transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2020-7-6-6-15transmed-571Research ArticleСЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯCARDIOVASCULAR MEDICINEПрогностическая значимость изменения уровня физической работоспособности для оценки благоприятной динамики метаболического синдрома у больных абдоминальным ожирениемPrognostic significance of changes in the level physical capacity to assess the favorable dynamics of metabolic syndrome in patients with abdominal obesityhttps://orcid.org/0000-0002-5770-3845БерезинаА. В.BerezinaA. V.

Березина Аэлита Валерьевна, д.м.н., главный научный сотрудник, руководитель НИЛ кардиопульмонального тестирования, ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России; ассистент кафедры факультетской терапии ФГБОУ ВО ПСПбГМУ им. И. П. Павлова Минздрава России

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Berezina Aelita V., MD, Dr. Sci., Chief Researcher, Head of the Laboratory of Cardiopulmonary testing, Almazov National Medical Research Centre; Assistant, Department of Faculty Therapy, Academician I. P. Pavlov First Saint Petersburg State Medical University

Akkuratova str. 2, Saint Petersburg, 197341

aelitaberezina@mail.ruБерковичО. А.BerkovichO. A.

Беркович Ольга Александровна, д.м.н., ведущий научный сотрудник НИЛ метаболического синдрома Института эндокринологии, ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России; профессор кафедры факультетской терапии ФГБОУ ВО ПСПбГМУ им. И. П. Павлова Минздрава России

Санкт-Петербург

Bercovich Olga A., MD, Dr. Sci., Leading Researcher, Research Laboratory of Metabolic Syndrome, Institute of Endocrinology, Almazov National Medical Research Centre; Professor, Department of Faculty Therapy, Academician I. P. Pavlov First Saint Petersburg State Medical University

Saint Petersburg

oberkovich@mail.ruБеляеваО. Д.BelyaevaO. D.

Беляева Ольга Дмитриевна, д.м.н., ведущий научный сотрудник НИЛ метаболического синдрома Института эндокринологии, профессор кафедры внутренних болезней Института медицинского образования, ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России; профессор кафедры факультетской терапии ФГБОУ ВО ПСПбГМУ им. И. П. Павлова Минздрава России

Санкт-Петербург

Belyaeva Olga D., MD, Dr. Sci., Leading Researcher, Research Laboratory of Metabolic Syndrome, Institute of Endocrinology, Professor, Department of Internal Medicine, Institute of Medical Education, Almazov National Medical Research Centre; Professor, Department of Faculty Therapy, Academician I. P. Pavlov First Saint Petersburg State Medical University

Saint Petersburg

olgad.bel@gmail.comБаженоваЕ. А.BazhenovaE. A.

Баженова Елена Анатольевна, к.м.н., старший научный сотрудник НИЛ метаболического синдрома Института эндокринологии, ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России; доцент кафедры факультетской терапии, ФГБОУ ВО ПСПбГМУ им. И. П. Павлова Минздрава России

Санкт-Петербург

Bazhenova Elena A., MD, PhD, Senior Researcher, Research Laboratory of Metabolic Syndrome, Institute of Endocrinology, Almazov National Medical Research Centre; Associate Professor, Department of Faculty Therapy, Academician I. P. Pavlov First Saint Petersburg State Medical University

Saint Petersburg

bazhenova@pisem.netКулешоваЭ. В.KuleshovaE. V.

Кулешова Эльвира Владимировна, д.м.н., профессор, главный научный сотрудник НИО ишемической болезни сердца

Санкт-Петербург

Kuleshova Elvira V., MD, Dr. Sci., Professor, Chief Researcher, Coronary Artery Disease Research Department

Saint Petersburg

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации; Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research Centre; Academician I. P. Pavlov First Saint Petersburg State Medical UniversityRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian Federation20201412202076615Copyright © Березина А.В., Беркович О.А., Беляева О.Д., Баженова Е.А., Кулешова Э.В., 20202020Березина А.В., Беркович О.А., Беляева О.Д., Баженова Е.А., Кулешова Э.В.Berezina A.V., Berkovich O.A., Belyaeva O.D., Bazhenova E.A., Kuleshova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/571

Актуальность. Абдоминальное ожирение (АО) — является ключевым компонентом метаболического синдрома (МС) и фактором риска сердечно-сосудистых заболеваний (ССЗ). Уровень физической работоспособности (ФР) является важным диагностическим и прогностическим критерием и фактором стратификации риска у здоровых и больных ССЗ. Цель. Оценить влияние изменения уровня ФР на течение МС у больных АО на фоне немедикаментозной коррекции массы тела. Материалы и методы. Проведено трехлетнее проспективное исследование по снижению массы тела немедикаментозными способами у 153 больных с АО и МС и/или факторами риска ССЗ. Оценивалась динамика МС, показателей углеводного и липидного обмена, уровня артериального давления в зависимости от изменения уровня ФР. Результаты. Благоприятное течение метаболического синдрома встречалось чаще у пациентов с приростом уровня ФР, чем у пациентов со снижением этого показателя (82,3 и 37,5 % соответственно; р = 0,0001). При увеличении VO2peak > 5 % до 15 % шанс благоприятного течения МС возрастает в 5,8 (1,5–22,3) и в 15,1 (5,7–39,9) раза соответственно. Заключение. Повышение уровня ФР ассоциируется с благоприятной динамикой МС.

