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마른 비만의 대사 및 심혈관계 질환 위험성과 선제적 예방을 위한 운동 중재

Cardiometabolic Disease Risk in Normal Weight Obesity and Exercise Interventions for Proactive Prevention

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PURPOSE: Normal weight obesity (NWO) is characterized by a normal body mass index but a high body fat mass percentage and low skeletal muscle mass, thereby increasing the risk of cardiometabolic dysfunction and morbidity. However, the effects of exercise intervention in reducing the risk of cardiometabolic disease in NWO have not been fully elucidated. Therefore, this review aimed to summarize the potential cardiometabolic disease risk and to provide implications of exercise interventions for the proactive prevention of cardiometabolic disease risk in NWO. METHODS: We searched and summarized the literature on the cardiometabolic risk factors in NWO. In addition, we summarized literature investigating the effects of exercise intervention on the cardiometabolic risk factors in NWO. We performed the literature search using PubMed, Web of Science, and Google Scholar databases. RESULTS: NWO was associated with increased visceral fat, ectopic fat, oxidative stress, inflammatory cytokines, insulin resistance, dyslipidemia, and subclinical atherosclerosis compared with normal weight lean. NWO requires exercise interventions that induce alterations in body composition, such as decreased body fat percentage and increased muscle mass. Resistance exercise (RE) and high-intensity interval exercise (HIIE) can improve lipid components and alter body composition in NWO. In addition, low-intensity blood flow restriction resistance exercise (BFR-RE) may enhance muscular strength and anaerobic power in NWO. CONCLUSIONS: The cardiometabolic disease risk is increased in NWO. We suggest that exercise interventions (RE, HIIE, and BFR-RE) may effectively prevent cardiometabolic disease risk and alter body composition in NWO. As this has potential implications for exercise interventions in NWO, further investigations are needed to find the optimal exercise for proactive prevention of cardiometabolic risk in NWO.

Abstract

PURPOSE: Normal weight obesity (NWO) is characterized by a normal body mass index but a high body fat mass percentage and low skeletal muscle mass, thereby increasing the risk of cardiometabolic dysfunction and morbidity. However, the effects of exercise intervention in reducing the risk of cardiometabolic disease in NWO have not been fully elucidated. Therefore, this review aimed to summarize the potential cardiometabolic disease risk and to provide implications of exercise interventions for the proactive prevention of cardiometabolic disease risk in NWO. METHODS: We searched and summarized the literature on the cardiometabolic risk factors in NWO. In addition, we summarized literature investigating the effects of exercise intervention on the cardiometabolic risk factors in NWO. We performed the literature search using PubMed, Web of Science, and Google Scholar databases. PURPOSE: Normal weight obesity (NWO) is characterized by a normal body mass index but a high body fat mass percentage and low skeletal muscle mass, thereby increasing the risk of cardiometabolic dysfunction and morbidity. However, the effects of exercise intervention in reducing the risk of cardiometabolic disease in NWO have not been fully elucidated. Therefore, this review aimed to summarize the potential cardiometabolic disease risk and to provide implications of exercise interventions for the proactive prevention of cardiometabolic disease risk in NWO. METHODS: We searched and summarized the literature on the cardiometabolic risk factors in NWO. In addition, we summarized literature investigating the effects of exercise intervention on the cardiometabolic risk factors in NWO. We performed the literature search using PubMed, Web of Science, and Google Scholar databases. RESULTS: NWO was associated with increased visceral fat, ectopic fat, oxidative stress, inflammatory cytokines, insulin resistance, dyslipidemia, and subclinical atherosclerosis compared with normal weight lean. NWO requires exercise interventions that induce alterations in body composition, such as decreased body fat percentage and increased muscle mass. Resistance exercise (RE) and high-intensity interval exercise (HIIE) can improve lipid components and alter body composition in NWO. In addition, low-intensity blood flow restriction resistance exercise (BFR-RE) may enhance muscular strength and anaerobic power in NWO. CONCLUSIONS: The cardiometabolic disease risk is increased in NWO. We suggest that exercise interventions (RE, HIIE, and BFR-RE) may effectively prevent cardiometabolic disease risk and alter body composition in NWO. As this has potential implications for exercise interventions in NWO, further investigations are needed to find the optimal exercise for proactive prevention of cardiometabolic risk in NWO.CONCLUSIONS: The cardiometabolic disease risk is increased in NWO. We suggest that exercise interventions (RE, HIIE, and BFR-RE) may effectively prevent cardiometabolic disease risk and alter body composition in NWO. As this has potential implications for exercise interventions in NWO, further investigations are needed to find the optimal exercise for proactive prevention of cardiometabolic risk in NWO.

