SummaryBackgroundEndothelial dysfunction and postprandial hyperglycemia represent independent risk factors for cardiovascular diseases. Obesity is connected with endothelial impairments; however, it is unclear whether weight loss can modify endothelial function during the postprandial period. The aim of this study was to evaluate endothelial response (post-ischemic forearm blood flow, PIFBF) in a fasted state and following ingestion of 75g glucose before and after very low caloric diet (VLCD).Material/Methods40 obese premenopausal women (age 39.6±7.8 years, BMI 34.3±3.2 kg/m2) participated in 4-week very low caloric diet (VLCD, 800kcal/day). Before and after VLCD, the baseline blood flow and PIFBF were measured using a mercury strain gauge plethysmography in fasting state as well as 1 hour after ingestion of 75 g glucose.ResultsDietary intervention resulted in a 7% weight loss (p<0.05) and a decrease in insulin resistance index HOMA-IR (2.44±1.25 vs. 1.66±0.81, p<0.05). Before VLCD intervention, PIFBF following oral glucose challenge decreased by 8.2±9.1 ml/min/100 g tissue, while after weight loss identical stimulus increased PIFBF by 4.2±8.9 ml/min/100 g tissue (p<0.05). Plasma ICAM-1 and VCAM-1 decreased by 8% and 10%, respectively, throughout the study.ConclusionsPostprandial endothelial dysfunction is ameliorated following weight loss in obese women. This finding demonstrates the beneficial effects of weight reduction on atherosclerosis risk.
This study aimed to analyze the changes in postural stability of individuals with obesity after bariatric surgery, and the effect of three months of regular exercise on the static postural stability. Twenty-two subjects (7 females and 15 males) aged 31 to 68 years (Body mass index 35–55 kg.m-2) completed the study. Participants were divided into two groups: one group participated in an exercise program after the bariatric surgery (n = 10; age 48.9 ± 7.5 years; Body mass index 42 ± 5.6 kg.m-2) while the second group did not exercise at all after bariatric surgery (n = 12; age 44.7 ± 13.6 years, Body mass index 42.6 ± 6.0 kg.m-2). Static postural stability was measured using a Tekscan MobileMat pressure plate before and 4 months after the bariatric surgery. The exercise program included exercising three times a week including: one hour of strengthening, one hour of aerobic group exercise and at least one session of individual exercise at home. There were no significant differences in Center of force sway, Center of force ranges and average speed before and 4 months after bariatric surgery. Also, no effect of exercise was found. Post-pre differences of some parameters were negatively related to age (r from—0.46 to—0.72). Further studies are needed to explore this topic in depth.
3. interní klinika -klinika endokrinologie a metabolismu 1. LF UK a VFN Praha 2 FTVS Praha -Katedra zdravotní TV a tělovýchovného lékařství, Praha 3 3. klinika rehabilitačního lékařství 1. LF UK a VFN Praha 4 ORP centrum, Praha Fyzická aktivita je nedílnou součástí léčby obezity. Až překvapivě i mezi zdravotníky přetrvává hodnocení léčby obezity pouze na základě hmotnostního poklesu. Léčba obezity není však jen prosté snižování hmotnosti, ale především léčba přidružených onemocnění, jako hypertenze, diabetes, dyslipidemie apod. Jen velmi zřídka je hodnocena fyzická zdatnost, ačkoliv ta nejlépe predikuje budoucnost a snižuje mortalitu ze všech příčin. Jedná se především o kardiovaskulární onemocnění, kde se ukazuje, že parametr VO 2Max je nejsilnějším prediktorem nejen kardiovaskulární mortality. Specifika preskripce fyzické aktivity pak s sebou přináší přítomnost nejen diabetu, hypertenze a kardiovaskulárních onemocnění, ale i artrózy nosných kloubů, event. absolvování bariatrické operace. K objektivizaci fyzické aktivity včetně subjektivních příznaků je vhodné využít moderních metod telemedicíny, která je tak budoucností při léčbě nejen obezity.
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