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Article(id=1325529985959875553, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325529948685091532, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025235, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1739203200000, receivedDateStr=2025-02-11, revisedDate=1744387200000, revisedDateStr=2025-04-12, acceptedDate=null, acceptedDateStr=null, onlineDate=1793960575808, onlineDateStr=2026-11-06, pubDate=1756051200000, pubDateStr=2025-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793960575808, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793960575808, creator=13701087609, updateTime=1793960575808, updator=13701087609, issue=Issue{id=1325529948685091532, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='8', pageStart='1065', pageEnd='1216', issueExtLink='null', onlineDate='null', pubDate='1756051200000', pubDateStr='2025-08-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793960566921, creator='13701087609', updateTime=1793960566921, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1185, endPage=1189, ext={EN=ArticleExt(id=1325529986177979362, articleId=1325529985959875553, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Effects of exercise combined with dietary intervention on vascular endothelial function and ferroptosis in obese female university students, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To compare the effects of aerobic exercise at maximal fat oxidation (FATmax) and FATmax intensity exercise combined with resistance training (RT), and dietary restriction on the body composition, vascular endothelial function and ferroptosis in obese female university students, so as to provide a reference for exploring the mechanisms by which exercise improves vascular endothelial function.

Methods

From February to May 2024, 70 obese female university students were recruited from Shanxi University and randomly divided into control group (n=24), FATmax group (n=24) and FATmax+RT group (n=22). From March 4 to May 26, 2024 control group maintained their normal living habits, FATmax group performed aerobic exercise at FATmax intensity three times per week for 60 minutes per session; FATmax +RT group performed combined aerobic and resistance exercise at FATmax intensity three times per week for 60 minutes per session. The daily dietary calorie intake for all groups was determined according to resting energy expenditure. Body composition, vascular endothelial function and ferroptosis were measured before and after the intervention.

Results

After 12 weeks of intervention, there were statistically significant differences in body mass, BMI, body fat, waist-hip ratio and muscle mass among the three groups (F=10.93, 5.88, 65.28, 21.14, 2.25, all P < 0.05). Compared with the control group, participants in both the FATmax group and the FATmax+RT group showed significant reductions in body weight, BMI, body fat and waist-hip ratio (all P < 0.05). Body fat and waist-hip ratio in FATmax+RT group were lower than those in FATmax group, and muscle mass was higher than those in FATmax group and control group (both P < 0.05). After 12 weeks of intervention, significant differences were observed among the three groups in serum NO, GSH, serum ferritin levels and FMD (F=9.14, 9.67, 4.78, 135.70, all P < 0.05). Compared with the control group, the serum NO, GSH levels and FMD significantly increased, and the serum ferritin level decreased (all P < 0.05) of obese female university students in FATmax group and FATmax+RT group. Serum GSH level and FMD increased and serum ferritin level decreased in FATmax +RT group when compared with FATmax group (all P < 0.05).

Conclusions

With the same exercise training duration and frequency, FATmax intensity aerobic exercise, alone or combined with resistance and dietary restriction, can significantly improve the body composition, vascular endothelial function and inhibit ferroptosis of obese female university students. However, FATmax intensity aerobic exercise combined with resistance training has more pronounced effects.

, authors=Mei YANG1, Anping CHEN1, Jingjing WANG1, Xiaoyun SU2, authorsList=Mei YANG, Anping CHEN, Jingjing WANG, Xiaoyun SU, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325529986551272419, articleId=1325529985959875553, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=运动结合饮食干预对肥胖女大学生血管内皮功能及铁死亡的影响, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的

比较最大脂肪氧化(FATmax)强度有氧运动、FATmax强度运动结合抗阻训练(RT)和饮食限制对肥胖女大学生身体成分及血管内皮功能和铁死亡的影响，为探讨运动改善血管内皮功能的机制提供参考。