참고문헌 (101)

  1. Kopelman PG, "Obesity as a medical problem", Nature, 404(6778), pp.635~643 (2000)
  2. Powell-Wiley TM, "Obesity and cardiovascular disease : a scientific statement from the american heart association", Circulation, 143(21), pp.e984~1010 (2021)
  3. Swinburn BA, "The global obesity pandemic : shaped by global drivers and local environments", Lancet, 378(9793), pp.804~814 (2011)
  4. Prentice AM, "Beyond body mass index", Obes Rev, 2(3), pp.141~147 (2001)
  5. Romero-Corral A, "Accuracy of body mass index in diagnosing obesity in the adult general population", Int J Obes(Lond), 32(6), pp.959~966 (2008)
  6. Oliveros E, "The concept of normal weight obesity", Prog Cardiovasc Dis, 56(4), pp.426~433 (2014)
  7. Clerc PG, "Overweight BMI(25-29)in active duty military : excess fat or more lean mass? a look at the evidence", Mil Med, 187(7-8), pp.201~203 (2022)
  8. De Lorenzo A, "New obesity classification criteria as a tool for bariatric surgery indication", World J Gastroenterol, 22(2), pp.681~703 (2016)
  9. Wijayatunga NN, "Normal weight obesity and unaddressed cardiometabolic health risk-a narrative review", Int J Obes(Lond), 45(10), pp.2141~2155 (2021)
  10. Franco LP, "Normal-weight obesity syndrome : diagnosis, prevalence, and clinical implications", Nutr Rev, 74(9), pp.558~570 (2016)
  11. De Lorenzo A, "Normal weight obese(NWO)women : an evaluation of a candidate new syndrome", Nutr Metab Cardiovasc Dis, 16(8), pp.513~523 (2006)
  12. Batsis JA, "Normal weight obesity and mortality in united states subjects ≥60 years of age(from the Third National Health and Nutrition Examination Survey)", Am J Cardiol, 112(10), pp.1592~1598 (2013)
  13. Marques-Vidal P, "Normal weight obesity : relationship with lipids, glycaemic status, liver enzymes and inflammation", Nutr Metab Cardiovasc Dis, 20(9), pp.669~675 (2010)
  14. Batsis JA, "Normal weight obesity and functional outcomes in older adults", Eur J Intern Med, 25(6), pp.517~522 (2014)
  15. García-Hermoso A, "Normal-weight obesity is associated with poorer cardiometabolic profile and lower physical fitness levels in children and adolescents", Nutrients, 12(4), pp.1171~ (2020)
  16. 김남욱, "5주간의 저강도 혈류제한 저항성운동과 중강도 저항성운동이 마른 비만 여성의 신체조성 및 혈중지질에 미치는 영향", 운동과학, 30(1), pp.70~79 (2021), 한국운동생리학회
  17. De Lorenzo A, "Normal-weight obese syndrome : early inflammation?", Am J Clin Nutr, 85(1), pp.40~45 (2007)
  18. Olafsdottir AS, "Health behavior and metabolic risk factors associated with normal weight obesity in adolescents", PLoS One, 11(8), pp.e0161451~ (2016)
  19. Marques-Vidal P, "Large differences in the prevalence of normal weight obesity using various cut-offs for excess body fat. e-SPEN", E Spen Eur E J Clin Nutr Metab, 3(4), pp.e159~e162 (2008)
  20. Mehrabian S, "Association of circulating irisin levels with normal weight obesity, glycemic and lipid profile", J Diabetes Metab Disord, 15, pp.17~ (2015)
  21. Di Renzo L, "Oxidative stress in normal-weight obese syndrome", Obesity(Silver Spring), 18(11), pp.2125~2130 (2010)
  22. Di Renzo L, "Normal weight obese syndrome : role of single nucleotide polymorphism of IL-1 5Ralpha and MTHFR 677C-->T genes in the relationship between body composition and resting metabolic rate", Eur Rev Med Pharmacol Sci, 10(5), pp.235~245 (2006)
  23. Marques-Vidal P, "Prevalence of normal weight obesity in switzerland : effect of various definitions", Eur J Nutr, 47(5), pp.251~257 (2008)
