El ejercicio y el síndrome metabólico

Autores/as

  • Manuel Ángel Ramírez España. Universidad Cádiz, Escuela Medicina del Deporte. Profesor
  • Jesús María Rosety España, Cádiz. Hospital Universitario Puerta del Mar. Investigador
  • Juan Marcos-Becerro España, Instituto de Longevidad y Salud. Presidente
  • Ignacio Rosety España. Universidad de Cádiz, Facultad de Medicina, Departamento Anatomía. Profesor Contratado-Doctor
  • Francisco Ordóñez España. Universidad de Cádiz, Facultad de Medicina, Departamento Anatomía. Profesor Titular de Anatomía
  • Manuel Rosety-Rodríguez España. Universidad Cádiz, Facultad de Medicina, Departamento Medicina. Profesor Titular de Medicina
  • María Rodríguez-Pareja España, Cádiz. Hospital Universitario de Jerez. Investigadora
  • Miguel Ángel Rosety España. Universidad de Cádiz, Facultad de Medicina, Departamento Anatomía Humana. Profesor Asociado

Palabras clave:

SÍNDROME X METABÓLICO, EJERCICIO

Resumen

El síndrome metabólico (SM) será la pandemia del siglo XXI. En Europa y en las Américas la prevalencia de obesidad alcanza a 17% de la población que padece SM, duplicándose el riesgo de ASCVD (enfermedad aterosclérotica cerebrovascular). Se debe priorizar la reversión de la obesidad y de la inactividad física. El SM se presenta como una secuencia de alteraciones metabólicas e inflamatorias a nivel molecular, celular o hemodinámico, compartiendo la resistencia a la insulina y la adiposidad de predominio abdominal. La asociación SM y nuevos factores de riesgo independientes como la homocisteína plasmática (HC) y la proteína C reactiva (PCR), son considerados como predictores de riesgo cardiometabólico. Entre los componentes del SM de mayor relevancia actualmente debe considerarse el estrés oxidativo y la influencia del ejercicio físico. La obesidad central o abdominal es un importante elemento diagnóstico del SM, estrechamente relacionada con enfermedades cardiovasculares, no existiendo una clara y directa relación con cardiopatías isquémicas, siendo la edad un factor ligado a la relación entre SM y cardiopatías, llegando a 86% en mujeres de edad avanzada. El valor del riesgo cardiovascular es variable y depende de los factores de riesgo específico. Nuestro objetivo es mostrar los beneficios que nos puede proporcionar el ejercicio físico frente al SM y, como consecuencia, reducir el riesgo de alteraciones vasculares, especialmente cardíacas. Los apartados utilizados en esta revisión son los relacionados con componentes fundamentales como obesidad abdominal, alteración del metabolismo glucídico, dislipidemia e hipertensión, además de aquellos implicados como factores de riesgo de enfermedades cardiovasculares como inflamación sistémica y estado protrombótico.

