Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Effect of Exercise Type and Intensity on Insulin Resistance and Cardiovascular Disease Risk Factors in Obese Middle Aged Women

운동 형태와 강도의 차이가 중년비만여성의 인슐린 저항성 및 심혈관질환 위험요인에 미치는 영향

  • Lee, Dae-Hee (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University) ;
  • Oh, Du-Hwan (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University) ;
  • Zhang, Seok-Am (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University) ;
  • Lee, Jang-Kyu (Dept. of Kinesiology & Medical Science, Graduate School, Dankook University)
  • 이대희 (단국대학교 대학원 운동의과학과) ;
  • 오두환 (단국대학교 대학원 운동의과학과) ;
  • 장석암 (단국대학교 대학원 운동의과학과) ;
  • 이장규 (단국대학교 대학원 운동의과학과)
  • Received : 2016.05.23
  • Accepted : 2016.06.02
  • Published : 2016.06.30
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Abstract

This study examined the effects of exercise intensity and type on insulin resistance, cardiovascular disease risk factors, and exercise time. Obese thirty-two subjects (>body fat 30%) were randomly assigned one of four experimental groups: VO2 max 50% aerobic exercise group (MAE, n=8), VO2 max 80% aerobic exercise group (VAE, n=8), VO2 max 50% + resistance exercise group (MARE, n=8), and VO2 max 80% + resistance exercise group (VARE, n=8). Body fat significantly decreased in all groups and insulin resistance decreased significantly in MARE and VARE (p<.05 & p<.01) after exercise. CRP and IL-6 were slightly reduced after exercise, although these did not reach statistical significance, whereas the IL-6 level of the VAE group decreased significantly (p<.05). TNF-${\alpha}$ significantly decreased in the MAE group (p<.05) but significantly increased in the VARE group after exercise (p<.05). For exercise time, higher intensity exercise groups were significantly less than the lower intensity exercise groups (p<.001). These results suggest that body fat is affected by all kinds of exercise intensity and type while CRP is not. Insulin resistance and TNF-${\alpha}$ were affected by exercise type, whereas IL-6, TNF-${\alpha}$, and exercise time were affected by exercise intensity.

이 연구의 목적은 8주간 동일한 운동량(일일 400kcal)으로 강도별 유산소성운동과 복합운동이 인슐린저항성과 심혈관질환 위험요인, 시간적 효율성에 어떠한 영향을 미치는 지를 구명하고자 한다. 2014년6월부터 2014년8월까지 40세 이상의 체지방률 30%이상인 여성 32명을 대상으로 하였으며, 유산소운동집단은 VO2max 50%(MAE, n=8)과 VO2max 80%(VAE, n=8)으로, 복합운동집단은 VO2max 50%+저항성운동(MARE, n=8)과 VO2max 80%+저항성운동(VARE, n=8)으로 각각 무선배정 하였다. 이 연구의 결과에서, 체지방률은 운동 후 모든 집단에서 유의한 감소를 보였으며, 인슐린저항성은 복합운동 두 집단에서 운동 후 유의하게 감소하였다(p<.05 & p<.01). CRP는 운동 후 낮아지는 경향을 보였지만 통계적으로 유의한 차이는 나타나지 않았으며 IL-6 또한 모든 집단에서 낮아지는 경향을 보였으나 VAE집단에서만 유의하게 낮아진 것으로 나타났다(p<.05). TNF-${\alpha}$의 농도의 변화에서는 MAE집단에서는 8주 후, 유의하게 감소되었지만(p<.05), VARE집단에서는 오히려 유의하게 증가되었다(p<.05). 운동시간의 변화에서는 모든 시기에서 낮은 강도의 운동집단보다는 높은 강도의 운동집단에서 유의하게 운동시간이 짧은 것으로 나타났다(p<.001). 이러한 결과는 체지방률은 운동의 강도와 형태에 관계없이 영향을 받는 것으로 나타났으며 CRP는 운동의 강도와 형태에 별다른 영향을 받지 않는 것으로 나타났다. 인슐린저항성과 TNF-${\alpha}$의 농도는 운동의 형태에 따라 어느 정도 영향을 받는 것으로 생각되며 IL-6와 TNF-${\alpha}$, 운동시간은 운동 강도에 영향을 받는 것으로 나타났고 특히 운동시간의 변화에서는 보다 큰 영향을 미치는 것으로 사료된다.