方法

2024年2—5月，从山西大学招募70名符合标准的肥胖女大学生随机分成对照组(n=24)、FATmax组(n=24)及FATmax+RT组(n=22)。2024年3月4日至5月26日，对照组维持正常的生活习惯，FATmax组进行每周3次、60 min/次的FATmax强度有氧运动，FATmax+RT组进行每周3次FATmax强度有氧结合抗阻运动(有氧运动和抗阻运动强度均维持在FATmax)；3组受试者均进行饮食限制，每日饮食摄入的能量依据静息能耗确定。分别于试验前、后测试3组受试者身体成分、血管内皮功能及铁死亡指标，组间比较采用t检验和单因素方差分析。

结果

不同方式干预12周后，3组肥胖女大学生体重、体质量指数(BMI)、体脂肪量、腰臀比及肌肉质量差异均有统计学意义(F值分别为10.93，5.88，65.28，21.14，2.25，P值均 < 0.05)。与对照组比较，FATmax组及FATmax+RT组肥胖女大学生体重、BMI、体脂肪量及腰臀比均下降；且FATmax+RT组体脂肪量及腰臀比低于FATmax组、肌肉质量高于FATmax组及对照组(P值均 < 0.05)。不同方式干预12周后，3组肥胖女大学生血清一氧化氮(NO)、谷胱甘肽(GSH)、血清铁蛋白水平及内皮依赖性血流介导的血管舒张功能(FMD)差异均有统计学意义(F值分别为9.14，9.67，4.78，135.70，P值均 < 0.05)。与对照组比较，FATmax组及FATmax+RT组肥胖女大学生血清NO、GSH水平及FMD均增加，血清铁蛋白水平下降；与FATmax组比较，FATmax+RT组血清GSH及FMD增加、血清铁蛋白水平下降(P值均 < 0.05)。

结论

基于FATmax设计的有氧运动结合抗阻训练与单纯有氧运动的2种运动干预方案，联合饮食限制均能改善肥胖女大学生身体成分和血管内皮功能及抑制铁死亡的发生，其中FATmax强度有氧运动结合抗阻训练效果更加显著。

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杨梅(1980-)，女，河北吴桥人，硕士，讲师，主要研究方向为体育教育、运动与健康

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杨梅(1980-)，女，河北吴桥人，硕士，讲师，主要研究方向为体育教育、运动与健康

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Comparison of body composition before and after experiment among the three groups of obese female university students(x ±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前后人数统计值体重/kgBMI /(kg·m-2)体脂肪量/kg腰臀比肌肉质量/kg
对照组干预前2476.69±4.7029.17±0.9930.09±1.710.92±0.0345.89±3.58
干预后2474.49±3.6628.01±0.8928.63±1.980.91±0.0445.37±3.41
t值7.167.736.821.903.62
P值< 0.01< 0.01< 0.010.07< 0.01
FATmax组干预前2477.40±3.3629.63±1.3830.38±1.870.92±0.0246.54±2.28
干预后2471.05±2.92##27.21±1.35#24.14±1.99##0.87±0.03##46.05±2.59
t值10.1910.3514.2610.652.06
P值< 0.01< 0.01< 0.01< 0.010.05
FATmax+RT组干预前2277.70±2.7329.78±0.9230.95±1.190.91±0.0547.09±2.04
干预后2270.28±3.21##26.93±1.06##22.82±1.40##▼0.84±0.04##▼47.73±2.29##▼
t值16.1616.5820.866.55-3.50
P值< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325529990431002631, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325529985959875553, language=CN, label=表1, caption=

试验前后3组肥胖女大学生身体成分指标比较(x ±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前后人数统计值体重/kgBMI /(kg·m-2)体脂肪量/kg腰臀比肌肉质量/kg
对照组干预前2476.69±4.7029.17±0.9930.09±1.710.92±0.0345.89±3.58
干预后2474.49±3.6628.01±0.8928.63±1.980.91±0.0445.37±3.41
t值7.167.736.821.903.62
P值< 0.01< 0.01< 0.010.07< 0.01
FATmax组干预前2477.40±3.3629.63±1.3830.38±1.870.92±0.0246.54±2.28
干预后2471.05±2.92##27.21±1.35#24.14±1.99##0.87±0.03##46.05±2.59
t值10.1910.3514.2610.652.06
P值< 0.01< 0.01< 0.01< 0.010.05
FATmax+RT组干预前2277.70±2.7329.78±0.9230.95±1.190.91±0.0547.09±2.04
干预后2270.28±3.21##26.93±1.06##22.82±1.40##▼0.84±0.04##▼47.73±2.29##▼
t值16.1616.5820.866.55-3.50
P值< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325529990506500104, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325529985959875553, language=EN, label=Tab.2, caption=

