| Objective:Obesity is a chronic, multi-factor complex disease caused by many factors such as heredity, environment and long-term accumulation of heat, etc., and the pathogenesis of obesity related hypertension is especially complicated, influenced by many factors. In recent years, obesity related hypertension enjoys early-onset tendency, and its disease incidence in obese adolescents is increasing. This study, based on 4 weeks of enclosed aerobic exercise intervention to obese adolescents respectively with hypertension and normal blood pressure, observes the changes of such indexes as glucolipid metabolism, renin-angiotensin-aldosterone system(RAAS) components, fat factors, inflammation levels, oxidative stress and endothelial function of obese adolescents. It aims to explore the influence of aerobic exercise on hypertension related pathogenic factors of obese adolescents; to provide theoretical and experimental basis for the prevention and reduction roles of aerobic exercise to hypertension onset risk of obese adolescents after they grow up into adults; and to provide theoretical support to the role of exercise in “preventive treatment of disease”. Methods:This study selected 62 research objects screened from obese adolescents aged between 13-17 in the enclosed weight loss camp of Shanghai Dianfeng Fitness Co., Ltd. based on their blood pressure and obesity. They were divided into two groups according to their blood pressure value, with 31 in hypertension group and 31 in normal blood pressure group. 4 weeks of aerobic exercise intervention was conducted to the two groups of research objects, with heart rate as the exercise intensity monitoring index. Target heart rate(THR)= Rest heart rate(RHR)+ heart rate reserve(maximum heart rate—RHR) ×(20%-40%). Personalized exercise prescriptions were formulated according to the health states and increasing exercise load test results of the subjects. Professional dietician would serve them meals according to the basal metabolic rate, to ensure the supply of fatty acids, essential amino acids, vitamins and other nutrients. The body shape indexes(height, weight, BMI, body fat rate, waist circumference, hip circumference, etc.) and morning fasting blood indexes(glucolipid metabolic index, fat factor, inflammation factors, circulating renin-angiotensin-aldosterone system components, endothelial function index, etc.) of the subjects were measured one day before the aerobic exercise intervention and the end of the 4 weeks. Research Results:(1) Two groups of subjects after 4 weeks of aerobic exercise intervention significantly improved body shape. Difference significant improvement of blood pressure level and pulse pressure test of obesity hypertension group of men and women; two groups of subjects and interfere with the object of existence different levels of glucose and lipid metabolism disorder, after two weeks of aerobic exercise intervention group object insulin resistance and fat metabolism disorder were significantly improved.(2) SBP is in high-positive correlation with HOMA-IR(P<0.01) and in positive correlation with TC(P<0.05); DBP is in high-positive correlation with LDL-C, HOMA-IR and LDL-C/HDL-C(P<0.01), and in positive correlation with TG, TC, TC/HDL-C(P<0.05).(3) The renin activity(PRA) and angiotensin II(ANGII) of hypertension group before aerobic exercise intervention were significantly higher than those of normal blood pressure group(P < 0.05); after 4 weeks of intervention, the ANGII of normal blood pressure group decreased significantly(P<0.05), and the PRA, ANGII and aldosterone(ALD) of hypertension group had highly significant drop(P < 0.01), but the ANGII level of hypertension group was still higher than that of the normal blood pressure group(P<0.05).(4) Before intervention, the leptin(LEP), hypersensitive c-reactive protein(hs- CRP), tumor necrosis factor a(TNF-a), interleukin 6(IL-6) and other indexes of the hypertension group were significantly higher than those of the normal blood pressure group(P<0.05); after 4 weeks of aerobic exercise intervention, the hs-CRP of hypertension group was still higher than that of the normal blood pressure group(P<0.05); after intervention, the Visfatin, LEP, adiponectin(ADPN), IL-6, and other indexes of the normal blood pressure group had no significant changes(P < 0.05), but the RETN and hs-CRP had highly significant decrease(P<0.01); in case of hypertension group, after 4 weeks of aerobic exercise intervention, the Visfatin, ADPN, hs-CRP and other indexes had significant changes(P < 0.05); while LEP, RETN, TNF-a, IL-6 and other indexes had highly significant decrease(P<0.01).(5) The partial correlation analysis results with age control showed that, the systolic blood pressure(SBP) was in significant positive correlation with LEP and RETN(P < 0.05), but in highly significant positive correlation with hs-CRP(P < 0.01); diastolic blood pressure(DBP) was in highly significant positive correlation with LEP, RETN, hs-CRP(P<0.01) but in significant positive correlation with TNF-a(P<0.05).(6) ADPN, RETN and hs-CRP were highly correlated with Ang II(P<0.01); LEP and TNF-a were in positive correlation with AngI(P<0.05), and RETN was in highly positive correlation with AngI(P<0.01); ADPN and TNF-a were correlated with ALD(P < 0.05), and IL-6 was in highly positive correlation with ALD(P < 0.01).(7) Before aerobic exercise intervention, the von willebrand factor(VWF) and endothelin 1/nitric oxide ratio(ET-1/NO) of hypertension group were high and had statistical significance when compared with the normal blood pressure group(P<0.05), but the level of NO was lower than that of the normal blood pressure group(P<0.05). After 4 weeks of aerobic exercise intervention, the soluble vascular cell adhesion molecule 1(Svcam 1) of the hypertension group was significantly higher than that of normal blood pressure group(P<0.05), while the other indexes of the two groups had no difference after intervention. Highly significant changes appeared in all indexes of the two groups before and after intervention(P<0.01). Conclusions: 1. The 4 weeks of aerobic exercise can obviously reduce the degree of obesity of obese adolescents, significantly improve the body shape of obese adolescents, greatly reduce the blood pressure and pulse pressure difference of obese adolescents, and remarkably improve the glucolipid metabolism of obese adolescents. TC/HDL-C and LDL-C/HDL-C can reflect the lipid metabolism than single blood lipid parameter and they can be included in the evaluation indexes of weight loss effects by exercise; the blood pressure level of obese adolescents with hypertension was closely related to insulin resistance, so aerobic exercise may be the important strategy and effective way to early prevent and treat obese adolescents with hypertension. 2. Moderate and severe obese adolescents are with excessive activation of RAAS, the expression of cycle RAAS components of obese adolescents with hypertension is higher than that of obese adolescents in normal blood pressure, and the 4 weeks of aerobic exercise can obviously improve the phenomenon of excessive activated RAAS; moderate and severe obese adolescents are with fat factor and inflammatory factor secretion disorder, and the body is in a state of low-grade inflammation. The leptin resistance and inflammation level of hypertensive obese adolescents are more serious than those of the obese adolescents with normal blood pressure. 4 weeks of aerobic exercise can obviously improve the fat factor secretion disorder and low-grade inflammation state; LEP, RETN, TNF-a and hs-CRP are closely related to blood pressure; the fat factor is closely related to inflammatory factor and RAAS, and they may be interactive to each other; moderate and severe obese adolescents have been associated with impaired endothelial function, and the endothelial dysfunction of obese adolescents with hypertension is higher than that of the obese adolescents with normal blood pressure; aerobic exercise can obviously improve the endothelial function. |
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