اﺛﺮ ﺗﻤﺮﯾﻦ ﻫﻮازي- ﻣﻘﺎوﻣﺘﯽ ﺑﺮ ﻏﻠﻈﺖ ﺳﺮﻣﯽ رﺗﯿﻨﻮل ﻣﺘﺼﻞ ﺑﻪ ﭘﺮوﺗﺌﯿﻦ4، ﭼﺎﻗﯽ ﺷﮑﻤﯽ و ﺷﺎﺧﺺ ﻫﺎي ﻣﺘﺎﺑﻮﻟﯿﮑﯽ در زﻧﺎن ﯾﺎﺋﺴﻪ ﻣﺒﺘﻼ ﺑﻪ ﮐﺒﺪ ﭼﺮب ﻏﯿﺮ اﻟﮑﻠﯽ

The Effect of Aerobic-Resistance Exercise on Serum Level of Retinol-Bonded Protein 4, Abdominal Obesity, and Metabolic Markers in Postmenopausal Women with Non-Alcoholic Fatty Liver

ﺳﺎﺑﻘﻪ و ﻫﺪف: اﻓﺰاﯾﺶ ﺳﻦ و ﺗﻐﯿﯿﺮات ﻫﻮرﻣﻮﻧﯽ در ﻫﻨﮕﺎم ﯾﺎﺋﺴﮕﯽ ﺑﺎﻋﺚ ﺗﻐﯿﯿﺮ ﻋﻤﻠﮑﺮد در ﺑﺮﺧﯽ ﺳﯿﺴﺘﻢ ﻫﺎي ﻓﯿﺰﯾﻮﻟﻮژﯾﮑﯽ ﺑﺪن ﻣﯽ ﮔﺮدد و ﺑﻪ ﻃﻮر ﻣﻨﺤﺼﺮ ﺑﻪ ﻓﺮدي زﻧﺎن را در ﻣﻌﺮض ﺑﯿﻤﺎري ﮐﺒﺪ ﭼﺮب ﻏﯿﺮ اﻟﮑﻠﯽ )NAFLD( ﻗﺮار ﻣﯽ دﻫﺪ. ﻫﺪف از اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ اﺛﺮ ﺗﻤﺮﯾﻦ ﻫﻮازي- ﻣﻘﺎوﻣﺘﯽ ﺑﺮ ﻏﻠﻈﺖ ﺳﺮﻣﯽ رﺗﯿﻨﻮل ﻣﺘﺼﻞ ﺑﻪ ﭘﺮوﺗﺌﯿﻦ4، ﭼﺎﻗﯽ ﺷﮑﻤﯽ و ﺷﺎﺧﺺ ﻫﺎي ﻣﺘﺎﺑﻮﻟﯿﮑﯽ در زﻧﺎن ﯾﺎﺋﺴﻪ ﻣﺒﺘﻼ ﺑﻪ ﮐﺒﺪ ﭼﺮب ﻏﯿﺮ اﻟﮑﻠﯽ ﺑﻮد. ﻣﻮاد و روﺷﻬﺎ: 24 زن ﯾﺎﺋﺴﻪ ﻏﯿﺮ ﻓﻌﺎل ﻣﺒﺘﻼ ﺑﻪ ﮐﺒﺪ ﭼﺮب ﺑﺎ داﻣﻨﻪ ﺳﻨﯽ 68-50 ﺳﺎل، ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه ﺗﻤﺮﯾﻦ و ﮐﻨﺘﺮل ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﺗﻤﺮﯾﻨﺎت ﻫﻮازي )ﺑﺎ ﺷﺪت 50 ﺗﺎ 75 درﺻﺪ ﺿﺮﺑﺎن ﻗﻠﺐ ﺑﯿﺸﯿﻨﻪ( و ﻣﻘﺎوﻣﺘﯽ )ﺑﺎ ﺷﺪت 50 ﺗﺎ 75 درﺻﺪ ﯾﮏ ﺗﮑﺮار ﺑﯿﺸﯿﻨﻪ( 3 ﺟﻠﺴﻪ در ﻫﻔﺘﻪ، ﺑﻪ ﻣﺪت 10 ﻫﻔﺘﻪ اﻧﺠﺎم ﺷﺪ. ﭼﺮﺑﯽ ﮐﺒﺪ ﺑﺎ ﺳﻮﻧﻮﮔﺮاﻓﯽ، ﻣﻘﺪار RBP4 ﺑﺎ روش اﻻﯾﺰا، ﺷﺎﺧﺺ ﻣﻘﺎوﻣﺖ ﺑﻪ اﻧﺴﻮﻟﯿﻦ )HOMA-IR(، ﺷﺎﺧﺺ ﻫﺎي آﻧﺘﺮوﭘﻮﻣﺘﺮﯾﮏ، ﭘﺮوﻓﺎﯾﻞ ﻟﯿﭙﯿﺪي و آﻧﺰﯾﻢ ﻫﺎي ﮐﺒﺪي اﻧﺪازه ﮔﯿﺮي ﺷﺪﻧﺪ. داده ﻫﺎ ﺑﺎ آزﻣﻮن ﮐﻮارﯾﺎﻧﺲ، t ﻫﻤﺒﺴﺘﻪ و وﯾﻠﮑﺎﮐﺴﻮن، ﻫﻤﭽﻨﯿﻦ آزﻣﻮن ﭘﯿﺮﺳﻮن و اﺳﭙﯿﺮﻣﻦ ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﺗﻤﺮﯾﻦ ﻫﻮازي ﻣﻘﺎوﻣﺘﯽ ﺑﺎﻋﺚ ﮐﺎﻫﺶ ﻣﻌﻨﺎدار ﺳﻄﺢ RBP4، ﺷﺎﺧﺺ ﻣﻘﺎوﻣﺖ ﺑﻪ اﻧﺴﻮﻟﯿﻦ، ﮔﻠﻮﮐﺰ ﻧﺎﺷﺘﺎ، ﺷﺎﺧﺺ ﻫﺎي آﻧﺘﺮوﭘﻮﻣﺘﺮﯾﮏ، آﺳﭙﺎرﺗﺎت آﻣﯿﻨﻮ ﺗﺮاﻧﺴﻔﺮاز )AST(، ﺗﺮي ﮔﻠﯿﺴﺮﯾﺪ )LDL ،(TG و ﮐﺒﺪ ﭼﺮب در ﮔﺮوه ﺗﻤﺮﯾﻦ در ﻣﻘﺎﯾﺴﻪ ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﺷﺪ )0.05P(. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﺗﻤﺮﯾﻦ ﻫﻮازي- ﻣﻘﺎوﻣﺘﯽ ﻣﯽ ﺗﻮاﻧﺪ در زﻧﺎن ﯾﺎﺋﺴﻪ ﺳﻄﺢ RBP4 و ﻣﻘﺎوﻣﺖ ﺑﻪ اﻧﺴﻮﻟﯿﻦ را ﮐﺎﻫﺶ دﻫﺪ و ﺑﺎ ﮐﺎﻫﺶ ﭼﺎﻗﯽ ﺷﮑﻤﯽ و ﭘﺮوﻓﺎﯾﻞ ﻟﯿﭙﯿﺪي در ﺑﻬﺒﻮد ﮐﺒﺪ ﭼﺮب ﻏﯿﺮ اﻟﮑﻠﯽ ﻣﻮﺛﺮ ﺑﺎﺷﺪ.

