DOI QR코드

DOI QR Code

유산소 운동과 짐볼 운동이 비알코올성 지방간 비만아의 간 기능평가 지수와 Adipokine 및 심혈관 질환 위험인자에 미치는 영향

Effect of Aerobic Exercise and Gym-ball Exercise on the Liver Function Test Index, Adipokines, and Cardiovascular Risk Factors in Obese Children with Nonalcoholic Fatty Liver Disease

  • 이성수 (동아대학교 스포츠과학대학 스포츠지도학과)
  • Lee, Sung-Soo (Department of Coaching, Collage of Sports Sciences, Dong-A University)
  • 투고 : 2012.08.16
  • 심사 : 2012.09.25
  • 발행 : 2012.09.30

초록

본 연구에서는 12주간 비알코올성 지방간을 가진 비만아동을 대상으로 유산소 운동군과 짐볼 운동군으로 나누어 운동을 실시한 결과 체중, BMI, 체지방율이 유의하게 감소하였다. 또한 Adiponectin의 증가와 Leptin의 감소로 인해 인슐린저항성과 혈당, 인슐린 농도도 유의하게 감소하는 것으로 나타났다. 또한 이러한 Adipokine들의 긍정적인 기능들로 인하여 비알콜성 지방간을 평가하는 간 기능 평가지수인 AST와 ALT도 감소하는 것으로 나타났다. 결론적으로 비알코올성 지방간을 가진 비만아동뿐만 아니라 비알코올성 지방간 환자에 있어 유산소운동 뿐만 아니라 짐볼 운동에서도 운동효과가 유사하게 나타났으므로 규칙적인 운동은 심폐체력 증진 및 혈중지질의 감소와 함께 혈중 Adiponectin 발현을 증가시킴으로서 인슐린저항성 개선을 통하여 비알코올성 지방간 기능 개선 뿐만 아니라 비만으로 인한 당뇨병, 심혈관 질환 발병의 예방에도 도움이 될 수 있을 것으로 기대된다.

The aim of the present study was to investigate effects of a 12-week aerobic exercise training program and a gym-ball exercise training program on body composition, aspartate aminotransferase (AST), alanine aminotransferase (ALT), adipokines, and cardiovascular risk factors in obese children with nonalcoholic fatty liver disease. The subjects were separated into two groups, an aerobic exercise group (n=10), which practiced moderate aerobic exercise training for 12 weeks, and a gym-ball exercise group (n=13), which practiced resistance exercise training for 12 weeks. The results of the analyses are as follows: Weight, body mass index, and body fat were significantly lower (p<0.01, respectively), whereas the $VO_2$ max was higher in both groups (p<0.01). Fasting glucose, insulin and HOMA-IR levels were significantly decreased in the gym-ball exercise group (p<0.05), whereas adiponectin, AST, and ALT levels were significantly increased (p<0.05, p<0.001, p<0.001, respectively) in both groups after the 12-week exercise training program. In addition, our results showed that HOMA-IR, insulin, and concentrations of C-reactive protein (CRP) were significantly lower in both groups. They demonstrate that a 12-week program of regular aerobic exercise or gym-ball exercise yields beneficial effects such as an amelioration of cardiovascular risk factors, body indices, and liver function in obese children with nonalcoholic fatty liver disease.