Citas

(1) Hanefeld M. The metabolic syndrome: roots, myths, and facts. En: Hanefeld M, Leonhardt W, eds. The metabolic syndrome. Jena: Gustav Fischer, 1997. p.13-24.
(2) Chandola T, Brunner E, Marmot M. Chronic stress at work and the metabolic syndrome: prospective study. BMJ 2006; 332(7540):521-5.
(3) Romero CE. El síndrome metabólico. Rev Med Urug 2006; 22(3):108-21.
(4) Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 2007; 49(4):403-14.
(5) Lucas JW, Schiller JS, Benson V. Summary health statistics for U.S. adults: National Health Interview Survey, 2001. Vital Health Stat 10 2004; 218:1-134.
(6) Martínez JA, Moreno B, Martínez-González MA. Prevalence of obesity in Spain. Obes Rev 2004; 5(3):171-2.
(7) Hayes M, Chustek M, Heshka S, Wang Z, Pietrobelli A, Heymsfield SB. Low physical activity levels of modern Homo sapiens among free-ranging mammals. Int J Obes (Lond) 2005; 29(1):151-6.
(8) Balkau B, Charles MA, Drivsholm T, Borch-Johnsen K, Wareham N, Yudkin JS, et al. European Group for the Study of Insulin Resistance. Frequency of the WHO metabolic syndrome in European cohorts and an alternative definition of an insulin resistance syndrome. Diabetes Metab 2002; 28(5):364-76.
(9) Ford ES. The metabolic syndrome and C-reactive protein, fibrinogen, and leukocyte count: findings from the Third National Health and Nutrition Examination Survey. Atherosclerosis 2003; 168(2):351-8.
(10) Alegría E, Cordero E, Laclaustra M, Grima A, León M, Casanovas JA, et al. Prevalencia del síndrome metabólico en población laboral española: registro MESYAS. Rev Esp Cardiol 2005; 58(7):797-806.
(11) Álvarez-León EE, Ribas Barba L, Serra Majem L. Prevalencia del síndrome metabólico en la población de la Comunidad Canaria. Med Clin (Barc) 2003; 120(5):172-4.
(12) Serrano Ríos M. El síndrome metabólico: ¿una versión moderna de la enfermedad ligada al estrés? Rev Esp Cardiol 2005; 58(7):768-71.
(13) Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24(4):683-9.
(14) Dunstan DW, Zimmet PZ, Welborn TA, Cameron AJ, Shaw J, de Courten M, et al. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) methods and response rates. Diabetes Res Clin Pract 2002; 57(2):119-29.
(15) Cameron I, Alam MA, Wang J, Brown L. Endurance exercise in a rat model of metabolic syndrome. Can J Physiol Pharmacol 2012; 90(11):1490-7.
(16) Hagnäs MP, Cederberg H, Mikkola I, Ikäheimo TM, Jokelainen J, Laakso M, et al. Reduction in metabolic syndrome among obese young men is associated with exercise-induced body composition changes during military service. Diabetes Res Clin Pract. 2012; 98(2):312-9.
(17) Carson JA, Michalsky L, Latson B, Banks K, Tong L, Gimpel N, et al. The Cardiovascular Health of Urban African Americans: diet-related results from the genes, nutrition, exercise, wellness, and spiritual growth (GoodNEWS) Trial. J Acad Nutr Diet 2012; 112(11):1852-8.
(18) Pritchett AM, Deswal A, Aguilar D, Foreyt JP, Chan W, Mann DL, et al. Lifestyle modification with diet and exercise in obese patients with heart failure: a pilot study. J Obes Weight Loss Ther 2012; 2(2):1-8.
(19) Pisabarro R. Nutrigenética y nutrigenómica: la revolución sanitaria del nuevo milenio. Implicancias clínicas en síndrome metabólico y diabetes tipo II. Rev Méd Urug 2006; 22(2):100-7.
(20) Churilla JR, Johnson TM, Magyari PM, Crouter SE. Descriptive analysis of resistance exercise and metabolic syndrome. Diabetes Metab Syndr 2012; 6(1):42-7.
(21) Golbidi S, Mesdaghinia A, Laher I. Exercise in the metabolic syndrome. Oxid Med Cell Longev 2012; 2012:349710.
(22) Onat A, Can G, Yüksel H. Dysfunction of high-density lipoprotein and its apolipoproteins: new mechanisms underlying cardiometabolic risk in the population at large. Turk Kardiyol Dern Ars 2012; 40(4):368-85.
(23) Janiszewski PM, Ross R. The utility of physical activity in the management of global cardiometabolic risk. Obesity 2009; 17(Suppl 3):S3-14.
(24) Sigal RJ, Kenny GP, Boulé NG, Wells GA, Prud'homme D, Fortier M, et al. Effects of aerobic training, resistance training, or both on glycaemic control in type 2 diabetes: a randomized trial. Ann Intern Med 2007; 147(6):357-69.
(25) Maffiuletti NA, Agosti F, Marinone PG, Silvestri G, Lafortuna CL, Sartorio A. Changes in body composition, physical performance and cardiovascular risk factors after a 3-week integrated body weight reduction program and after 1-y follow-up in severely obese men and women. Eur J Clin Nutr 2005; 59(5):685-94.
(26) Fang J, Wylie-Rosett J, Cohen HW, Kaplan RC, Alderman MH. Exercise, body mass index, caloric intake, and cardiovascular mortality. Am J Prev Med 2003; 25(4):283-9.
