Effect of mechanical and metabolic factors on motor function and fatigue in obese men and women: A cross-sectional study
Tóm tắt
Background: Mechanical overload and poor quality of contractile elements related to metabolic abnormalities concur to motor disability of obesity. The independent contribution of these factors to motor dysfunction in obese individuals is scarcely defined. Aim: Aim of the study is to test the hypothesis that metabolic factors may independently affect motor function in obesity. Methods: Leg maximum power output per unit body mass (Ẇmb), per unit fat-free mas (Ẇffm) and fatigue in daily functioning were assessed in 635 obese [body mass index (BMI)≥35 kg/m2] individuals (286 men, 349 women) aged 19–78 yr. The independent effects of age, BMI, insulin resistance and the five components of the metabolic syndrome on Ẇmb, Ẇffm and fatigue were evaluated by multivariate analysis. Results: A multiple regression analysis revealed that in both genders Ẇmb (denoting the individual’s performance capability during anaerobic tasks) was independently reduced by age (p<0.001), BMI (p<0.05–0.001) and abnormalities of glucose metabolism (p<0.06–0.01), while Ẇffm (representing the muscle intrinsic anaerobic capability) was affected only by age (p<0.001) and glucose metabolism impairment (p<0.06–0.01). In both genders fatigue was increased by age (p<0.001) and BMI (p<0.05–0.01), but augmented by low levels of HDL-cholesterol in men only (p<0.05). Conclusions: Besides depending on mechanical overload and age, low muscle power output in obese individuals was independently associated also with metabolic abnormalities related to impaired glucose homeostasis. Fatigue and performance, although similarly influenced by age and body mass excess, are affected by different metabolic factors.
Tài liệu tham khảo
Flegal KM. The obesity epidemic in children and adults: current evidence and research issues. Med Sci Sports Exer 1999, 31: S509–14.
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006, 295: 1549–55.
Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999, 282: 1523–9.
Nantel J, Mathieu ME, Prince F. Physical activity and obesity: biomechanical and physiological key concepts. J Obes 2011, 2011: 650230.
Evers Larsson U, Mattsson E. Functional limitations linked to high body mass index, age and current pain in obese women. Int J Obes Relat Metab Disord 2001, 25: 893–9.
Hulens M, Vansant G, Lysens R, Claessens AL, Muls E. Exercise capacity in lean versus obese women. Scand J Med Sci Sports 2001, 11: 305–9.
Ells LJ, Lang R, Shield JP, et al. Obesity and disability — a short review. Obes Rev 2006, 7: 341–5.
Han TS, Tijhuis MA, Lean ME, Seidell JC. Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998, 88: 1814–20.
Mattsson E, Larsson UE, Rössner S. Is walking for exercise too exhausting for obese women?. Int J Obes Relat Metab Disord 1997, 21: 380–6.
Lafortuna CL, Maffiuletti NA, Agosti F, Sartorio A. Gender variations of body composition, muscle strength and power output in morbid obesity. Int J Obes (Lond) 2005, 29: 833–41.
Hilton TN, Tuttle LJ, Bohnert KL, Mueller MJ, Sinacore DR. Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function. Phys Ther 2008, 88: 1336–44.
Peterson MD, Liu D, Gordish-Dressman H, et al. Adiposity attenuates muscle quality and the adaptive response to resistance exercise in non-obese, healthy adults. Int J Obes (Lond) 2011, 35: 1095–103.
Goodpaster BH, Carlson CL, Visser M, et al. Attenuation of skeletal muscle and strength in the elderly: The Health ABC Study. J Appl Physiol 2001, 90: 2157–65.
Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol 2000, 89: 104–10.
Goodpaster BH, Thaete FL, Kelley DE. Thigh adipose tissue distribution is associated with insulin resistance in obesity and in type 2 diabetes mellitus. Am J Clin Nutr 2000, 71: 885–92.
Lafortuna CL, Fumagalli E, Vangeli V, Sartorio A. Lower limb alactic anaerobic power output assessed with different techniques in morbid obesity. J Endocrinol Invest 2002, 25: 134–41.
Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care 2004, 27: 1487–95.
Margaria R, Aghemo P, Rovelli E. Measurement of muscular power (anaerobic) in man. J Appl Physiol 1966, 21: 1662–4.