키워드

참고문헌

  1. Angulo, P. 2002. Nonalcoholic fatty liver disease. N. Engl. J. Med. 346, 1221-1231. https://doi.org/10.1056/NEJMra011775
  2. Benson, A. C., Torode, M. E. and Fiatarone Singh, M. A. 2008. The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial. Int. J. Obes.(Lond). 32, 1016-1027. https://doi.org/10.1038/ijo.2008.5
  3. Clark, J. M., Brancati, F. L. and Diehl, A. M. 2003. The prevalence and etiology of elevated aminotransferase levels in the United States. Am. J. Gastroenterol. 98, 960-967. https://doi.org/10.1111/j.1572-0241.2003.07486.x
  4. Clark, J. M., Brancati, F. L. and Diehl, A. M. 2002. Nonalcoholic fatty liver disease. Gastroenterology 122, 1649-1657. https://doi.org/10.1053/gast.2002.33573
  5. Eisenmann, J. C., Baetee, R. T., Smith, D. T., Welk, G. J. and Fu, Q. 2008. Combined influence of physical activity and television viewing on the risk of overweight in US youth. Int. J. Obes. 32, 613-618. https://doi.org/10.1038/sj.ijo.0803800
  6. Fantuzzi, G. 2005. Adipose tissue, adipokines, and inflammation. J. Allergy Clin. Immunol. 115, 911-919. https://doi.org/10.1016/j.jaci.2005.02.023
  7. Hotamisligil, G. S., Arner, P., Caro, J. F., Atkinson, R. L. and Spiegelman, B. M. 1995. Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. J. Clin. Invest. 95, 2409-2415. https://doi.org/10.1172/JCI117936
  8. Hui, J. M., Hodg, A., Farrell, G. C., Kench, J. G., Kriketos, A. and Geroge, J. 2004. Beyond insulin resistance in NASH: TNF-alpha or adiponectin? Hepatology 40, 46-54.
  9. Laurson, K., Eisenmann, J. C. and Moore, S. 2008. Lack of association between television viewing, soft drink, physical activity and body mass index in children. Acta. Paediatr. 97, 795-800. https://doi.org/10.1111/j.1651-2227.2008.00713.x
  10. Ludwig, J., Viggiano, T. R., McGill, D. B. and Oh, B. J. 1980. Nonalcoholic steatohepatitis : Mayo Clinic experiences with a hitherto unnamed disease. Mayo. Clin. Proc. 55, 434-438.
  11. Mathur, P., Das, M. K. and Arora, N. K. 2007. Non-alcoholic fatty liver disease and childhood obesity. Indian J. Pediatr. 74, 401-407. https://doi.org/10.1007/s12098-007-0068-0
  12. Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F. and Turner, R. C. 1985. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetology 28, 412-419. https://doi.org/10.1007/BF00280883
  13. Nam, S. N. and An, S. H. 2008. The effect of combination exercise on body composition blood cholesterol and cardiac risk factors in middle obesity man. Korean Society of Exer. Physiol. 17, 49-58.
  14. Neuschwander-Tetri, B. A. and Caldwell, S. H. 2003. Nonalcoholic steatohepatitis : summary of an AASLD Single Topic Conference. Hepatology 37, 1202-1219. https://doi.org/10.1053/jhep.2003.50193
  15. Nobili, V., Marcellini, M., Devito, R., Ciampalini, P., Piemonte, F., Comparcola, D., Sartorelli, M. R. and Angulo, P. 2006. NAFLD in children: a prospective clinical-pathological study and effect of lifestyle advice. Hepatology 44, 458-465. https://doi.org/10.1002/hep.21262
  16. Obisesan, T. O., Ferrell, R. E., Goldberg, A. P., Phares, D. A., Ellis, T. J. and Hagberg, J. M. 2008. APOE genotype affects black-white responses of high-density lipoprotein cholesterol subspecies to Aerobic exercise training. Metabolism 57, 1669-1676 https://doi.org/10.1016/j.metabol.2008.07.022
  17. Parti, D., Tailoi, E. and Zanella, A. 2002. Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann. Intern. Med. 137, 1-10. https://doi.org/10.7326/0003-4819-137-1-200207020-00006
  18. Rashid, M. and Roberts, E. A. 2000. Nonalcoholic steatohepatitis in children. J. Pediatr. Gastroenterol. Nutr. 30, 48-53. https://doi.org/10.1097/00005176-200001000-00017
  19. Sanyal, A. J. 2002. American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease. Gastroenterology 123, 1705-1725. https://doi.org/10.1053/gast.2002.36572
  20. Savoye, M., Shaw, M., Dziura, J., Tamborlane, W. V., Rose, P., Guandalini, C., Goldberg-Gell, R., Burgert, T. S., Cali, A. M., Weiss, R. and Caprio, S. 2007. Effects of a weight management program on body Composition and metabolic parameters in overweight children : a randomized controlled trial. JAMA. 297, 697-704. https://doi.org/10.1001/jama.297.7.697-a
  21. Schindhelm, R. K., Dekker, J. M. and Nijpels, G. 2007. Alanine aminotransferase predict coronary heart disease events: a 10-year follow-up of the Hoorn study. Atherosclerosis 191, 391-396. https://doi.org/10.1016/j.atherosclerosis.2006.04.006
  22. Tragher, G. and Arcaro, G. 2007. Nonalcoholic fatty liver disease and increased risk of cardiovascular disease. Atherosclerosis 191, 235-240. https://doi.org/10.1016/j.atherosclerosis.2006.08.021
  23. Tragher, G., Bertolini, L. and Poli, F. 2005. Nonalcoholic fatty liver disease and risk of future cardiovascular event among type 2 diabetic patients. Diabetes 54, 3541-3546. https://doi.org/10.2337/diabetes.54.12.3541
  24. Trayhurn, P. and Wood, I. S. 2004. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br. J. Nutr. 92, 347-355. https://doi.org/10.1079/BJN20041213
  25. Vettor, R., Milan, G., Rossato, M. and Federspil, G. 2005. Review article: adipocytokines and insulin resistance. Aliment. Pharmacol. Ther. 22, 3-10. https://doi.org/10.1111/j.1365-2036.2005.02587.x
  26. Yang, H. R., Ko, J. S. and Seo, J. K. 2007. The Role of Adipokines in the Pathogenesis of Non-alcoholic Fatty Liver Disease in Obese Children: the Relationship between Body Fat Distribution and Insulin Resistance. Pediatric Gastroenterology, Hepatol. Nutr. 10, 185-192.

피인용 문헌

  1. The Analysis of Non-pharmacological Intervention Study for Nonalcoholic Fatty Liver Disease: Intervention Types and Measurement Parameters vol.15, pp.2, 2013, https://doi.org/10.7586/jkbns.2013.15.2.43