  24. Kim MK, "Normal weight obesity in Korean adults", Clin Endocrinol(Oxf), 80(2), pp.214~220 (2014)
  25. Dvorak RV, "Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women", Diabetes, 48(11), pp.2210~2214 (1999)
  26. Correa-Rodríguez M, "Normal-weight obesity is associated with increased cardiometabolic risk in young adults", Nutrients, 12(4), pp.1106~ (2020)
  27. Wiklund P, "Normal-weight obesity and cardiometabolic risk : A 7-year longitudinal study in girls from prepuberty to early adulthood", Obesity(Silver Spring), 25(6), pp.1077~1082 (2017)
  28. Moy FM, "Cardiometabolic risks profile of normal weight obese and multi-ethnic women in a developing country", Maturitas, 81(3), pp.389~393 (2015)
  29. Ohlsson B, "Sociodemographic and lifestyle factors in relation to overweight defined by BMI and"normal-weight obesity"", J Obes, 2020, pp.2070297~ (2020)
  30. Männistö S, "Dietary and lifestyle characteristics associated with normal-weight obesity : the National FINRISK 2007 Study", Br J Nutr, 111(5), pp.887~894 (2014)
  31. Di Renzo L, "Association between-308 G", A TNF-α polymorphism and appendicular skeletal muscle mass index as a marker of sarcopenia in normal weight obese syndrome, 2013, pp.35(6), 615~623
  32. Bellissimo MP, "Relationships between plasma apelin and adiponectin with normal weight obesity, body composition, and cardiorespiratory fitness in working adults", J Clin Transl Endocrinol, 24, pp.100257~ (2021)
  33. Wannamethee SG, "Muscle loss and obesity : the health implications of sarcopenia and sarcopenic obesity", Proc Nutr Soc, 74(4), pp.405~412 (2015)
  34. Baek SJ, "Sarcopenia and sarcopenic obesity and their association with dyslipidemia in korean elderly men: the 2008-2010 korea national health and nutrition examination survey", J Endocrinol Invest, 37(3), pp.247~260 (2014)
  35. Kim TN, "Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the korean sarcopenic obesity study (KSOS)", Diabetes Care, 33(7), pp.1497~1499 (2010)
  36. Madeira FB, "Normal weight obesity is associated with metabolic syndrome and insulin resistance in young adults from a middle-income country", PLoS One, 8(3), pp.e60673~ (2013)
  37. Kapoor N, "Prevalence of normal weight obesity and its associated cardiometabolic risk factors-Results from the baseline data of the Kerala Diabetes Prevention Program(KDPP)", PLoS One, 15(8), pp.e0237974~ (2020)
  38. Xu S, "Normal weight obesity and the risk of diabetes in chinese people : a 9-year population-based cohort study", Sci Rep, 11(1), pp.6090~ (2021)
  39. Fiuza-Luces C, "Exercise benefits in cardiovascular disease : beyond attenuation of traditional risk factors", Nat Rev Cardiol, 15(12), pp.731~743 (2018)
  40. Fiuza-Luces C, "Exercise is the real polypill", Physiology(Bethesda), 28(5), pp.330~358 (2013)
  41. Pedersen BK, "Exercise as medicine-evidence for prescribing exercise as therapy in 26 different chronic diseases", Scand J Med Sci Sports, 25(Suppl 3), pp.1~72 (2015)
  42. Kim S, "Normal-weight obesity is associated with increased risk of subclinical atherosclerosis", Cardiovasc Diabetol, 14, pp.58~ (2015)
  43. Cheng S, "The effects of muscle mass and muscle quality on cardio-metabolic risk in peripubertal girls : a longitudinal study from childhood to early adulthood", Int J Obes(Lond), 42(4), pp.648~654 (2018)
