Stensvold D, Tjønna AE, Skaug EA, Aspenes S, Stølen T, Wisløff U, Slørdahl SA. Strength training versus aerobic interval training to modify risk factors of metabolic syndrome. J Appl Physiol 108: 804-810, 2010. First published January 21, 2010 doi:10.1152/japplphysiol.00996.2009.-Metabolic syndrome is characterized by central obesity, elevated blood pressure, high fasting glucose and triglyceride levels, and low HDL levels. Regular physical activity can improve the metabolic profile and reduce the risks of cardiovascular diseases and premature mortality. However, the optimal training regime to treat metabolic syndrome and its associated cardiovascular abnormalities remains undefined. Fortythree participants with metabolic syndrome were randomized to one of the following groups: aerobic interval training (AIT; n ϭ 11), strength training (ST; n ϭ 11), a combination of AIT and ST (COM; n ϭ 10) 3 times/wk for 12 wk, or control (n ϭ 11). Risk factors comprising metabolic syndrome were evaluated before and after the intervention. Waist circumference (in cm) was significantly reduced after AIT [95% confidence interval (CI): Ϫ2.5 to Ϫ0.04], COM (95% CI: Ϫ2.11 to Ϫ0.63), and ST (95% CI: Ϫ2.68 to Ϫ0.84), whereas the control group had an increase in waist circumference (95% CI: 0.37-2.9). The AIT and COM groups had 11% and 10% increases in peak O2 uptake, respectively. There were 45% and 31% increases in maximal strength after ST and COM, respectively. Endothelial function, measured as flow-mediated dilatation (in %), was improved after AIT (95% CI: 0.3-3), COM (95% CI: 0.3-3), and ST (95% CI:

These data represent the largest reference material of objectively measured VO2peak in healthy men and women age 20-90 yr. Even in people considered to be fit, VO2peak was clearly associated with levels of conventional cardiovascular risk factors.

The distribution of FMD in this study is representative of the respective age and gender groups of a healthy population and may be a useful reference for future studies. The high proportion of endothelial dysfunction came as a surprise. Its age and gender distribution suggest that FMD ≤0% precedes cardiovascular disease and that it may be a powerful non-invasive biomarker for identifying high-risk individuals.

BackgroundSeveral studies suggest that cardiovascular risk factors comprising the metabolic syndrome have larger effects on the development of cardiovascular disease in women than in men. A recent study in self-reported healthy subjects demonstrated a marked gender difference in endothelial dysfunction that may be an important precursor of manifest cardiovascular disease. The aim of the present study was to determine whether the association between endothelial function and cardiovascular risk factors is different in self-reported healthy women compared to self-reported healthy men.Methods and ResultsAssociations between endothelial function (flow mediated dilation, FMD, of the brachial artery measured by ultrasound), anthropometric variables, peak oxygen uptake (VO2peak), blood pressure, serum lipids, blood glucose and a questionnaire on general health and lifestyle including smoking status were studied by logistic and linear regression in 2 528 women and 2 211 men aged 20–89 years, free from self-reported cardiovascular disease. In women with hyperglycemia, endothelial dysfunction (FMD ≤0%) occurred twice as frequently as in male counterparts. The presence of the metabolic syndrome, high blood pressure and low VO2peak increased the prevalence of endothelial dysfunction more in women than in men.ConclusionEndothelial dysfunction is more strongly associated with cardiovascular risk factors in self-reported healthy women than in self-reported healthy men. This finding could explain why the metabolic syndrome, and especially hyperglycemia, is associated with higher cardiovascular risk and a worse prognosis in women.