Keywords

References

  1. Statistics Korea, 2014 Social Survey in Busan, 2015.
  2. Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, & Friedman, J. M, "Positional cloning of the mouse obese gene and its human homologue. Nature", Erratum in: Nature, 1, 372(6505), pp. 425-32, 1994. https://doi.org/10.1038/372425a0
  3. Rokling-Andersen M. H, Reseland J. E, Veierod M. B, Anderssen S. A, Jacobs D. R, Jr, Urdal. P, Jansson J. O, & Drevon C. A, "Effects of long-term exercise and diet intervention on plasma adipokine concentrations," American Joural of Clinical Nutrition, 86(5), pp. 1293-301, 2007. https://doi.org/10.1093/ajcn/86.5.1293
  4. Fain JN. Release of inflammatory mediators by human adipose tissue is enhanced in obesity and primarily by the nonfat cells: a review. Mediators Inflamm. 2010; 2010:513948. Epub 2010 May 23. Review. DOI: http://dx.doi.org/10.1155/2010/513948
  5. Caprio S1. Definitions and pathophysiology of the metabolic syndrome in obese children and adolescents. Int J Obes (Lond). Suppl 2, pp. 24-5, 2005.
  6. Frank LL, Sorensen BE, Yasui Y, Tworoger SS, Schwartz RS, Ulrich CM, Irwin ML, Rudolph RE, Rajan KB, Stanczyk F, Bowen D, Weigle DS, Potter JD, McTiernan A. "Effects of exercise on metabolic risk variables in overweight postmenopausal women". a randomized clinical trial. Obes Res, 13(3), pp. 615-25, 2005. DOI: http://dx.doi.org/10.1038/oby.2005.66
  7. Pacifico L, Anania C, Martino F, Poggiogalle E, Chiarelli F, Arca M, Chiesa C. "Management of metabolic syndrome in children and adolescents". Nutr Metab Cardiovasc Dis, 21(6), pp. 455-66, 2011. DOI: http://dx.doi.org/10.1016/j.numecd.2011.01.011
  8. Goedecke JH1, Micklesfield LK. "The effect of exercise on obesity, body fat distribution and risk for type 2 diabetes". Med Sport Sci. 60, pp. 82-93, 2014. DOI: http://dx.doi.org/10.1159/000357338
  9. Hawley JA. "Adaptations of skeletal muscle to prolonged, intense endurance training". Clin Exp Pharmacol Physiol, 29(3), pp. 218-222, 2002. DOI: http://dx.doi.org/10.1046/j.1440-1681.2002.03623.x
  10. Fitts RH, Booth FW, Winder WW, Hollosay JO. "Effect of exercise on response of liver lipogenic enzymes to a high fructose diet". Proc Soc Exp Biol Med 148(4), pp. 1150-1154, 1975. DOI: http://dx.doi.org/10.3181/00379727-148-38706
  11. Hawley, JA. "Specificity of training adaptation: time for a rethink?". Journal of Physiology, pp. 586:1-2, 2008. DOI: http://dx.doi.org/10.1113/jphysiol.2007.147397
  12. Trost SG, Owen N, Bauman AE, Sallis JF and Brown W, "Correlates of adults' participation in physical activity: review and update," Med Sci Sports Exerc, 34, pp. 1996-2001, 2002. DOI: http://dx.doi.org/10.1097/00005768-200212000-00020
  13. Marcus BH, King TK, Clark MM, Pinto BM, Bock BC. "Theories and techniques for promoting physical activity behaviours". Sports Med 22(5), pp.321-331, 1996. DOI: http://dx.doi.org/10.2165/00007256-199622050-00005
  14. ACSM, "Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults," Medicine & Science in Sports & Exercise, 41(2), pp. 459-471, 2009. DOI: http://dx.doi.org/10.1249/MSS.0b013e3181949333
  15. Siri W. E, "Body composition from fluid spaces and densities : analysis of methods. In Brozek, J., Henschel, A.(eds): Techniques for Measuring Body. Composition," Washington DC, National Academy of Sciences, pp. 223-244, 1961.