  44. Thomas EL, "Excess body fat in obese and normal-weight subjects", Nutr Res Rev, 25(1), pp.150~161 (2012)
  45. Romero-Corral A, "Normal weight obesity : a risk factor for cardiometabolic dysregulation and cardiovascular mortality", Eur Heart J, 31(6), pp.737~746 (2010)
  46. Barter P, "The role of HDL-cholesterol in preventing atherosclerotic disease", Eur Heart J Suppl, 7(Suppl_F), pp.F4~F8 (2005)
  47. Ross R, "The pathogenesis of atherosclerosis : a perspective for the 1990s", Nature, 362(6423), pp.801~809 (1993)
  48. Richter EA, "Exercise, GLUT4, and skeletal muscle glucose uptake", Physiol Rev, 93(3), pp.993~1017 (2013)
  49. Janssen I, "Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr", J Appl Physiol(1985), 89(1), pp.81~88 (2000)
  50. Frontera WR, "Skeletal muscle : a brief review of structure and function", Calcif Tissue Int, 96(3), pp.183~195 (2015)
  51. Baskin KK, "Muscle as a ‘‘mediator’’ of systemic metabolism", Cell Metab, 21(2), pp.237~248 (2015)
  52. Hwang YC, "Differential association between sarcopenia and metabolic phenotype in Korean young and older adults with and without obesity", Obesity(Silver Spring), 25(1), pp.244~251 (2017)
  53. Kim TN, "The association of low muscle mass with soluble receptor for advanced glycation end products (sRAGE): the korean sarcopenic obesity study (KSOS)", Diabetes Metab Res Rev, 34(3), pp.e2974~ (2018)
  54. Kang S, "Subclinical vascular inflammation in subjects with normal weight obesity and its association with body fat: an 18 F-FDG-PET", CT study, 2014, pp.13, 70~
  55. Ramsaran C, "Normal weight obesity among young adults in trinidad and tobago : prevalence and associated factors", Int J Adolesc Med Health, 29(2), pp.20150042~ (2017)
  56. Bodine SC, "Akt", mTOR pathway is a crucial regulator of skeletal muscle hypertrophy and can prevent muscle atrophy in vivo, 2001, pp.3(11), 1014~1019
  57. Horii N, "Resistance exercise-induced increase in muscle 5α-dihydrotestosterone contributes to the activation of muscle Akt", mTOR, AS160, pp.GLUT4-signaling pathways in type 2 diabetic rats, Faseb J[DOI]
  58. Strasser B, "Resistance training for diabetes prevention and therapy : experimental findings and molecular mechanisms", Biomed Res Int, 2013, pp.805217~ (2013)
  59. Pérez-López A, "Skeletal muscle IL-15", IL-15Rα and myofibrillar protein synthesis after resistance exercise, 2018, pp.28(1), 116~125
  60. Strasser B, "Resistance training, visceral obesity and inflammatory response : a review of the evidence", Obes Rev, 13(7), pp.578~591 (2012)
  61. Tresierras MA, "Resistance training in the treatment of diabetes and obesity: mechanisms and outcomes", J Cardiopulm Rehabil. Prev, 29(2), pp.67~75 (2009)
  62. Garber CE, "American college of sports medicine position stand. quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults:guidance for prescribing exercise", Med Sci Sports Exerc, 43(7), pp.1334~1359 (2011)
  63. Pollock ML, "AHA science advisory. resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription:an advisory from the committee on exercise, rehabilitation, and prevention, council on clinical cardiology, american heart associ ation; position paper endorsed by the american college of sports medicine", Circulation, 101(7), pp.828~833 (2000)
  64. Kelley GA, "Impact of progressive resistance training on lipids and lipoproteins in adults : a meta-analysis of randomized controlled trials", Prev Med, 48(1), pp.9~19 (2009)
