactivity and TcPO₂ in the two groups were significantly higher than those of the control group (P<0.05) . The intervention modality and duration produced obvious interactive effects on NO, eNOS, VEGF and HOMA-IR of three groups (P<0.05) . In particular, the average NO, eNOS, and VEGF increased significantly and HOMA-IR decreased significantly in both aerobic exercise group and combined aerobic and resistance exercise group after the intervention (P<0.05) . Moreover, these two groups showed higher average post-intervention levels of NO and lower average post-intervention level of HOMA-IR than the control group (P<0.05) .

Conclusion

Both 10-week aerobic exercise and combined aerobic and resistance exercise at FATmax intensity could reduce body weight, body fat percentage, BMI and HOMA-IR in obese college students, and the latter may be more effective in improving microvascular reactivity and HOMA-IR. These two modalities of exercise improved microcirculation may be by improving the levels of NO, ET-1, VEGF and other factors.

Key words: Obesity, Obesity management, Aerobic exercise, Resistance exercise, Maximum fat oxidation intensity, Microcirculation function

摘要：

背景

微循环功能障碍与肥胖的发生、发展都有密切关系。运动干预是改善肥胖人群微循环功能的有效方式，但运动强度的制定存在缺乏个体差异性及精度不够等问题。FATmax基于个体化的脂肪氧化速率而定，能实现运动强度的精准化、个体化。

目的

比较FATmax下的有氧运动和有氧结合抗阻运动对肥胖大学生微循环功能的影响，并从一氧化氮（NO）、内源性一氧化氮合酶（eNOS）、内皮素-1（ET-1）、内皮细胞生长因子（VEGF）角度探讨运动改善微循环功能的机制。

方法

2021年3月，从湖北民族大学招募66例符合标准的肥胖大学生为研究对象。在性别比例一致的情况下，随机将66例受试者分成对照组、有氧运动组及有氧结合抗阻运动组。有氧运动组进行4次/周、60 min/次的有氧运动，有氧结合抗阻运动组进行4次/周有氧结合抗阻运动，其中有氧运动和抗阻运动强度均维持在FATmax；对照组受试者维持正常的生活习惯。分别在试验前1 d和试验后1 d测试三组受试者体质量、体脂率、体质指数（BMI）、微血管反应性、经皮氧分压（TcPO₂）、肌氧饱和度（SmO₂）及NO、eNOS、ET-1、VEGF、胰岛素抵抗指数（HOMA-IR）等指标。

结果

试验前后，三组受试者体质量、BMI和体脂率治疗与时间的交互作用具有统计学意义（P<0.05），其中有氧运动组和有氧结合抗阻运动组体质量、BMI和体脂率均低于试验前及对照组，差异有统计学意义（P<0.05）；三组受试者微血管反应性、TcPO₂、SmO₂治疗与时间的交互作用具有统计学意义（P<0.05），有氧运动组和有氧结合抗阻运动组微血管反应性、TcPO₂高于试验前及对照组，SmO₂高于试验前，差异有统计学意义（P<0.05）；三组受试者NO、eNOS、VEGF、HOMA-IR治疗与时间的交互作用具有统计学意义（P<0.05），有氧运动组和有氧结合抗阻运动组NO高于试验前及对照组，eNOS、VEGF高于试验前，HOMA-IR低于试验前及对照组，差异有统计学意义（P<0.05）。

结论

10周基于FATmax的有氧运动和有氧结合抗阻运动均能降低肥胖大学生体质量、体脂率、BMI及HOMA-IR，且有氧结合抗阻运动在改善微血管反应性、胰岛素抵抗方面效果更佳。另外，运动可能通过改善NO、ET-1、VEGF等因子水平提高肥胖大学生微循环功能。

关键词: 肥胖症, 肥胖管理, 有氧运动, 抗阻运动, 最大脂肪氧化强度, 微循环功能

Zhe XIAO,Huan ZHU,Jiangping HU, et al. Mechanism of Action of 10-week Aerobic Exercise versus Combined Aerobic and Resistance Exercise in Improving the Microcirculation in Obese College Students[J]. Chinese General Practice, 2022, 25(19): 2349-2355. DOI: 10.12114/j.issn.1007-9572.2022.0118.
肖哲,朱欢,胡江平等. 10周有氧运动和有氧结合抗阻运动对肥胖大学生微循环功能的影响及机制研究[J]. 中国全科医学, 2022, 25(19): 2349-2355. DOI: 10.12114/j.issn.1007-9572.2022.0118.

