Dyspnea on Exertion in Obesity: Effects of Exercise Training and Weight Loss

肥胖患者用力时呼吸困难：运动训练和减肥的效果

基本信息

批准号：
8600718
负责人：
TONY G BABB
金额：
$ 42.38万
依托单位：
UT SOUTHWESTERN MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-01-01 至 2016-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8600718
关键词：
Adult American Americas Body Weight decreased Breathing Cardiovascular Deconditioning Cardiovascular system Cessation of life Chest wall structure Clinical Comorbidity Coronary heart disease Data Development Diabetes Mellitus Disease Dyspnea Effectiveness Epidemic Ergometry Exercise Exertion Fatty acid glycerol esters Health Hyperpnea Intervention Malignant Neoplasms Measures Metabolic Metabolic syndrome Morbidity - disease rate Obesity Overweight Oxygen Patients Physical activity Physiological Prevalence Prevention Quality of life Research Respiratory Mechanics Risk Risk Factors Shortness of Breath Sleep Apnea Syndromes Stroke Testing Training United States Woman Work of Breathing base clinically relevant conditioning cost experience heart disease risk hypertensive heart disease improved mortality novel obesity treatment prevent respiratory response therapy development

项目摘要

7. PROJECT SUMMARY/ABSTRACT Obesity is an epidemic problem in the United States and is among the most important health challenges of the 21st Century. The major consequences of obesity are increased rates of mortality and morbidity from heart disease, hypertension, diabetes, sleep-disordered breathing, and the metabolic syndrome. Many obese adults experience exertional dyspnea and are unable to exercise. Therefore, exertional dyspnea in obese adults is not only an important and prolific clinical concern it is an obstacle to the prevention and treatment of obesity and obesity-related comorbidities. Although most obese adults with dyspnea on exertion are generally considered to be deconditioned, our preliminary data challenge this conventional wisdom. For example, in women with dyspnea on exertion, we have found the oxygen cost of breathing (i.e., work of breathing) to be markedly increased and highly associated with exertional dyspnea. Thus, it is presently unclear if exertional dyspnea in obesity is due to cardiovascular deconditioning, in which exercise training would be dramatically beneficial, or to obesity-related changes in respiratory mechanics, in which aggressive weight loss measures may be necessary before exercise training can be tolerated. The overall objective of this application is to investigate whether exertional dyspnea in otherwise healthy obese adults can be ameliorated by endurance exercise training (i.e., increase in cardiovascular conditioning), or by weight loss (i.e., decrease in obesity related-respiratory limitations, specifically, the oxygen cost of breathing). We hypothesize that exertional dyspnea in otherwise healthy obese adults will not improve with endurance exercise training since obese adults with exertional dyspnea are not deconditioned, and exercise training alone is unlikely to decrease obesity-related respiratory limitations, specifically the oxygen cost of breathing. In contrast, we hypothesize that exertional dyspnea will be ameliorated with weight loss, since weight loss should decrease obesity related-respiratory limitations, in particular, the oxygen cost of breathing. In this application, we will utilize two interventions to investigate our proposals: 1) endurance exercise training without weight loss, and 2) weight loss without endurance exercise training. Specific Aims: To accomplish the overall objective, the following hypotheses will be tested: 1) Endurance exercise training will not ameliorate exertional dyspnea in obese adults with dyspnea on exertion; and 2) Weight loss, especially loss of chest wall fat, will ameliorate exertional dyspnea in obese adults with dyspnea on exertion. Our long-term objective is to investigate the mechanism of exertional dyspnea in obese adults and provide novel and clinically relevant results that could potentially alter interventional approaches for preventing obesity, treating obesity, and reducing the risk of heart disease, hypertension, and the metabolic syndrome in obese patients.

7。项目摘要/摘要肥胖是美国的流行病问题，是最重要的健康挑战之一 21世纪。肥胖的主要后果是死亡率和发病率提高心脏病，高血压，糖尿病，睡眠呼吸的呼吸和代谢综合征。许多肥胖的成年人患有锻造性呼吸困难，无法运动。因此，劳累性呼吸困难肥胖的成年人不仅是重要且多产的临床关注，这是预防和治疗肥胖和肥胖相关的合并症。虽然大多数肥胖的成年人患有呼吸困难通常认为努力是被剥夺的，我们的初步数据挑战了这个常规的智慧。例如，在劳累呼吸困难的女性中，我们发现呼吸的氧气成本（即呼吸的工作）要明显增加并高度与劳累呼吸困难相关。因此，是目前尚不清楚肥胖症中的肌肉呼吸困难是否是由于心血管疾病引起的，其中运动训练将极为有益，或者对与肥胖相关的呼吸机械变化，其中在耐受运动训练之前，可能需要采取积极的减肥措施。总体该应用的目的是调查其他健康肥胖成年人中的肌肉呼吸困难可以通过耐力运动训练（即心血管调节的增加）或通过体重减轻（即，肥胖相关呼吸局限性的减少，特别是氧气成本呼吸）。我们假设在健康肥胖的成年人中施加劳一般呼吸困难将无法改善耐力运动训练，因为肥胖的成年人患有劳累性呼吸困难，并没有进行锻炼仅训练就不太可能降低与肥胖相关的呼吸限制，特别是氧气成本呼吸。相比之下，我们假设劳累性呼吸困难将随着体重减轻而改善，因为体重减轻应减少肥胖相关呼吸限制，特别是呼吸。在此应用程序中，我们将利用两种干预措施来研究我们的建议：1）耐力不体重减轻的运动训练，2）体重减轻而无需耐力运动训练。具体目的：为了实现总体目标，将测试以下假设：1）耐力运动培训在劳累时肥胖的成年人中不会改善施加性呼吸困难； 2）减肥，尤其是胸壁脂肪的损失，会减轻肥胖成年人呼吸困难的劳累呼吸困难用力。我们的长期目标是研究肥胖成年人和提供新颖和临床相关的结果，可能会改变介入方法预防肥胖，治疗肥胖，降低心脏病，高血压和代谢的风险肥胖患者综合征。