Comparison of vascular endothelial function and ferroptosis before and after experiment among the three groups of obese female university students(x ±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前后人数统计值NO/ (μmol·L-1)ET-1/ (ng·L-1)FMD/%GSH/ (μmol·L-1)GPX 4/ (ng·mL-1)血清铁蛋白/ (μg·L-1)
对照组干预前2438.79±4.1258.29±10.128.02±0.45114.67±12.3672.75±11.89112.38±14.21
干预后2438.38±3.7256.42±9.797.92±0.47117.66±11.7072.96±10.49110.29±12.73
t值1.142.732.16-3.16-0.404.23
P值0.270.010.04< 0.010.70< 0.01
FATmax组干预前2436.92±4.2360.79±9.737.88±0.61118.83±15.2073.29±12.94113.33±10.81
干预后2442.04±3.10##53.75±8.8710.90±1.08##124.54±11.66#74.87±10.90107.96±8.60#
t值-14.1312.65-15.61-3.67-2.616.15
P值< 0.01< 0.01< 0.01< 0.010.02< 0.01
FATmax+RT组干预前2236.77±3.8961.18±8.787.72±0.51115.09±10.2174.05±12.95111.45±10.63
干预后2242.64±4.25##53.23±7.7912.96±1.41##▼131.05±6.38#▼79.32±10.14#101.09±9.41##▼
t值-14.5917.93-19.96-12.51-6.1817.44
P值< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325529990573608969, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325529985959875553, language=CN, label=表2, caption=

试验前后3组肥胖女大学生血管内皮功能及铁死亡指标比较(x ±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前后人数统计值NO/ (μmol·L-1)ET-1/ (ng·L-1)FMD/%GSH/ (μmol·L-1)GPX 4/ (ng·mL-1)血清铁蛋白/ (μg·L-1)
对照组干预前2438.79±4.1258.29±10.128.02±0.45114.67±12.3672.75±11.89112.38±14.21
干预后2438.38±3.7256.42±9.797.92±0.47117.66±11.7072.96±10.49110.29±12.73
t值1.142.732.16-3.16-0.404.23
P值0.270.010.04< 0.010.70< 0.01
FATmax组干预前2436.92±4.2360.79±9.737.88±0.61118.83±15.2073.29±12.94113.33±10.81
干预后2442.04±3.10##53.75±8.8710.90±1.08##124.54±11.66#74.87±10.90107.96±8.60#
t值-14.1312.65-15.61-3.67-2.616.15
P值< 0.01< 0.01< 0.01< 0.010.02< 0.01
FATmax+RT组干预前2236.77±3.8961.18±8.787.72±0.51115.09±10.2174.05±12.95111.45±10.63
干预后2242.64±4.25##53.23±7.7912.96±1.41##▼131.05±6.38#▼79.32±10.14#101.09±9.41##▼
t值-14.5917.93-19.96-12.51-6.1817.44
P值< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01
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运动结合饮食干预对肥胖女大学生血管内皮功能及铁死亡的影响
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杨梅 1 , 陈安平 1 , 王晶晶 1 , 苏晓云 2
中国学校卫生 | 疾病控制 2025,46(8): 1185-1189
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中国学校卫生 |疾病控制 2025 , 46 (8) : 1185 -1189
运动结合饮食干预对肥胖女大学生血管内皮功能及铁死亡的影响
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杨梅1, 陈安平1, 王晶晶1, 苏晓云2
作者信息
  • 1山西大学体育学院，太原 030006
  • 2山西医科大学汾阳学院护理学系
作者简介:

杨梅(1980-)，女，河北吴桥人，硕士，讲师，主要研究方向为体育教育、运动与健康

Effects of exercise combined with dietary intervention on vascular endothelial function and ferroptosis in obese female university students
Mei YANG1, Anping CHEN1, Jingjing WANG1, Xiaoyun SU2
Affiliations
  • 1Department of Physical Education, Shanxi University, Taiyuan 030006, Shanxi Province, China
出版时间: 2025-08-25 doi: 10.16835/j.cnki.1000-9817.2025235
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摘要
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目的