  16. Jackson A. S, Pollock M. L, & Waed A, "Generalized equations for predicting body density of women," Medicine and Science in Sports and Exercise, 12(3), pp. 175-181, 1980. DOI: http://dx.doi.org/10.1249/00005768-198023000-00009
  17. Matthews D. R, Hosker J. P, Rudenski A. S, Naylor B. A, Treacher D. F, & Turner R. C,. "Homeostasis model assessment: nsulin resistance and beta-cell function from fastiog plasma glucose and insulin concentrations in man," Diabetologia, 28(7), pp. 412-419, 1985. DOI: http://dx.doi.org/10.1007/BF00280883
  18. Rintala P, Dunn J. M, & McCubbin J. A, "Validity of a cardiorespiratory fitness test for men with mental retardation," Medicine and Science in sports and Exercise, 24, pp. 941-945, 1992. DOI: http://dx.doi.org/10.1249/00005768-199208000-00017
  19. Venables M. C, & Jeukendrup A. E, "Physical inactivity and obesity: links with insulin resistance and type 2 diabetes mellitus. Diabetes," Metabolism Research and Reviews, 25(Suppl 1), pp. S18-S23, 2009. DOI: http://dx.doi.org/10.1002/dmrr.983
  20. Chang-Soo Han, Gyu-Seung Lee, Moo-sik Lee, & Hye-Jeong Hwang "The Effect of Changing the Order of Exercise Types on Body Composition and Blood Lipid in Obese Women". Korea Academia- Industrial cooperation Society, 10(12), pp. 3888-3894, 2009. https://doi.org/10.5762/KAIS.2009.10.12.3888
  21. Kondo T, Kobayashi I., & Murakami M, "Effect of exercise on circulating adipokine levels in obese young women," Endocr. J., 53(2), pp. 189-195, 2006. DOI: http://dx.doi.org/10.1507/endocrj.53.189
  22. Dohm G. L, "Invited review: Regulation of skeletal muscle GLUT-4 expression by exercise," Journal of Applied physiology, 93(2), pp. 782-787, 2002. DOI: http://dx.doi.org/10.1152/japplphysiol.01266.2001
  23. Friedenreich C, M, Neilson H. K, Woolcott C. G, McTieman A, Wang Q, Ballard-Barbash R, et al. "Changes in insulin resistance indicators, IGFs, and adipokines in a year-long trial of aerobic exercise in postmenopausal women," Endocr Relat Cancer., 18(3), pp. 357-369, 2011. DOI: http://dx.doi.org/10.1530/ERC-10-0303
  24. Holten M. K, Zacho M, Gaster M, Juel C, Wojtaszewski J. F, & Dela F. "Strength training increased insulin mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes," Diabetes, 53, pp. 294-305, 2004. DOI: http://dx.doi.org/10.2337/diabetes.53.2.294
  25. Snowling N. L, & Hopkins W. G, "Effects of different models of exercise training on gulcose control and risk factor for complications in type 2 diabetic patients: a meta analysis," Diabetes Care, 29, pp. 2518-2527, 2006. DOI: http://dx.doi.org/10.2337/dc06-1317
  26. Davidson L. E, Hudson R, Kilpatrick K, Kuk J. L, McMillan K, Janiszewski P. M, Lee S, Lam M, & Ross R. "Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial," Archives of Internal Medicine, 169(2), pp. 122-131, 2009. DOI: http://dx.doi.org/10.1001/archinternmed.2008.558
  27. Kelly D. E, & Goodpaster B. H, "Effects of physical activity on insulin action and olucose tolerance in obesity," Medicine and Science in Sport and Exercise, 31, pp. 619-623, 1999. DOI: http://dx.doi.org/10.1097/00005768-199911001-00021
  28. Gonzalez, A. S, Guerrero D. B, Soto M. B., Diaz S. .P, Martinez-Olmos M, & Vidal O. "Metabolic syndrome, insulin resistance and the inflammation makers C-reactive protein and ferritin," European journal of Clinical Nutrition, 60(6), pp. 802-809, 2006. DOI: http://dx.doi.org/10.1038/sj.ejcn.1602384