(27) Weiss EC, Galuska DA, Khan LK, Gillespie C, Serdula MD. Weight regain in U.S. adults who experienced substantial weight loss, 1999-2002. Am J Prev Med 2007; 33(1):34-40.
(28) Lee IM, Djoussé L, Sesso HD, Wang L, Buring JE. Physical activity and weight gain prevention. JAMA 2010; 303(12):1173-9.
(29) Ormsbee MJ, Thyfault JP, Johnson EA, Kraus RM, Choi MD, Hickner RC. Fat metabolism and acute resistance exercise in trained men. J Appl Physiol 2007; 102(5):1767-72.
(30) Sundell J. Resistance Training Is an Effective Tool against Metabolic and Frailty Syndromes. Adv Prev Med 2011; 2011:984683. Disponible en: http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3168930/ Consulta: 6 de marzo de 2012.
(31) Fett CA, Fett WC, Marchini JS. Circuit weight training vs jogging in metabolic risk factors of overweight/obese women. Arq Bras Cardiol 2009; 93(5):519-25.
(32) Yassine HN, Marchetti CM, Krishnan RK, Vrobel TR, Gonzalez F, Kirwan JP. Effects of exercise and caloric restriction on insulin resistance and cardiometabolic risk factors in older obese adults-a randomized clinical trial. J Gerontol A Biol Sci Med Sci 2009; 64(1):90-5.
(33) Katano S, Nakamura Y, Nakamura A, Murakami Y, Tanaka T, Nakagawa H, et al. Relationship among Physical Activity, Smoking, Drinking and Clustering of the Metabolic Syndrome Diagnostic Components. J Atheroscler Thromb 2010; 17(6):644-50.
(34) Maggio AB, Aggoun Y, Martin XE, Marchand LM, Beghetti M, Farpour-Lambert NJ. Long-term follow-up of cardiovascular risk factors after exercise training in obese children. Int J Pediatr Obes 2011; 6(2-2):e603-10.
(35) Nicklas BJ, Wang X, You T, Lyles MF, Demons J, Easter L, et al. Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial. Am J Clin Nutr 2009; 89(4):1043-52.
(36) Balducci S, Zanuso S, Nicolucci A, De Feo P, Cavallo S, Cardelli P, et al; Italian Diabetes Exercise Study (IDES) Investigators. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 2010; 170(20):1794-803.
(37) Tresierras MA, Balady GJ. Resistance training in the treatment of diabetes and obesity: mechanisms and outcomes. J Cardiopulm Rehabil Prev 2009; 29(2):67-75.
(38) Ho SS, Dhaliwal SS, Hills A, Pal S. Acute exercise improves postprandial cardiovascular risk factors in overweight and obese individuals. Atherosclerosis 2011; 214(1):178-84.
(39) Koopman R, Manders RJ, Jonkers RA, Hul GB, Kuipers H, van Loon LJ. Intramyocellular lipid and glycogen content are reduced following resistance exercise in untrained healthy males. Eur J Appl Physiol 2006; 96(5):525-34.
(40) Koopman R, Manders RJ, Zorenc AH, Hul GB, Kuipers H, Keizer HA, et al. A single session of resistance exercise enhances insulin sensitivity for at least 24 h in healthy men. Eur J Appl Physiol 2005; 94(1-2):180-7.
(41) Irvine C, Taylor NF. Progressive resistance exercise improves glycaemic control in people with type 2 diabetes mellitus: a systematic review. Aust J Physiother 2009; 55(4):237-46.
(42) Bweir S, Al-Jarrah M, Almalty AM, Maayah M, Smimova IV, Novikova L, et al. Resistance exercise training lowers HbA1c more than aerobic training in adults with type 2 diabetes. Diabetol Metab Syndr 2009; 1:27.
(43) Davidson LE, Hudson R, Kilpatrick K, Kuk JL, McMillan K, Janiszewski PM, et al. Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial. Arch Intern Med 2009;169(2):122-31.
(44) Teixeira-Lemos E, Nunes S, Teixeira F, Reis F. Regular physical exercise training assists in preventing type 2 diabetes development: focus on its antioxidant and anti-inflammatory properties. Cardiovasc Diabetol 2011; 10:12.
(45) Colberg SR, Albright AL, Blissmer BJ, Braun B, Chasan-Taber L, Fernhall B, et al. American College of Sports Medicine; American Diabetes Association. Exercise and type 2 diabetes. American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and type 2 diabetes. Med Sci Sports Exerc 2010; 42(12):2282-303.
(46) American Diabetes Association. Standards of medical care in diabetes 2009. Diabetes Care 2009; 32(Suppl 1):S13-61.
(47) Li G, Zhang P, Wang J, Gregg EW, Yang W, Gong Q, et al. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet 1989; 371(9626):1783-9.
(48) Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD. Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care 2006; 29(6):1433-8.
(49) Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care 2006; 29(11):2518-27.
(50) Teixeira de Lemos E, Reis F, Baptista S, Pinto R, Sepodes B, Vala H, et al. Exercise training decreases proinflammatory profile in Zucker diabetic (type 2) fatty rats. Nutrition 2009; 25(3):330-9.