абдоминальное ожирениекардиопульмональное тестированиеметаболический синдромфизическая работоспособностьabdominal obesitycardiopulmonary exercise testingmetabolic syndromephysical capacityReferencesArena R, Myers J, Williams MA, et al. Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on exercise, rehabilitation, and prevention of the council on clinical cardiology and the council on cardiovascular nursing. Circulation. 2007; 116 (3): 329–343.Arena R, Myers J, Williams MA, et al. Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on exercise, rehabilitation, and prevention of the council on clinical cardiology and the council on cardiovascular nursing. Circulation. 2007; 116 (3): 329–343.Hallal PC, Andersen LB, Bull FC, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012; 380 (9838): 247–257.Hallal PC, Andersen LB, Bull FC, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012; 380 (9838): 247–257.WHO Global Recommendations on Physical Activity for Health. WHO. Geneva. 2010.WHO Global Recommendations on Physical Activity for Health. WHO. Geneva. 2010.Muers J, Kokkinos P, Nyelin E. Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome. Nutrients. 2019; 11 (7): 1652.Muers J, Kokkinos P, Nyelin E. Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome. Nutrients. 2019; 11 (7): 1652.Flint AJ, Rexrode KM, Hu FB, et al. Body mass index, waist circumference, and risk of coronary heart disease: a prospective study among men and women. Obes Res Clin Pract. 2010; 4 (3): e171–e181.Flint AJ, Rexrode KM, Hu FB, et al. Body mass index, waist circumference, and risk of coronary heart disease: a prospective study among men and women. Obes Res Clin Pract. 2010; 4 (3): e171–e181.Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010; 56 (14): 1113–1132.Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010; 56 (14): 1113–1132.Barlow CE, Kohl 3rd HW, Gibbons LW, et al. Physical fitness, mortality and obesity. Int J Obes Relat Metab Disord. 1995; 19 Suppl 4: S41–S44.Barlow CE, Kohl 3rd HW, Gibbons LW, et al. Physical fitness, mortality and obesity. Int J Obes Relat Metab Disord. 1995; 19 Suppl 4: S41–S44.Stevens J, Cai J, Evenson KR, et al. Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study. Am J Epidemiol. 2002; 156 (9): 832–841.Stevens J, Cai J, Evenson KR, et al. Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study. Am J Epidemiol. 2002; 156 (9): 832–841.Franks PW, Ekelund U, Brage S, et al. Does the association of habitual physical activity with the metabolic syndrome differ by level of cardiorespiratory fitness? Diabetes Care. 2004; 27 (5): 1187–1193.Franks PW, Ekelund U, Brage S, et al. Does the association of habitual physical activity with the metabolic syndrome differ by level of cardiorespiratory fitness? Diabetes Care. 2004; 27 (5): 1187–1193.Lee SH, Lee Y, Seo JH, et al. Association between Exercise and metabolic syndrome in Koreans. J Obes Metab Syndr. 2018; 27 (2): 117–124.Lee SH, Lee Y, Seo JH, et al. Association between Exercise and metabolic syndrome in Koreans. J Obes Metab Syndr. 2018; 27 (2): 117–124.Huang C-Y, Chen H-Y, Liu S-S. The relationship between physical fitness capacity and risk factors of metabolic syndrome. Physiotherapy. 2015; 101 Suppl 1: e598–eS599.Huang C-Y, Chen H-Y, Liu S-S. The relationship between physical fitness capacity and risk factors of metabolic syndrome. Physiotherapy. 2015; 101 Suppl 1: e598–eS599.Rheaume C, Arsenault BJ, Belangers S, et al. Low cardiorespiratory fitness levels and elevated blood pressure: what is the contribution of visceral adiposity? Hypertension. 2009; 54 (1): 91–97.Rheaume C, Arsenault BJ, Belangers S, et al. Low cardiorespiratory fitness levels and elevated blood pressure: what is the contribution of visceral adiposity? Hypertension. 2009; 54 (1): 91–97.Arsenault BJ, Lachance D, Lemieux I, et al. Visceral adipose tissue accumulation, cardiorespiratory fitness, and features of the metabolic syndrome. Arch Inretn Med. 2007; 167 (14): 1518–1525.Arsenault BJ, Lachance D, Lemieux I, et al. Visceral adipose tissue accumulation, cardiorespiratory fitness, and features of the metabolic syndrome. Arch Inretn Med. 2007; 167 (14): 1518–1525.Hidalgo-Santamaria M, Fernandez-Motero A, Martinez-Gonzales MA, et al. Exercise intencity and incidence of metabolic syndrome: The SUN Project. Am J Prev Med. 2017; 52 (4): e95–e101.Hidalgo-Santamaria M, Fernandez-Motero A, Martinez-Gonzales MA, et al. Exercise intencity and incidence of metabolic syndrome: The SUN Project. Am J Prev Med. 2017; 52 (4): e95–e101.Botoseneanu