  29. Festa A, D'Agostino, R, Howard G, Mykkanen L, Tracy R. P, & Harrner S. M, "Chronic subclinical inflammation as part of the insulin resistance syndrome: The insulin resistance atherosclerosis study(IRAS)," Circulation, 102, pp. 42-47, 2000. DOI: http://dx.doi.org/10.1161/01.CIR.102.1.42
  30. Wannamethee S. G, Lowe G. D, Whincup P. H, Rurnley A, Walker M, & Lennon L. "Physical actibity and hemostatic and inflammatory variables in elderly men," Circulation, 105(15), pp. 1785-1790, 2002. DOI: http://dx.doi.org/10.1161/hc1502.107117
  31. Albert M. A, Glynn R. J, & Ridker P. M, "Effect of physical activity on serum C-reactive protein," Am, J. Cardiol., 93, pp. 221-225, 2004. DOI: http://dx.doi.org/10.1016/j.amjcard.2003.09.046
  32. Marfella R, Esposito K, Siniscalchi M, Cacciapuoti F, Giugliano F, Labriola D, Ciotola M, Di Palo C, Misso L, & Giugliano D. "Effect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women," Diabetes Care, 27(1), pp. 47-52, 2004. DOI: http://dx.doi.org/10.2337/diacare.27.1.47
  33. Geffken D. F, Cushman M, Burke G. L, Polak J. F, Sakkinen P. A, & Tracy R. P, "Association between Physical Activity and Markers of Inflammation In a Healthy Elderly Population," American Journal of epidemiology, 153, pp. 242-250, 2001. DOI: http://dx.doi.org/10.1093/aje/153.3.242
  34. Nieman D. C, "Current perspective on exercise immunology," Current Sports Medicine Reports, 2(5), pp. 239-242, 2003. DOI: http://dx.doi.org/10.1249/00149619-200310000-00001
  35. Tall A. R, "C-reactive protein reassessed," New. Engl. J. Med., 350(14), pp.1450-1452, 2004. DOI: http://dx.doi.org/10.1056/NEJMe048020
  36. de Salles B. F, Simao R, Fleck S. J, Dias I, Kraemer-Aguiar L. G, & Bouskela E. "Effects of resistance training on cytokines," Int. J. Sports. Med. 31(7), pp. 441-450, 2010. DOI: http://dx.doi.org/10.1055/s-0030-1251994
  37. Nicklas B. J, Ambrosius W, Messier S. P, Miller G. D, Penninx B. W, Loeser J. H, Palla R. F, Bleecker E, & Pahor M. "Diet-induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial," Am. J. Clin. Nut, 79, pp.544-551, 2004. https://doi.org/10.1093/ajcn/79.4.544
  38. Aidhahi W, & Hamdy O, "Adipokines, inflammation and the endothelium in diabetes," Current Diabetes Reports, 3(4), pp. 293-298, 2003. DOI: http://dx.doi.org/10.1007/s11892-003-0020-2
  39. Ryan A. S, & Nicklas B. J, "Reductions in plasma cytokine lecels with weight loss improve insulin sensitivity in overweight and obese postmenopausal women," Diabetes Care, 27(7), pp. 1699-1705, 2004. DOI: http://dx.doi.org/10.2337/diacare.27.7.1699
  40. Smith L. L, Mckune A. J, Semple S. J, Sibanda E, Steel H, & Anderson R. "Changes in serum cytokine safer repeated outs of down hill running," Appl. Physiol. Nutr. Metab, 32(2), pp.233-240, 2007. DOI: http://dx.doi.org/10.1139/h06-106
  41. Ostrowski K, Rohde T, Asp S, Schjerling P, & Pedersin B. K, "Pro-and anti- inflammatory cytokine balance in strenuous exercise in humans," J. Physiol(Lond), 515, pp. 287-291, 1999. DOI: http://dx.doi.org/10.1111/j.1469-7793.1999.287ad.x
  42. Kohut M. L, McCann D. A, Russell D. W, Konopka D. N, Ounnick J. E, Franke W. D, Castillo M, C, Reighaed A. E, & Vanderah E, "Aerobic exercise, but not flexibility/resistanceexercise, reduces serum IL-1, CRP and IL-6 independent of beta-blockers, BMI and psychological factors in older adults," Brain Below. Immun., 24, pp. 252-265, 2006.