(51) Lira FS, Yamashita AS, Uchida MC, Zanchi NE, Gualano B, Martins E Jr, et al. Low and moderate, rather than high intensity strength exercise induces benefit regarding plasma lipid profile. Diabetol Metab Syndr 2010; 2:31.
(52) Green DJ, O'Driscoll G, Joyner MJ, Cable NT. Exercise and cardiovascular risk reduction: time to update the rationale for exercise? J Appl Physiol 2008; 105(2):766-8.
(53) Look AHEAD Research Group, Pi-Sunyer X, Blackburn G, Brancati FL, Bray GA, Bright R, Clark JM, et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care 2007; 30(6):1374-83.
(54) Ho SS, Dhaliwal SS, Hills A, Pal S. Acute exercise improves postprandial cardiovascular risk factors in overweight and obese individuals. Atherosclerosis 2011; 214(1):178-84.
(55) Carroll S, Dudfield M. What is the relationship between exercise and metabolic abnormalities? A review of the metabolic syndrome. Sports Med 2004; 34(6):371-418.
(56) Johnson JL, Slentz CA, Houmard JA, Samsa GP, Duscha BD, Aiken LB, et al. Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise). Am J Cardiol 2007; 100(12):1759-66.
(57) Leon AS, Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001; 33(6 Suppl):S502-15.
(58) Tambalis K, Panagiotakos DB, Kavouras SA, Sidossis LS. Responses of blood lipids to aerobic, resistance, and combined aerobic with resistance exercise training: a systematic review of current evidence. Angiology 2009; 60(5):614-32.
(59) Leibowitz A, Grossman E. How to define prehypertension in diabetes/metabolic syndrome. Diabetes Care 2009; 32(Suppl 2):S275-9.
(60) American Diabetes Association. Executive summary: standards of medical care in diabetes 2008. Diabetes Care 2008; 31( Suppl 1):S5-11.
(61) Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25(6):1105-87.
(62) Barone BB, Wang NY, Bacher AC, Stewart KJ. Decreased exercise blood pressure in older adults after exercise training: contributions of increased fitness and decreased fatness. Br J Sports Med 2008; 43(1):52-6.
(63) Cardoso CG Jr, Gomides RS, Queiroz AC, Pinto LG, da Silveira Lobo F, Tinucci T, et al. Acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure. Clinics (Sao Paulo) 2010; 65(3):317-25.
(64) Bündchen DC, Panigas CF, Dipp T, Panigas TF, Richter CM, Belli KC, et al. Ausência de influência da massa corporal na reduçao da pressao arterial após exercício físico. Arq Bras Cardiol 2010; 94(5):678-83.
(65) American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription. 7th ed. Baltimore: Lippincott Williams & Wilkins, 2006.
(66) Braith RW, Stewart KJ. Resistance exercise training: its role in the prevention of cardiovascular disease. Circulation 2006; 113(22):2642-50.
(67) Das UN. Obesity, metabolic syndrome X, and inflammation. Nutrition 2002; 18(5):430-2.
(68) Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol 2005; 45(10):1563-9.
(69) Ford ES. Does exercise reduce inflammation? Physical activity and C-reactive protein among U.S. adults. Epidemiology 2002; 13(5):561-8.
(70) Weiss C, Welsch B, Albert M, Friedmann B, Strobel G, Jost J, et al. Coagulation and thrombomodulin in response to exercise of different type and duration. Med Sci Sports Exerc 1998; 30(8):1205-10.
(71) Coppola L, Grassia A, Coppola A, Tondi G, Peluso G, Mordente S, et al. Effects of a moderate-intensity aerobic program on blood viscosity, platelet aggregation and fibrinolytic balance in young and middle-aged sedentary subjects. Blood Coagul Fibrinolysis 2004; 15(1):31-7.
(72) Wang JS, Jen CJ, Chen HI. Effects of chronic exercise and deconditioning on platelet function in women. J Appl Physiol 1997; 83(6):2080-5.
(73) Simpson KA, Singh MA. Effects of exercise on adiponectin: a systematic review. Obesity (Silver Spring) 2008; 16(2): 241-56.
(74) Kato H, Kashiwagi H, Shiraga M, Tadokoro S, Kamae T, Ujiie H, et al. Adiponectin acts as an endogenous antithrombotic factor. Arterioscler Thromb Vasc Biol 2006; 26(1):224-30.
(75) Cooper CE, Vollaard NB, Choueiri T, Wilson MT. Exercise, free radicals and oxidative stress. Biochem Soc Trans 2002; 30(2):280-5.

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2012-12-31

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1.
Ramírez M Ángel, Rosety JM, Marcos-Becerro J, Rosety I, Ordóñez F, Rosety-Rodríguez M, et al. El ejercicio y el síndrome metabólico. Rev. Méd. Urug. [Internet]. 31 de diciembre de 2012 [citado 19 de abril de 2024];28(4):309-16. Disponible en: https://revista.rmu.org.uy/index.php/rmu/article/view/329

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