  65. Ferreira FC, "Circuit resistance training in women with normal weight obesity syndrome : body composition, cardiometabolic and echocardiographic parameters, and cardiovascular and skeletal muscle fitness", J Sports Med Phys Fitness, 57(7-8), pp.1033~1044 (2017)
  66. Bird SP, "Designing resistance training programmes to enhance muscular fitness : a review of the acute programme variables", Sports Med, 35(10), pp.841~851 (2005)
  67. Scott BR, "Hypoxia and resistance exercise : a comparison of localized and systemic methods", Sports Med, 44(8), pp.1037~1054 (2014)
  68. Törpel A, "Strengthening the brain-Is resistance training with blood flow restriction an effective strategy for cognitive improvement?", J Clin Med, 7(10), pp.337~ (2018)
  69. Manini TM, "Growth hormone responses to acute resistance exercise with vascular restriction in young and old men", Growth Horm IGF Res, 22(5), pp.167~172 (2012)
  70. Takano H, "Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow", Eur J Appl Physiol, 95(1), pp.65~73 (2005)
  71. Karabulut M, "The effects of low-intensity resistance training with vascular restriction on leg muscle strength in older men", Eur J Appl Physiol, 108(1), pp.147~155 (2010)
  72. Centner C, "Effects of blood flow restriction training on muscular strength and hypertrophy in older individuals : a systematic review and meta-analysis", Sports Med, 49(1), pp.95~108 (2019)
  73. Linero C, "Effect of blood flow restriction during low-intensity resistance training on bone markers and physical functions in postmenopausal women", J Exerc Sci. Fit, 19(1), pp.57~65 (2021)
  74. Ferguson RA, "The acute angiogenic signalling response to low-load resistance exercise with blood flow restriction", Eur J Sport Sci, 18(3), pp.397~406 (2018)
  75. Shimizu R, "Low-intensity resistance training with blood flow restriction improves vascular endothelial function and peripheral blood circulation in healthy elderly people", Eur J Appl Physiol, 116(4), pp.749~757 (2016)
  76. Zhang T, "Effects of low-load blood flow restriction training on hemodynamic responses and vascular function in older adults : a meta-analysis", Int J Environ Res Public Health, 19(11), pp.6750~ (2022)
  77. Saatmann N, "Effects of blood flow restriction exercise and possible applications in type 2diabetes", Trends Endocrinol Metab, 32(2), pp.106~117 (2021)
  78. Slysz J, "The efficacy of blood flow restricted exercise : a systematic review & meta-analysis", J Sci Med Sport, 19(8), pp.669~675 (2016)
  79. Lopes KG, "Exercise with blood flow restriction improves muscle strength and mass while preserving the vascular and microvascular function and structure of older adults", Clin Hemorheol Microcirc (2022)[DOI]
  80. Mattocks KT, "The effects of upper body exercise across different levels of blood flow restriction on arterial occlusion pressure and perceptual responses", Physiol Behav, 171, pp.181~186 (2017)
  81. 김태호, "일회성 혈류제한 저항성 운동이 성인남성의 대퇴둘레, 젖산, CK 및 산화스트레스에 미치는 영향", 운동과학, 27(1), pp.50~61 (2018), 한국운동생리학회[DOI]
  82. Patterson SD, "Blood flow restriction exercise : considerations of methodology, application, and safety", Front Physiol, 10, pp.533~ (2019)
  83. Thompson WR, "Worldwide survey of fitness trends for 2020", ACSMs Health Fit J, 23(6), pp.10~18 (2019)
  84. Gibala MJ, "Physiological adaptations to low-volume, high-intensity interval training in health and disease", J Physiol, 590(5), pp.1077~1084 (2012)