  43. Matsuzawa T, Funahashi T, & Nakamura T, "Molecular mechanism of metabolic syndrome X: contribution of adipocyrokines adipocytederived bioactive substances," Ann. NY. Acad. Sci, 892, pp. 146-154, 1999. DOI: http://dx.doi.org/10.1111/j.1749-6632.1999.tb07793.x
  44. Roth S. M, Metter E. J, Ling S, & Ferrucci L. "Inflammatory factors in age-related muscle wasting. Eurr," Opin. Rheumatol., 18, pp.625-630, 2006. DOI: http://dx.doi.org/10.1097/01.bor.0000245722.10136.6d
  45. Trayhum P, & Wood I. S, "Signaling role of adipose tissue: adipokines and inflammation in obesity," Biochem. Soc. Trans, 33, pp. 1078-1081, 2005. DOI: http://dx.doi.org/10.1042/BST20051078
  46. Olsznaecka-Glinianowicz M, Zahorska-Markiewicz B, & Janowska J. "The effect of weight loss on serum concentrations of nitric oxide, TNF-${\alpha}$ and soluble TNF-${\alpha}$ receptors," Endokrynologia Polska, 57(5), pp. 487-493, 2006.
  47. Laimer M, Ebenbichler C. F, Kaser S, Sandhofer A, Weiss H, Nehoda H, et al. "Markers of chronic inflammation and obesity:a prospective study on the reversibility of this association in middle-aged women undergoing weight loss by surgical intervention," Int J Obes Relat Metab Disord, 26(5) pp. 659-662, 2002. DOI: http://dx.doi.org/10.1038/sj.ijo.0801970
  48. Dvorakova-Lorenzova A, Suchanek P, Havel P. J, Stavek P, Karasova L, Valenta Z, Tintera J, & Poledne R, "The decrease in C-reactive protein concentration after diet and physical activity induced weight reduction is associated with changes in plasma lipids, but not interleukin-6 or adiponectin," Metabolism, 55(3), pp. 359-365, 2006. DOI: http://dx.doi.org/10.1016/j.metabol.2005.09.010
  49. Straczkowski M, Kowalska I, Dzienis-Straczkowska S, Stepien A, Skibinska E, Szelachowska M, et al. "Changes in tumor necrosis factor-alpha system and insulin sensitivity during an exercise training program in obese women with normal and impaired glucose tolerance," Eur J Endocrinol, 145(3) pp. 273-280, 2001. DOI: http://dx.doi.org/10.1530/eje.0.1450273
  50. Ferguson M. A, White L. J, McCoy S, Kim H. W, Petty T, & Wilsey J. "Plasma adiponectin response to acute exercise in healthy subjects," Eur. J. Appl. Physiol, 91(2-3), pp. 324-329, 2004. DOI: http://dx.doi.org/10.1007/s00421-003-0985-1