Figures/Tables 5

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组别		最大脂肪氧化速率（g/min）	FATmax对应的摄氧量		功率（W）	心率（次/min）
组别		最大脂肪氧化速率（g/min）	绝对值（ml/min）	相对值（ml·kg^-1·min^-1）	功率（W）	心率（次/min）
试验前
	有氧运动组	0.39±0.32	1 468±456	20.26±5.45	77±18	130±18
	联合运动组	0.40±0.25	1 492±346	20.42±4.21	78±21	128±16
第5周
	有氧运动组	0.51±0.21	1 508±311	21.88±4.15	85±14	135±20
	联合运动组	0.53±0.19	1 539±401	22.22±3.82	88±20	134±23

组别		最大脂肪氧化速率（g/min）	FATmax对应的摄氧量		功率（W）	心率（次/min）
组别		最大脂肪氧化速率（g/min）	绝对值（ml/min）	相对值（ml·kg^-1·min^-1）	功率（W）	心率（次/min）
试验前
	有氧运动组	0.39±0.32	1 468±456	20.26±5.45	77±18	130±18
	联合运动组	0.40±0.25	1 492±346	20.42±4.21	78±21	128±16
第5周
	有氧运动组	0.51±0.21	1 508±311	21.88±4.15	85±14	135±20
	联合运动组	0.53±0.19	1 539±401	22.22±3.82	88±20	134±23

组别	例数	男/女	年龄（±s，岁）	身高（±s，m）	体质量（±s，kg）	体脂率（±s，%）	BMI（±s，kg/m²）
对照组	22	8/14	20.9±1.7	1.63±0.08	73.67±8.92	33.08±3.72	27.70±2.04
有氧运动组	22	8/14	20.8±1.1	1.64±0.08	72.47±7.73	32.47±4.30	26.94±2.14
联合运动组	22	8/14	20.8±1.8	1.63±0.09	73.03±9.13	32.98±4.70	27.32±2.29
F值		-	0.034	0.073	0.066	0.543	0.496
P值		-	0.967	0.930	0.937	0.585	0.613

组别	例数	男/女	年龄（±s，岁）	身高（±s，m）	体质量（±s，kg）	体脂率（±s，%）	BMI（±s，kg/m²）
对照组	22	8/14	20.9±1.7	1.63±0.08	73.67±8.92	33.08±3.72	27.70±2.04
有氧运动组	22	8/14	20.8±1.1	1.64±0.08	72.47±7.73	32.47±4.30	26.94±2.14
联合运动组	22	8/14	20.8±1.8	1.63±0.09	73.03±9.13	32.98±4.70	27.32±2.29
F值		-	0.034	0.073	0.066	0.543	0.496
P值		-	0.967	0.930	0.937	0.585	0.613

组别	例数	体质量（kg）		BMI（kg/m²）		体脂率（%）
组别	例数	试验前	试验后	试验前	试验后	试验前	试验后
对照组	22	73.67±8.92	74.41±8.40	27.70±2.04	28.01±1.72	33.08±3.72	33.73±4.72
有氧运动组	22	72.47±7.73	68.52±7.53^ab	26.94±2.14	25.52±2.03^ab	32.47±4.30	29.91±3.60^ab
联合运动组	22	73.03±9.13	67.92±11.76^ab	27.32±2.29	25.44±2.30^ab	32.98±4.70	29.63±3.92^ab
F值		F_组间=5.764，F_交互=4.763，F_时间=5.104		F_组间=4.280，F_交互=4.320，F_时间=5.940		F_组间=4.771，F_交互=5.764，F_时间=4.075
P值		P_组间=0.013，P_交互=0.030，P_时间=0.026		P_组间=0.042，P_交互=0.041，P_时间=0.017		P_组间=0.031，P_交互=0.013，P_时间=0.046

Mechanism of Action of 10-week Aerobic Exercise versus Combined Aerobic and Resistance Exercise in Improving the Microcirculation in Obese College Students

10周有氧运动和有氧结合抗阻运动对肥胖大学生微循环功能的影响及机制研究

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组别	例数	MBP基础值（PU）		MBP加热值（PU）		TcPO₂（mm Hg）		SmO₂（%）
组别	例数	试验前	试验后	试验前	试验后	试验前	试验后	试验前	试验后
对照组	22	8.45±4.01	8.43±2.36	90.15±19.60	86.95±18.12	59.87±7.34	58.81±7.26	61.60±5.67	60.09±6.25
有氧运动组	22	7.78±2.00	7.93±2.56	89.94±20.11	105.25±19.38^ab	59.02±6.98	65.92±7.28^ab	61.56±6.99	64.93±5.41^a
联合运动组	22	7.83±2.58	8.32±2.46	89.10±20.32	123.32±26.11^abc	59.13±7.13	67.49±7.50^ab	59.82±6.23	65.11±4.95^a
F值		F_组间=0.444，F_交互=0.081，F_时间=0.155		F_组间=6.888，F_交互=7.704，F_时间=16.931		F_组间=3.117，F_交互=4.598，F_时间=11.935		F_组间=1.598，F_交互=3.229，F_时间=4.496
P值		P_组间=0.642，P_交互=0.922，P_时间=0.694		P_组间=0.002，P_交互=0.001，P_时间<0.001		P_组间=0.048，P_交互=0.012，P_时间=0.001		P_组间=0.207，P_交互=0.044，P_时间=0.036