  85. Gibala MJ, "Brief intense interval exercise activates AMPK and p38 MAPK signaling and increases the expression of PGC-1alpha in human skeletal muscle", J Appl Physiol(1985), 106(3), pp.929~934 (2009)
  86. Burgomaster KA, "Similar metabolic adaptations during exercise after low volume sprint interval and traditional endurance training in humans", J Physiol, 586(1), pp.151~160 (2008)
  87. Sandri M, "PGC-1alpha protects skeletal muscle from atrophy by suppressing FoxO3 action and atrophy-specific gene transcription", Proc Natl Acad Sci USA, 103(44), pp.16260~16265 (2006)
  88. Benton CR, "Modest PGC-1alpha overexpression in muscle in vivo is sufficient to increase insulin sensitivity and palmitate oxidation in subsarcolemmal, not intermyofibrillar, mitochondria", J Biol Chem, 283(7), pp.4228~4240 (2008)
  89. Marcangeli V, "Impact of high-intensity interval training with or without l-citrulline on physical performance, skeletal muscle, and adipose tissue in obese older adults", J Cachexia Sarcopenia Muscle, 13(3), pp.1526~1540 (2022)
  90. WisløffU, "Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients : a randomized study", Circulation, 115(24), pp.3086~3094 (2007)
  91. Tjønna AE, "Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome : a pilot study", Circulation, 118(4), pp.346~354 (2008)
  92. Kong Z, "Comparison of high-intensity interval training and moderate-to-vigorous continuous Training for cardiometabolic health and exercise enjoyment in obese young women : a randomized controlled trial", PLoS One, 11(7), pp.e0158589~ (2016)
  93. Ramos JS, "The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function : a systematic review and meta-analysis", Sports Med, 45(5), pp.679~692 (2015)
  94. Hanssen H, "Acute effects of interval versus continuous endurance training on pulse wave reflection in healthy young men", Atherosclerosis, 238(2), pp.399~406 (2015)
  95. Reichert FF, "The role of perceived personal barriers to engagement in leisure-time physical activity", Am J Public Health, 97(3), pp.515~519 (2007)
  96. Batacan RB, Jr, "Effects of high-intensity interval training on cardiometabolic health : a systematic review and meta-analysis of intervention studies", Br J Sports Med, 51(6), pp.494~503 (2017)
  97. 정원상, "Comparison of excess post-exercise oxygen consumption of different exercises in normal weight obesity women", Physical Activity and Nutrition, 23(2), pp.22~27 (2019), 한국운동영양학회[DOI]
  98. Hu J, "Effects of high-intensity interval training on improving arterial stiffness in chinese female university students with normal weight obese : a pilot randomized controlled trial", J Transl Med, 20(1), pp.60~ (2022)
  99. Lora-Pozo I, "Anthropometric, cardiopulmonary and metabolic benefits of the high-intensity interval training versus moderate, low-intensity or control for type 2 diabetes : systematic review and meta-analysis", Int J Environ Res Public Health, 16(22), pp.4524~ (2019)
  100. Su L, "Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and", or obesity : a meta-analysis, 2019, pp.14(1), e0210644~
  101. Wen D, "Effects of different protocols of high intensity interval training for VO(2)max improvements in adults : a meta-analysis of randomised controlled trials", J Sci Med Sport, 22(8), pp.941~947 (2019)

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