比较最大脂肪氧化(FATmax)强度有氧运动、FATmax强度运动结合抗阻训练(RT)和饮食限制对肥胖女大学生身体成分及血管内皮功能和铁死亡的影响，为探讨运动改善血管内皮功能的机制提供参考。

方法

2024年2—5月，从山西大学招募70名符合标准的肥胖女大学生随机分成对照组(n=24)、FATmax组(n=24)及FATmax+RT组(n=22)。2024年3月4日至5月26日，对照组维持正常的生活习惯，FATmax组进行每周3次、60 min/次的FATmax强度有氧运动，FATmax+RT组进行每周3次FATmax强度有氧结合抗阻运动(有氧运动和抗阻运动强度均维持在FATmax)；3组受试者均进行饮食限制，每日饮食摄入的能量依据静息能耗确定。分别于试验前、后测试3组受试者身体成分、血管内皮功能及铁死亡指标，组间比较采用t检验和单因素方差分析。

结果

不同方式干预12周后，3组肥胖女大学生体重、体质量指数(BMI)、体脂肪量、腰臀比及肌肉质量差异均有统计学意义(F值分别为10.93，5.88，65.28，21.14，2.25，P值均 < 0.05)。与对照组比较，FATmax组及FATmax+RT组肥胖女大学生体重、BMI、体脂肪量及腰臀比均下降；且FATmax+RT组体脂肪量及腰臀比低于FATmax组、肌肉质量高于FATmax组及对照组(P值均 < 0.05)。不同方式干预12周后，3组肥胖女大学生血清一氧化氮(NO)、谷胱甘肽(GSH)、血清铁蛋白水平及内皮依赖性血流介导的血管舒张功能(FMD)差异均有统计学意义(F值分别为9.14，9.67，4.78，135.70，P值均 < 0.05)。与对照组比较，FATmax组及FATmax+RT组肥胖女大学生血清NO、GSH水平及FMD均增加，血清铁蛋白水平下降；与FATmax组比较，FATmax+RT组血清GSH及FMD增加、血清铁蛋白水平下降(P值均 < 0.05)。

结论

基于FATmax设计的有氧运动结合抗阻训练与单纯有氧运动的2种运动干预方案，联合饮食限制均能改善肥胖女大学生身体成分和血管内皮功能及抑制铁死亡的发生，其中FATmax强度有氧运动结合抗阻训练效果更加显著。

运动活动  /  饮食习惯  /  干预性研究  /  血管  /  学生
Objective

To compare the effects of aerobic exercise at maximal fat oxidation (FATmax) and FATmax intensity exercise combined with resistance training (RT), and dietary restriction on the body composition, vascular endothelial function and ferroptosis in obese female university students, so as to provide a reference for exploring the mechanisms by which exercise improves vascular endothelial function.

Methods

From February to May 2024, 70 obese female university students were recruited from Shanxi University and randomly divided into control group (n=24), FATmax group (n=24) and FATmax+RT group (n=22). From March 4 to May 26, 2024 control group maintained their normal living habits, FATmax group performed aerobic exercise at FATmax intensity three times per week for 60 minutes per session; FATmax +RT group performed combined aerobic and resistance exercise at FATmax intensity three times per week for 60 minutes per session. The daily dietary calorie intake for all groups was determined according to resting energy expenditure. Body composition, vascular endothelial function and ferroptosis were measured before and after the intervention.

