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运动减肥对肥胖儿童少年脂蛋白脂酶活性和血脂影响的研究

Effects of Exercise-Induced Weight Loss on Plasma LPL Activity and Plasma Lipid in Obese Children and Adolescents

作者: 专业:运动人体科学 导师:陈文鹤 年度:2010 学位:硕士  院校: 上海体育学院

Keywords

obese children and adolescent, exercise-induced weight loss, plasma lipid, lipoprotein lipase

        研究目的在评定肥胖程度、运动能力和健康状况的基础上,为肥胖儿童少年制定个性化的运动减肥处方,并在实施过程中进行监督指导。比较研究对象运动减肥前后身体形态指标(身高、体重、体脂、腰围、臀围等)、血液生化指标(空腹血脂、脂蛋白脂酶等)变化程度及变化规律。分析探讨4周中小强度长时间有氧运动对身体形态、血脂、脂蛋白酯酶活性的影响,为运动减肥的理论和方法提供实验依据。研究对象与方法研究对象:参加2009年上海市巅峰儿童青少年暑期减肥运动营的肥胖儿童少年29名,平均年龄13.20±0.44岁(8~17岁),其中,男15人,女14人。研究方法:采用问卷法对研究对象的饮食习惯、运动情况、疾病史、家族史、过敏史及肥胖发生过程等情况进行调查,了解研究对象的基本情况,确定其为单纯性肥胖;通过体质测试和运动负荷试验,了解其肥胖程度和运动能力,排除研究对象心血管系统的机能障碍,保证运动的安全性。取研究对象空腹肘静脉血,测定甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和脂蛋白脂酶(LPL)活性。根据体格检查、肥胖程度、运动负荷试验和血液生化指标测试结果,制定个性化的运动减肥处方。运动减肥持续4周,每周运动6天,每天运动5-6小时,以中小强度长时间有氧运动为原则,对研究对象减肥过程进行指导和监督。4周运动减肥结束后,测定相同的身体形态和血液指标。使用SAS6.12软件包对研究对象减肥前后的数据进行配对T检验。指标间的相关性采用线性相关分析,P<0.05为差别具有显著性统计学意义,P<0.01为差别具有非常显著性统计学意义。研究结果1.运动减肥前后形态指标的变化4周运动减肥后,肥胖儿童少年体重、体重指数(BMI)、体脂率和体脂量均明显下降,与减肥前相比,差异具有非常显著的统计学意义(p<0.01)。男女体重分别下降7.56kg、6.08kg,下降体重占减肥前体重10.13%、8.39%,BMI分别下降2.93、2.67,体脂率分别下降6.57%、6.70%,身体脂肪重量分别下降6.93kg、7.25kg。反映肥胖程度的围度减小非常明显(p<0.01),男性腰围(WC)减小14.90cm,臀围(HC)减小9.59cm,女性分别减少12.95cm和8.88cm。腰臀比(WHR)前后比较,差异具有非常显著的统计学意义(p<0.01)。2.运动减肥前后空腹血脂的变化4周运动减肥后,男性肥胖儿童少年TG由1.80mmol/L下降到0.67mmol/L,TC由5.06mmol/L下降到3.50mmol/L, LDL由2.90mmol/L下降到2.0mmol/L,HDL有下降趋势,但无统计学意义,LDL/HDL由2.33下降到1.75。女性TG由1.24mmol/L下降到0.7mmol/L, TC由4.44mmol/L下降到3.42mmol/L, LDL由2.55mmol/L下降到2.0mmol/L, HDL有下降趋势,但无统计学意义,LDL/HDL由2.21下降到1.93,差别都具有非常显著的统计学意义(p<0.01)。3.运动减肥前后空腹血清LPL活性的变化4周运动减肥后,男女肥胖儿童少年LPL的活性都明显升高,男性由529.34U/L上升到612.62U/L,p<0.05,女性由486.19U/L上升到543.18U/L,p<0.05,差别都具有显著的统计学意义。4.血清LPL活性和体脂率、腰围及年龄的关系男性肥胖儿童少年减肥前后LPL活性与减肥前后体脂率呈负相关,p<0.01,具有非常显著的统计学意义。女性肥胖儿童少年减肥前后LPL活性与减肥前后体脂率呈负相关,p<0.05,具有显著的统计学意义。男女肥胖儿童少年减肥前LPL活性与减肥前腰围存在负相关关系,p<0.05,具有显著的统计学意义。男女肥胖儿童少年减肥前后LPL活性和年龄存在负相关关系,p<0.05,具有显著的统计学意义结论1、中小强度长时间有氧运动是减肥的有效途径,能明显改善肥胖儿童少年身体形态。2、中小强度长时间有氧运动可以提高肥胖儿童少年空腹血清脂蛋白脂酶的活性,促进乳糜微粒和极低密度脂蛋白中甘油三酯的水解,提高机体利用脂肪供能的比例,改善体内脂类代谢。3、血清脂蛋白脂酶活性和腹型肥胖的程度呈负相关,两者可能存在互为因果关系。4、随着儿童少年肥胖年限的增加,肥胖儿童少年的血清脂蛋白脂酶活性逐渐下降,肥胖儿童少年运动减肥宜早期进行,有利于早期纠正脂代谢紊乱,降低成年后由于脂代谢紊乱而造成的代谢综合征的发生率。
    Research purposeThe aim of this research is to formulate individualized exercise prescription for the obese children and adolescents before and during exercise-induced weight loss and to supervise in practice. To measure the body shape indicators including body height, body weight, percentage of body fat, waistline, blood biochemical indicators including fasting plasma lipid and plasma LPL activity before and after weight reduction exercise. To find the effects of 4 weeks weight reduction exercise, and also to find what the effects are on plasma lipid and plasma LPL activity and to provide theoretical evidence for research on the method of exercise-induced weight loss.Subjects and methodSubjects:29 obese children and adolescents (male:15, female:14,8-17 yrs) who taking part in the adolescents Summer Sports Camp in Shanghai 2009.Methods:before the study, we investigated the eating habit, exercise habit, medical record, family medical history, hypersusceptibility history and obese history to make sure the subjects were simple obese adolescents. Physique test and exercise load test was made to know the subjects’health condition and exercise capacity and to exclude subjects who suffered from cardiovascular system dysfunction from normal