A, Ambrosius WT, Beavers DP, et al. Prevalence of metabolic syndrome and its association with physical capacity, disability, and self-rated health in lifestyle interventions and independence for elders study participants. J Am Geriatr Soc. 2015; 63 (2): 222–232.Botoseneanu A, Ambrosius WT, Beavers DP, et al. Prevalence of metabolic syndrome and its association with physical capacity, disability, and self-rated health in lifestyle interventions and independence for elders study participants. J Am Geriatr Soc. 2015; 63 (2): 222–232.Rheaume C, Arsenault BJ, Dumas M-P, et al. Contribution of cardiorespiratory fitness and visceral adiposity to six-year changes in cardiometabolic risk markers in apparently healthy men and women. J Clin Endocrinol Metab. 2011; 96 (5): 1462–1468.Rheaume C, Arsenault BJ, Dumas M-P, et al. Contribution of cardiorespiratory fitness and visceral adiposity to six-year changes in cardiometabolic risk markers in apparently healthy men and women. J Clin Endocrinol Metab. 2011; 96 (5): 1462–1468.Arner P. Impact of exercise on adipose tissue metabolism in humans. Int J Obes Relat Metab Disord. 1995; 19 Suppl 4: S18–S21.Arner P. Impact of exercise on adipose tissue metabolism in humans. Int J Obes Relat Metab Disord. 1995; 19 Suppl 4: S18–S21.Kirwan JP, Kohrt WM, Wojta DM, et al. Endurance exercise training reduces glucose-stimulated insulin levels in 60- to 70-year-old men and women. J Gerontol. 1993; 48 (3): M84–M90.Kirwan JP, Kohrt WM, Wojta DM, et al. Endurance exercise training reduces glucose-stimulated insulin levels in 60- to 70-year-old men and women. J Gerontol. 1993; 48 (3): M84–M90.Hodgetts V, Coppack SW, Frayn KN, et al. Factors controlling fat mobilization from human subcutaneous adipose tissue during exercise. J Appl Physiol. 1991; 71 (2): 445–451.Hodgetts V, Coppack SW, Frayn KN, et al. Factors controlling fat mobilization from human subcutaneous adipose tissue during exercise. J Appl Physiol. 1991; 71 (2): 445–451.Wolf RR, Klein S, Carraro F, et al. Role of triglyceride-fatty acid cycle in controlling fat metabolism in humans during and after exercise. Am J Physiol. 1990; 258 (2 Pt 1): E382–E389.Wolf RR, Klein S, Carraro F, et al. Role of triglyceride-fatty acid cycle in controlling fat metabolism in humans during and after exercise. Am J Physiol. 1990; 258 (2 Pt 1): E382–E389.Barlow CE, LaMonte MJ, Fitzgerald SJ, et al. Cardiorespiratory fitness is an independent predictor of hypertension incidence among initially normotensive healthy women. Am J Epidemiol. 2006; 163 (2): 142–150.Barlow CE, LaMonte MJ, Fitzgerald SJ, et al. Cardiorespiratory fitness is an independent predictor of hypertension incidence among initially normotensive healthy women. Am J Epidemiol. 2006; 163 (2): 142–150.Chase NL, Sui X, Lee D, et al. The association of cardiorespiratory fitness and physical activity with incidence of hypertension in men. Am J Hypertens. 2009; 22 (4): 417–424.Chase NL, Sui X, Lee D, et al. The association of cardiorespiratory fitness and physical activity with incidence of hypertension in men. Am J Hypertens. 2009; 22 (4): 417–424.Ratajczak M, Skrypnik D, Bogdanski P, et al. Effects of endurance and endurance-strength training on endothelial function in women with obesity: a randomized trail. Int J Envision Res Public Health. 2019; 16 (21): 4291.Ratajczak M, Skrypnik D, Bogdanski P, et al. Effects of endurance and endurance-strength training on endothelial function in women with obesity: a randomized trail. Int J Envision Res Public Health. 2019; 16 (21): 4291.Pialoux V, Brown AD, Leigh R, et al. Effect of cardiorespiratory fitness on vascular regulation and oxidative stress in postmenopausal women. Hypertension. 2009; 54 (5): 1014–1020.Pialoux V, Brown AD, Leigh R, et al. Effect of cardiorespiratory fitness on vascular regulation and oxidative stress in postmenopausal women. Hypertension. 2009; 54 (5): 1014–1020.Pescatello LS, Franklin BA, Fagard R, et al. American college of sports medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004; 36 (3): 533–553.Pescatello LS, Franklin BA, Fagard R, et al. American college of sports medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004; 36 (3): 533–553.LaMonte MJ, Barlow CE, Jurca R, et al. Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. Circulation. 2005; 112 (4): 505–512.LaMonte MJ, Barlow CE, Jurca R, et al. Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. Circulation. 2005; 112 (4): 505–512.

The authors declare that there are no conflicts of interest present.