Results

After 12 weeks of intervention, there were statistically significant differences in body mass, BMI, body fat, waist-hip ratio and muscle mass among the three groups (F=10.93, 5.88, 65.28, 21.14, 2.25, all P < 0.05). Compared with the control group, participants in both the FATmax group and the FATmax+RT group showed significant reductions in body weight, BMI, body fat and waist-hip ratio (all P < 0.05). Body fat and waist-hip ratio in FATmax+RT group were lower than those in FATmax group, and muscle mass was higher than those in FATmax group and control group (both P < 0.05). After 12 weeks of intervention, significant differences were observed among the three groups in serum NO, GSH, serum ferritin levels and FMD (F=9.14, 9.67, 4.78, 135.70, all P < 0.05). Compared with the control group, the serum NO, GSH levels and FMD significantly increased, and the serum ferritin level decreased (all P < 0.05) of obese female university students in FATmax group and FATmax+RT group. Serum GSH level and FMD increased and serum ferritin level decreased in FATmax +RT group when compared with FATmax group (all P < 0.05).

Conclusions

With the same exercise training duration and frequency, FATmax intensity aerobic exercise, alone or combined with resistance and dietary restriction, can significantly improve the body composition, vascular endothelial function and inhibit ferroptosis of obese female university students. However, FATmax intensity aerobic exercise combined with resistance training has more pronounced effects.