组别	例数	MBP基础值（PU）		MBP加热值（PU）		TcPO₂（mm Hg）		SmO₂（%）
组别	例数	试验前	试验后	试验前	试验后	试验前	试验后	试验前	试验后
对照组	22	8.45±4.01	8.43±2.36	90.15±19.60	86.95±18.12	59.87±7.34	58.81±7.26	61.60±5.67	60.09±6.25
有氧运动组	22	7.78±2.00	7.93±2.56	89.94±20.11	105.25±19.38^ab	59.02±6.98	65.92±7.28^ab	61.56±6.99	64.93±5.41^a
联合运动组	22	7.83±2.58	8.32±2.46	89.10±20.32	123.32±26.11^abc	59.13±7.13	67.49±7.50^ab	59.82±6.23	65.11±4.95^a
F值		F_组间=0.444，F_交互=0.081，F_时间=0.155		F_组间=6.888，F_交互=7.704，F_时间=16.931		F_组间=3.117，F_交互=4.598，F_时间=11.935		F_组间=1.598，F_交互=3.229，F_时间=4.496
P值		P_组间=0.642，P_交互=0.922，P_时间=0.694		P_组间=0.002，P_交互=0.001，P_时间<0.001		P_组间=0.048，P_交互=0.012，P_时间=0.001		P_组间=0.207，P_交互=0.044，P_时间=0.036

组别	例数	NO（μmol/L）		eNOS（U/mL）		ET-1（ng/L）		VEGF（ng/L）		HOMA-IR
组别	例数	试验前	试验后	试验前	试验后	试验前	试验后	试验前	试验后	试验前	试验后
对照组	22	39.49±4.88	37.91±5.10	7.98±0.84	7.73±0.90	49.80±6.84	50.91±7.09	160.65±14.58	157.41±15.34	2.76±0.25	2.80±0.47
有氧运动组	22	39.85±4.18	44.78±4.38^ab	7.54±1.14	8.45±1.40^a	51.38±6.34	46.84±5.92^a	159.01±14.15	177.37±16.45^a	2.68±0.41	2.45±0.34^ab
联合运动组	22	39.03±5.89	45.20±6.14^ab	7.59±0.89	9.08±1.01^a	51.16±7.07	44.68±6.53^a	160.95±15.09	173.99±16.40^a	2.73±0.21	2.27±0.26^abc
F值		F_组间=3.743，F_交互=3.929，F_时间=6.833		F_组间=1.308，F_交互=4.255，F_时间=8.353		F_组间=0.805，F_交互=2.113，F_时间=4.451		F_组间=2.640，F_交互=3.222，F_时间=6.723		F_组间=4.430，F_交互=3.196，F_时间=7.420
P值		P_组间=0.029，P_交互=0.024，P_时间=0.011		P_组间=0.227，P_交互=0.018，P_时间=0.005		P_组间=0.451，P_交互=0.129，P_时间=0.039		P_组间=0.079，P_交互=0.046，P_时间=0.012		P_组间=0.016，P_交互=0.047，P_时间=0.008

组别	例数	NO（μmol/L）		eNOS（U/mL）		ET-1（ng/L）		VEGF（ng/L）		HOMA-IR
组别	例数	试验前	试验后	试验前	试验后	试验前	试验后	试验前	试验后	试验前	试验后
对照组	22	39.49±4.88	37.91±5.10	7.98±0.84	7.73±0.90	49.80±6.84	50.91±7.09	160.65±14.58	157.41±15.34	2.76±0.25	2.80±0.47
有氧运动组	22	39.85±4.18	44.78±4.38^ab	7.54±1.14	8.45±1.40^a	51.38±6.34	46.84±5.92^a	159.01±14.15	177.37±16.45^a	2.68±0.41	2.45±0.34^ab
联合运动组	22	39.03±5.89	45.20±6.14^ab	7.59±0.89	9.08±1.01^a	51.16±7.07	44.68±6.53^a	160.95±15.09	173.99±16.40^a	2.73±0.21	2.27±0.26^abc
F值		F_组间=3.743，F_交互=3.929，F_时间=6.833		F_组间=1.308，F_交互=4.255，F_时间=8.353		F_组间=0.805，F_交互=2.113，F_时间=4.451		F_组间=2.640，F_交互=3.222，F_时间=6.723		F_组间=4.430，F_交互=3.196，F_时间=7.420
P值		P_组间=0.029，P_交互=0.024，P_时间=0.011		P_组间=0.227，P_交互=0.018，P_时间=0.005		P_组间=0.451，P_交互=0.129，P_时间=0.039		P_组间=0.079，P_交互=0.046，P_时间=0.012		P_组间=0.016，P_交互=0.047，P_时间=0.008