subjects by ECG as well as exercise load test ECG.. Blood biochemical indicators including fasting plasma lipid, plasma LPL activity was obtained before study.We formulated individualized exercise prescription based on the results of the test. Obese children and adolescents took part in 4 weeks weight reduction plan,6 days per week and 5-6 hours everyday by moderate and low-intensity long duration aerobic exercise. Same measurement and test were carried out after 4 weeks. The data have been analyzed by SAS6.12 statistical package in student T test, the correlation between indicators have been analized in linear correlation. It was significantly changed by P <0.01 and obviously changed by P<0.05.Research result1.Body shape indicators change after 4 weeks intervention。The body weight, BMI, percentage of body fat decreased in obese children and adolescents after 4 weeks intervention (highly significant). Body weight decrease 7.56kg for male and 6.08kg for female (decreased 10.13% and 8.39%). BMI decreased 2.93 for male and 2.67 for female. Percentage of body fat decreased 6.57% for male and 6.70% for female. Body fat decreased 6.93kg for male and 7.25kg for female. WC decreased 14.90cm for male and 12.95cm for female (highly significant). HC decreased 9.59cm for male and 8.88cm for femal. Waist hip rate decreased both for male and femal (highly significant). 2. Fasting plasma lipid change after 4 weeks interventionAfter 4 weeks intervention, TG decreased from 1.80mmol/L to 0.67mmol/L for male and from 1.24mmol/L to 0.7mmol/L for female. TC decreased from 5.06mmol/L to 3.50mmol/L for male and from 4.44mmol/L to 3.42mmol/L for female. LDL decreased from 2.90mmol/L to 2.0mmol/L for male and from 2.55mmol/L to 2.0mmol/L for female. There were no significant changes in HDL for male and female although it tended to decrease. LDL/HDL decreased from 2.33 to 1.75 for male and from 2.21 to 1.93 for female (all highly significant).3. The change of fasting plasma LPL activity after 4 weeks intervention.After 4 weeks, the LPL activity increased both in male and female. It increased from 529.34U/L to 612.62U/L for male (highly significant) and from 486.19U/L to 543.18U/L (highly significant).4. The correlation between LPL activity and percentage of body fat, waist circumference and age.LPL activity is negatively related to the percentage of fat both in male and female (highly significant). LPL activity is negatively related to the waist circumference in male and female as a whole (highly significant). LPL activity is negatively related to age in male and female as a whole.Conclusions1. It is utility way to reduce body fat weight and improve the obese children and adolescents’body configuration indicators by moderate and low-intensity exercise.2. It is utility way to increase the LPL activity in blood serum of obese children and adolescents and to promote the hydrolysis of TG in triglyceride rich lipoprotein and then to improve the lipid metabolism of the children and adolescents by moderate and low-intensity exercise.3. LPL activity is negatively related to the degree of abdominal obesity, it exist causal relation between them reciprocally.4. The LPL activity in blood serum of obese children and adolescents will gradually decrease as they grow old, so it is good to carry out weight reduction exercise on earlier period and it will contribute to improve dyslipidemic states on earlier period, and to reduce the incidence rate of MS when they grow up.
        