Motor activity  /  Food habits  /  Intervention studies  /  Blood vessels  /  Students
杨梅, 陈安平, 王晶晶, 苏晓云. 运动结合饮食干预对肥胖女大学生血管内皮功能及铁死亡的影响. 中国学校卫生, 2025 , 46 (8) : 1185 -1189 . DOI: 10.16835/j.cnki.1000-9817.2025235
Mei YANG, Anping CHEN, Jingjing WANG, Xiaoyun SU. Effects of exercise combined with dietary intervention on vascular endothelial function and ferroptosis in obese female university students[J]. Chinese Journal of School Health, 2025 , 46 (8) : 1185 -1189 . DOI: 10.16835/j.cnki.1000-9817.2025235
正文
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肥胖通常伴有血管内皮功能障碍的发生[1]，主要表现为内皮依赖性血管舒张功能受损，是动脉粥样硬化和高血压等心血管疾病的早期预测指标[2]。研究表明，铁死亡可增加活性氧和脂质过氧化的积累造成内皮功能障碍，从而导致动脉粥样硬化的发生发展[3]。运动结合饮食是治疗和预防肥胖及相关心脏代谢疾病的一种有效的非药物干预方法[4]，最大脂肪氧化(maximum fat oxidation intensity，FATmax)强度运动可以最大程度地促进脂肪分解，达到最佳减脂效果，并可改善心肺功能和微血管功能，但对肌肉质量没有改变[5]。抗阻训练(resistance training，RT)是运动方案的一个重要组成部分，主要用于增强肌肉力量，影响静息能量消耗和脂肪代谢，并改善肥胖患者血管内皮功能及舒张功能[6]。本研究旨在通过比较12周FATmax强度运动结合饮食干预与FATmax+RT结合饮食干预对肥胖女大学生身体成分、血管内皮功能及铁死亡等指标的影响，为改善肥胖女大学生身体健康状况提供运动处方参考。
1　对象与方法
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1.1　对象
2024年2月，以山西大学在校大学生为招募对象，经过网上发布通知、山西大学健康体检中心体检及心血管功能检查等，共计75名符合标准的肥胖女大学生入选。纳入标准：按照《国家学生体质健康标准(2014年修订)》体质量指数(body mass index, BMI)超过28 kg/m2[7]，健康状况良好，为单纯性肥胖，无代谢性、心血管及运动障碍等疾病，近半年无规律性运动，未服用激素类等药物。采用随机数字表法将75名肥胖女大学生随机分为对照组(饮食限制组)、FATmax组(FATmax强度运动结合饮食限制)及FATmax+RT组(FATmax强度运动+抗阻训练结合饮食限制)。对照组及FATmax组分别有1人、FATmax+RT组3人因个人原因没有完成试验，在统计分析时被剔除，最终对照组及FATmax组各24名，FATmax+RT组22名肥胖女大学生完成试验。基线时3组肥胖女大学生的年龄、身高、体重、BMI差异均无统计学意义(F值分别为2.05，0.09，0.44，1.88，P值均>0.05)。本研究经山西大学学术研究伦理委员会批准(批号：2024032)，且获得所有参与者的知情同意。
1.2　方法
1.2.1　FATmax强度测试
测试仪器为运动心肺功能仪(PFT Ergo、意大利)及配套的功率自行车。依据前期学者描述的方案[8]，受试者先在功率自行车上无负荷热身5 min，然后增加10 W/min，自行车转数保持在(55~65)r/min，直到受试者达到力竭。根据FATmax判断标准[9]：采用每级负荷后15 s气体代谢数据，将每级负荷下测得的VO2和VCO2带入公式：氧化的脂肪(g/min)=1.67×VO2(L/min)-1.67×VCO2(L/min)，最大值所对应的摄氧量、心率为FATmax强度运动，每4周按上述实验流程重新测定FATmax强度运动，并根据测定结果调整运动强度。
1.2.2　运动方案
对照组受试者试验期间不进行系统性的体力活动或体育锻炼；2024年3月4日至5月26日在学校健身房对FATmax组进行12周的FATmax强度运动，FATmax+RT组进行12周FATmax强度运动结合抗阻训练，每周3次(周一、周三、周五的18:00—19:00)，每次运动持续时间为60 min，包括5 min热身及5 min放松(慢跑及伸展运动)。FATmax组正式运动时间为50 min，运动强度为FATmax强度(50.39%VO2max，FATmax为0.50 g/min，对应的心率为135.67次/min)。FATmax+RT组正式运动时间为50 min，其中FATmax强度跑步运动25 min(与FATmax组方案相同)，抗阻运动25 min；运动过程中，跑步及抗阻运动(抗阻运动依次为负重深蹲，卧推，坐姿下拉，上肢、躯干及下肢屈及伸展，每个动作持续30~45 s，然后休息30~45 s进行下一个动作)穿插进行。