Background and Purpose: Aging and postmenopausal hormonal changes cause changes in the function of certain physiological systems of the body, and expose women to the risk of non-alcoholic fatty liver disease (NAFLD) in a unique manner. The present study was conducted to investigate the effect of aerobic-resistance exercise on serum concentration of retinol-bonded protein 4 (RBP4), abdominal obesity, and metabolic markers in postmenopausal women with non-alcoholic fatty liver. Methodology: Twenty-four 50-68 year-old sedentary postmenopausal women with fatty liver were randomly divided into exercise and control groups. Aerobic (at intensity of 50% to 75% of maximum heart rate) and resistance (at intensity of 50% to 75% of a maximum repetition) exercises were carried out over three sessions per week for ten weeks. The following indices were measured: liver fat by ultrasound, RBP4 by ELISA method, insulin resistance index (HOMA-IR), anthropometric indices, lipid profile, and liver enzymes. The data were analyzed using ANCOVA, paired t, Wilcoxon, Pearson and Spearman tests. Results: Aerobic-resistance exercise significantly reduced RBP4 level, insulin resistance index, fasting blood glucose, Anthropometric characteristics, aspartate aminotransferase (AST), triglyceride (TG), LDL, and fatty liver in the exercise group compared to those in the control group (p < 0.05). Moreover, RBP4 had significant relationships with fatty liver, triglyceride, abdominal obesity, and body weight (p < 0.05). No significant change was observed in alanine aminotransferase (ALT), fasting insulin, and HDL (P>0.05). Conclusion: Aerobic-resistance exercise can reduce RBP4 level and insulin resistance, and improve NAFLD in postmenopausal women by reducing abdominal obesity and lipid profile.