运动减肥对肥胖儿童少年脂蛋白脂酶活性和血脂影响的研究

摘要4-6
Abstract6-7
1 前言11-12
2 文献综述12-25
    2.1 肥胖症概述12
    2.2 肥胖症的流行病学12
    2.3 肥胖症的病因和发病机制12-13
    2.4 LPL和肥胖症的关系13-18
        2.4.1 LPL概述13-14
        2.4.2 影响LPL活性的因素14-17
            2.4.2.1 血浆脂蛋白对LPL活性的影响14-15
            2.4.2.2 肌纤维类型对肌肉组织LPL活性的影响15
            2.4.2.3 饮食对肌肉组织和脂肪组织LPL活性的影响15
            2.4.2.4 运动对LPL活性的影响15-17
        2.4.3 LPL活性与代谢综合征,腹型肥胖的关系17
        2.4.4 LPL活性与糖尿病的关系17-18
        2.4.5 LPL活性与冠心病的关系18
    2.5 肥胖症对健康的危害18-20
        2.5.1 肥胖症与脂代谢紊乱19
        2.5.2 肥胖症与血液流变学异常19
        2.5.3 肥胖症与心血管疾病19-20
        2.5.4 肥胖症与糖尿病20
        2.5.5 肥胖症与肺功能20
    2.6 肥胖症的治疗20-24
        2.6.1 饮食疗法20-21
        2.6.2 中医疗法21
        2.6.3 药物疗法21
        2.6.4 运动疗法21-24
            2.6.4.1 运动减肥的机制21-22
            2.6.4.2 运动处方的制定22-24
        2.6.5 运动结合饮食调整疗法24
    2.7 运动减肥对儿童少年生长发育和健康的影响24-25
3 研究对象与方法25-28
    3.1 研究对象25
    3.2 研究方法25-28
        3.2.1 问卷调查法25
        3.2.2 实验法25-28
            3.2.2.1 运动处方的制定25-26
            3.2.2.2 运动处方的实施26
            3.2.2.3 饮食调整26
            3.2.2.4 测试指标与方法26-28
        3.2.3 统计学分析28
4 研究结果28-33
    4.1 运动减肥前后研究对象身体形态指标的变化28
    4.2 运动减肥前后研究对象空腹血脂及LPL活性的变化28-29
    4.3 LPL活性和体脂率、腰围及年龄的关系29-33
5 分析讨论33-40
    5.1 中小强度长时间有氧运动对身体形态学指标的影响33-35
        5.1.1 中小强度长时间有氧运动对体脂率的影响33-34
        5.1.2 中小强度长时间有氧运动对围度的影响34-35
    5.2 中小强度长时间有氧运动对空腹血脂的影响35-37
        5.2.1 中小强度长时间有氧运动对空腹TG水平的影响35-36
        5.2.2 中小强度长时间有氧运动对空腹TC水平的影响36
        5.2.3 中小强度长时间有氧运动对空腹LDL水平的影响36
        5.2.4 中小强度长时间有氧运动对空腹HDL水平的影响36-37
    5.3 中小强度长时间有氧运动对LPL活性的影响37-38
    5.4 LPL活性与血脂成分之间的关系38-39
    5.5 LPL活性与年龄的关系39
    5.6 LPL活性与腰围及体脂率的关系39-40
6 结论40-41
7 参考文献41-48
8 致谢48
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