FATmax组和FATmax+RT组2种运动方式全程使用polarTeam2团队心率表(芬兰polar公司)对受试者运动强度进行监控，并及时调整抗阻运动的强度和时间，保证抗阻运动强度不超过FATmax强度心率的10次/min[10]。若遇到特殊天气及女生月经期等适当调整；节假日期间，提前告知每位学生的运动处方，要求学生按照运动处方进行锻炼并做好记录。训练前均被进行训练指导且每次训练均安排1名教练及1名医务人员进行医务监督。
1.2.3　饮食安排
所有受试者饮食方案由专业营养师根据受试者日常饮食习惯制定个性化的饮食处方，并告知受试者饮食干预的重要性及注意事项。受试者每日饮食摄入的能量依据静息能耗确定，并由小组成员监督完成。一日三餐的能量分配比例约为3∶4∶3，每餐碳水化合物、蛋白质、脂肪供能比例分别占当餐摄入总能量的(55~65)%，(10~15)% 及(20~35)%。
1.3　指标测量
1.3.1　身体成分
试验前及试验结束后使用韩国身体成分测试仪(Inbody 520)测量受试者体重(kg)、BMI(kg/m2)、体脂肪量(kg)、肌肉质量(kg)及腰臀比(腰围/臀围)。具体方法：受试者赤足站在身体成分测试仪脚板上、手握电极柄，根据提示输入受试者编号、性别、年龄及身高等信息，测试数据并保存。
1.3.2　血管内皮功能
指标为内皮依赖性血管舒张功能(flow-mediated dilation, FMD)，肱动脉FMD测量采用美国GE公司生产的彩色多普勒超声诊断仪(LOGIQE20型)。测试前受试者平卧休息20 min；测试时取仰卧位，将袖带绑至前臂，测量安静血压后，使用10 MHz的线性探头记录安静状态下右臂肱动脉影像，获取安静时肱动脉管腔的基础直径(mm)。随后将袖带加压至收缩压+50 mmHg(1 mmHg=0.133 kPa)，维持5 min后迅速放气减压；测定减压后2 min内血流介导的血管舒张的最大扩张血管直径(mm)。
FMD(%)=(最大血管直径-安静时血管直径)/安静时血管直径×100%。
1.3.3　铁死亡指标
分别于干预前、后收集受试者静脉血。采血前禁食12 h，然后于清晨(7:00—9:00)抽取受试者肘部静脉血10 mL。取血后室温静置1 h，随后离心机离心10 min(4 000 r/min，离心半径20 cm)，取血清-80 ℃保存。采用酶联免疫法吸附法测定谷胱甘肽(GSH)、谷胱甘肽过氧化物酶4(glutathion peroxidase 4, GPX 4)及血清铁蛋白水平。
1.3.4　血管内皮功能相关指标
血清一氧化氮(nitric oxide, NO)采用硝酸还原酶法测定；内皮素(endothelin-1, ET-1)采用酶联免疫法吸附法测定。
1.4　质量控制
干预前，对参与研究的所有人员进行统一培训。干预过程中，测试人员对受试者干预方案进行动作讲解及示范，为保证数据的可靠性和准确性，试验前后受试者身体形态、血液数据及FMD测量均由同一批测试人员完成；试验中若出现受试者无法坚持的情况，则视为被动退出研究。此外，为了让受试者更好地完成饮食限制，学生每次的饮食均需拍照发微信群，并由2名研究生监督受试者按照营养师制定的食谱完成饮食。
1.5　统计学分析
利用Excel 2019对研究数据进行整理，再用SPSS 26.0软件对所有数据进行统计学处理。计量资料经Shapiro-Wilk法检验各组数据均服从正态分布，采用(x ±s)表示。组内数据实验前后比较采用配对样本t检验，组间比较采用单因素方差分析，方差齐用LSD(least significant difference)检验，不齐用Dunnett's法进行检验。以P < 0.05为差异有统计学意义。
2　结果
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2.1　干预对肥胖女大学生身体成分的影响
表1所示，不同方式干预12周后，3组肥胖女大学生体重、BMI、体脂肪量较干预前均下降，腰臀比只有FATmax组及FATmax+RT组低于干预前；且肌肉质量对照组低于干预前，FATmax+RT组高于干预前(P值均 < 0.01)。干预前3组大学生身体成分指标差异均无统计学意义(F值分别为0.44，1.88，1.63，0.58，1.08，P值均>0.05)；干预12周后，3组肥胖女大学生体重、BMI、体脂肪量、腰臀比、肌肉质量差异均有统计学意义(F值分别为10.93，5.88，65.28，21.14，2.25，P值均 < 0.05)。与对照组比较，FATmax组及FATmax+RT组肥胖女大学生体重、BMI、体脂肪量及腰臀比均下降；而FATmax+RT组体脂肪量及腰臀比低于FATmax组，肌肉质量高于FATmax组及对照组(P值均 < 0.05)。
2.2　干预对肥胖女大学生血管内皮功能的影响
表2所示，与干预前比较，3组肥胖女大学生血清ET-1水平下降，FMD增加，NO水平仅FATmax组及FATmax+RT组高于干预前(P值均 < 0.05)。干预前3组上述指标差异均无统计学意义(F值分别为1.79，1.77，0.63，P值均>0.05)；干预12周后，3组肥胖女大学生血清NO水平及FMD差异均有统计学意义(F值分别为9.14，135.70，P值均 < 0.05)，而血清ET-1水平差异无统计学意义(F=0.87，P>0.05)；与对照组比较，FATmax组及FATmax+RT组肥胖女大学生血清NO水平及FMD均增加，且FATmax+RT组FMD高于FATmax组(P值均 < 0.05)。
2.3　干预对肥胖女大学生铁死亡的影响