Sartorio A, Fontana P, Trecate L, Lafortuna CL. Short-term changes of fatigability and muscle performance in severe obese patients after an integrated body mass reduction program. Diab Nutr Metab 2003, 16: 88–93.
Grieve FG, Harris DS, Fairbanks SD. Extending the Fatigue Severity Scale to an obese population. Eat Weight Disord 2000, 5: 161–5.
Young A. Ageing and physiological functions. Philos Trans R Soc Lond B Biol Sci 1997, 352: 1837–43.
Sartorio A, Proietti M, Marinone PG, Agosti F, Adorni F, Lafortuna CL. Influence of gender, age and BMI on lower limb muscular power output in a large population of obese men and women. Int J Obes (Lond) 2004, 28: 91–8.
Browning RC, Baker EA, Herron JA, Kram R. Effects of obesity and sex on the energetic cost and preferred speed of walking. J Appl Physiol 2006, 100: 390–8.
Lafortuna CL, Agosti F, Galli R, Busti C, Lazzer S, Sartorio A. The energetic and cardiovascular response to treadmill walking and cycle ergometer exercise in obese women. Eur J Appl Physiol 2008, 103: 707–17.
Anton-Kuchly B, Roger P, Varene P. Determinants of increased energy cost of submaximal exercise in obese subjects. J Appl Physiol 1984, 56: 18–23.
Lafortuna CL, Chiavaroli S, Rastelli F, et al. Energy cost and cardiovascular response to upper and lower limb rhythmic exercise with different equipments in normal-weight and severely obese individuals. J Endocrinol Invest 2011, 34: 131–9.
Lafortuna CL, Tresoldi D, Rizzo G. Influence of body adiposity on structural characteristics of skeletal muscle in men and women. Clin Physiol Funct Imaging 2014, 34: 47–55.
Maffiuletti NA, Jubeau M, Munzinger U, et al. Differences in quadriceps muscle strength and fatigue between lean and obese subjects. Eur J Appl Physiol 2007, 101: 51–9.
Gallagher D, Kuznia P, Heshka S, et al. Adipose tissue in muscle: a novel depot similar in size to visceral adipose tissue. Am J Clin Nutr 2005, 81: 903–10.
Regitz-Zagrosek V, Lehmkuhl E, Weickert MO. Gender differences in the metabolic syndrome and their role for cardiovascular disease. Clin Res Cardiol 2006, 95: 136–47.
Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest 2000, 106: 473–81.
Laakso M, Edelman SV, Brechtel G, Baron AD. Decreased effect of insulin to stimulate skeletal muscle blood flow in obese man. A novel mechanism for insulin resistance. J Clin Invest 1990, 85: 1844–52.
Lteif A, Vaishnava P, Baron AD, Mather KJ. Endothelin limits insulin action in obese/insulin-resistant humans. Diabetes 2007, 56: 728–34.
Salvadego D, Lazzer S, Busti C, et al. Gas exchange kinetics in obese adolescents. Inferences on exercise tolerance and prescription. Am J Physiol Regul Integr Comp Physiol 2010, 299: R1298–305.
Holgate ST, Komaroff AL, Mangan D, Wessely S. Chronic fatigue syndrome: understanding a complex illness. Nat Rev Neurosci 2011, 12: 539–44.
Lim W, Hong S, Nelesen R, Dimsdale JE. The association of obesity, cytokine levels, and depressive symptoms with diverse measures of fatigue in healthy subjects. Arch Intern Med 2005, 165: 910–5.
Vgontzas AN, Bixler EO, Chrousos GP. Obesity-related sleepiness and fatigue. Ann NY Acad Sci 2006, 1083: 329–44.
Kennedy G, Spence VA, McLaren M, Hill A, Underwood C, Belch JJ. Oxidative stress levels are raised in chronic fatigue syndrome and are associated with clinical symptoms. Free Radic Biol Med 2005, 39: 584–9.
Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001, 414: 813–20.
Borrás C, Sastre J, García-Sala D, Lloret A, Pallardó FV, Viña J. Mitochondria from females exhibit higher antioxidant gene expression and lower oxidative damage than males. Free Radic Biol Med 2003, 34: 546–52.
Bloomer RJ, Fisher-Wellman KH. Blood oxidative stress biomarkers: influence of sex, exercise training status, and dietary intake. Gend Med 2008, 5: 218–28.