表2所示，与干预前比较，3组肥胖女大学生血清GSH水平增加、血清铁蛋白水平降低，血清GPX 4水平仅FATmax组及FATmax+RT组高于干预前(P值均 < 0.05)。干预前3组血清GSH、GPX 4及血清铁蛋白水平差异均无统计学意义(F值分别为0.76，0.06，0.14，P值均>0.05)；干预12周后，3组肥胖女大学生血清GSH及血清铁蛋白水平差异均有统计学意义(F值分别为9.67，4.78，P值均 < 0.05)，而血清GPX 4水平差异无统计学意义(F=2.19，P>0.05)；与对照组比较，FATmax组及FATmax+RT组肥胖女大学生血清GSH水平增加、血清铁蛋白水平降低，仅FATmax+RT组血清GPX 4水平高于对照组(P值均 < 0.05)；与FATmax组比较，FATmax+RT组肥胖女大学生血清GSH水平增高、血清铁蛋白水平下降(P值均 < 0.05)。
3　讨论
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研究证实，相较于单独有氧运动或抗阻训练，联合运动在达到减脂效果的同时对人体健康的收益更大[10]，但相关研究结论不一。本研究结果发现，与对照组(单独饮食限制)相比，FATmax强度运动结合饮食限制及FATmax+RT结合饮食限制均使肥胖女大学生体重、BMI、体脂及腰臀比下降，且FATmax+RT组体脂肪量及腰臀比低于FATmax组，与齐玉刚等[11]研究结果相同。本研究还发现，经过12周干预，FATmax+RT运动可使肥胖女大学生肌肉质量增加，且高于FATmax组及对照组，而FATmax强度运动对肥胖女大学生肌肉量无显著影响；说明抗阻训练结合Fatmax强度运动可以增加瘦体重，而增加瘦体重与更好的体重减轻和预防体重反弹有关[12]。提示在运动减脂干预过程中，相同强度、时间的抗阻和有氧运动结合具有协同作用，与单纯有氧运动的减脂相比效果更为理想，但是所涉及的机制尚需进一步深入研究。
本研究基于FATmax强度理论，对肥胖女大学生制定了个体化运动强度，且FATmax和FATmax+RT两组运动的运动强度及时间相同。结果发现，两种方式运动均可增加肥胖女大学生FMD，且相对于FATmax强度有氧运动，FATmax+RT运动肥胖女大学生FMD增加幅度较高。研究发现，在健康和无症状的成年人中，FMD每增加1%，可使心血管风险降低4%[13]，因此该结果具有重要的临床意义。此外本研究还发现，FATmax及FATmax+RT两种干预方式均可使肥胖女大学生血管收缩性因子血清ET-1水平下降，血管舒张因子NO水平增加，但两组比较差异无统计学意义，说明除NO、ET-1等内皮细胞因子外，还存在其他影响血管舒张反应的生物学机制。
据报道，内皮细胞中的慢性铁超载会降低血管中NO的生物利用度，改变平滑肌细胞的增殖和肥厚，导致大鼠血管内皮功能障碍，进而加剧动脉粥样硬化[14]。因此，抑制铁死亡可能成为肥胖导致血管内皮功能障碍治疗的新策略。刘炎冰等[15]研究发现，12周FATmax强度运动可通过抑制铁死亡进而抑制肝脏氧化损伤与脂代谢紊乱；并且抗阻训练可通过调节自噬、坏死性凋亡和铁死亡通路，改善早衰模型小鼠骨骼肌萎缩[16]。因此，可以推测FATmax强度运动结合抗阻训练在对抗铁死亡方面效果可能更好。本研究结果发现，FATmax强度运动及FATmax+RT结合饮食限制均可使肥胖女大学生铁死亡标志物出现有益变化，而FATmax+RT在抑制肥胖女大学生铁死亡及脂质过氧化方面效果更显著。有研究报道，较高的体脂肪量和中心脂肪量与FMD均呈负相关，瘦体重与FMD呈正相关[17]。因此，本研究FATmax+RT运动相较于FATmax强度运动对血管FMD改善效果较好，可能与此运动降低体脂肪量、增加瘦体重及抑制铁死亡有关，具体机制需进一步研究。
综上所述，在时间和锻炼频率相同的情况下，基于FATmax强度的有氧运动结合抗阻训练与单独有氧运动和饮食限制均能降低肥胖女大学生体脂肪量，增强血管内皮功能及抑制铁死亡，但联合运动结合饮食限制在降低腹部脂肪、增加肌肉质量及抑制铁死亡和改善血管舒张功能方面效果更为显著。
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2025年第46卷第8期
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doi: 10.16835/j.cnki.1000-9817.2025235
  • 接收时间：2025-02-11
  • 首发时间：2026-11-06
  • 出版时间：2025-08-25
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  • 收稿日期：2025-02-11
  • 修回日期：2025-04-12
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2021年山西省研究生教育改革研究课题(2021YJJG001)
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    1山西大学体育学院，太原 030006
    2山西医科大学汾阳学院护理学系
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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