Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Sports Medicine
Erschienen in: Sports Medicine 6/2004

01.05.2004 | Review Article

What is the Relationship Between Exercise and Metabolic Abnormalities?

A Review of the Metabolic Syndrome

Erschienen in: Sports Medicine | Ausgabe 6/2004

Einloggen, um Zugang zu erhalten

Abstract

Prevention of the metabolic syndrome and treatment of its main characteristics are now considered of utmost importance in order to combat the epidemic of type 2 diabetes mellitus and to reduce the increased risk of cardiovascular disease and all-cause mortality. Insulin resistance/hyperinsulinaemia are consistently linked with a clustering of multiple clinical and subclinical metabolic risk factors. It is now widely recognised that obesity (especially abdominal fat accumulation), hyperglycaemia, dyslipidaemia and hypertension are common metabolic traits that, concurrently, constitute the distinctive insulin resistance or metabolic syndrome. Cross-sectional and prospective data provide an emerging picture of associations of both physical activity habits and cardiorespiratory fitness with the metabolic syndrome. The metabolic syndrome, is a disorder that requires aggressive multi-factorial intervention. Recent treatment guidelines have emphasised the clinical utility of diagnosis and an important treatment role for ‘therapeutic lifestyle change’, incorporating moderate physical activity. Several previous narrative reviews have considered exercise training as an effective treatment for insulin resistance and other components of the syndrome. However, the evidence cited has been less consistent for exercise training effects on several metabolic syndrome variables, unless combined with appropriate dietary modifications to achieve weight loss.
Recently published randomised controlled trial data concerning the effects of exercise training on separate metabolic syndrome traits are evaluated within this review. Novel systematic review and meta-analysis evidence is presented indicating that supervised, long-term, moderate to moderately vigorous intensity exercise training, in the absence of therapeutic weight loss, improves the dyslipidaemic profile by raising high density lipoprotein-cholesterol and lowering triglycerides in overweight and obese adults with characteristics of the metabolic syndrome. Lifestyle interventions, including exercise and dietary-induced weight loss may improve insulin resistance and glucose tolerance in obesity states and are highly effective in preventing or delaying the onset of type 2 diabetes in individuals with impaired glucose regulation. Randomised controlled trial evidence also indicates that exercise training decreases blood pressure in overweight/obese individuals with high normal blood pressure and hypertension. These evidence-based findings continue to support recommendations that supervised or partially supervised exercise training is an important initial adjunctive step in the treatment of individuals with the metabolic syndrome. Exercise training should be considered an essential part of ‘therapeutic lifestyle change’ and may concurrently improve insulin resistance and the entire cluster of metabolic risk factors.
Literatur
1.
Grundy SM, Bazzarre T, Cleeman J, et al. Prevention Conference V: beyond secondary prevention. Identifying the high-risk patient for primary prevention: medical office assessment: Writing Group 1. American Heart Association Medical/Scientific Statement. Circulation 2000; 101: 111–6PubMedCrossRef
2.
Grundy SM, Brewer Jr HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Circulation 2004; 109: 433–8PubMedCrossRef
3.
Einhorn D, Reaven GM, Cobin RH, et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9: 237–52PubMed
4.
Wilson PWF, Kannel WB, Silbershatz H, et al. Clustering of metabolic factors and coronary heart disease. Arch Intern Med 1999; 159: 1104–9PubMedCrossRef
5.
Garvey WT, Hermayer KL. Clinical implications of the insulin resistance syndrome. Clin Cornerstone 1998; 1: 13–8PubMedCrossRef
6.
Lamarche B, Lewis GF. Atherosclerosis prevention for the next decade: risk assessment beyond low density lipoprotein cholesterol. Can J Cardiol 1998; 14: 841–51PubMed
7.
Yki-Jarvinen H. Pathogenesis of non-insulin dependent diabetes mellitus. Lancet 1994; 343: 91–5PubMedCrossRef
8.
De Fronzo RA. The triumvirate: β-cell, muscle and liver: a collusion responsible for NIDDM. Diabetes 1988; 37: 667–87
9.
Smiley T, Oh P, Shane LG. The relationship of insulin resistance measured with reliable indexes to coronary artery disease risk factors and outcomes: a systematic review. Can J Cardiol 2001; 17: 797–805PubMed
10.
Ruige JB, Assenfelt WJJ, Dekker JM, et al. Insulin and risk of cardiovascular disease: a meta-analysis. Circulation 1998; 97: 996–1001PubMedCrossRef
11.
Ferrannini E, Haffner SM, Mitchell BD, et al. Hyperinsulinemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia 1991; 34: 416–22PubMedCrossRef
12.
Stern MP. Diabetes and cardiovascular disease: the common soil hypothesis. Diabetes 1995; 44: 369–74PubMedCrossRef
13.
14.
De Fronzo RA. Insulin resistance, hyperinsulinemia, and coronary artery disease: a complex metabolic web. J Cardiovasc Pharm 1992; 20Suppl. 11: S1–16CrossRef
15.
Meigs JB. Epidemiology of the metabolic syndrome. Am J Manag Care 2002; 8Suppl. 11: S283–92PubMed
16.
Reaven G. Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation 2002; 106: 286–8PubMedCrossRef
17.
Hansen BC. The metabolic syndrome X. Ann N Y Acad Sci 1999; 18: 1–24CrossRef
18.
World Health Organisation Consultation. Definition, diagnosis and classification of diabetes mellitus and its complications: report of the World Health Organisation Consultation. Geneva: World Health Organisation, 1999
19.
Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary on the third report on the The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–97
20.
The European Group for the Study of Insulin Resistance (EGIR). Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab 2002; 28: 364–76
21.
Westheim A, Os I. Physical activity and the metabolic cardiovascular syndrome. J Cardiovasc Pharmacol 1992; 20Suppl. 8: S49–53PubMed
22.
Buemann B, Tremblay A. Effects of exercise training on abdominal obesity and related metabolic complications. Sports Med 1996; 21: 191–212PubMedCrossRef
23.
Shahid SK, Schneider SH. Effects of exercise on insulin resistance syndrome. Coron Artery Dis 2000; 11: 103–9PubMedCrossRef
24.
Eriksson J, Taimela S, Koivisto VA. Exercise and the metabolic syndrome. Diabetologia 1997; 40: 125–35PubMedCrossRef
25.
Dela F. Physical training in the treatment of metabolic syndrome. Ugeskr Laeger 2002; 164: 2147–52PubMed
26.
Stefanick ML. Physical activity for preventing and treating obesity-related dyslipoproteinemias. Med Sci Sports Exerc 1999; 31: S609–18PubMedCrossRef
27.
Ivy JL. Role of exercise training in the prevention and treatment of insulin resistance and non-insulin dependent diabetes mellitus. Sports Med 1997; 24: 321–36PubMedCrossRef
28.
Kelley DE, Goodpaster BH. Effects of physical activity on insulin action and glucose tolerance in obesity. Med Sci Sports Exerc 1999; 31: S619–23PubMedCrossRef
29.
National Heart, Lung and Blood Institute. Obesity Education Initiative Expert Panel: clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report. Bethesda (MD): National Institutes of Health, 1998 Sep. NIH publication no.98-4083: 1–228
30.
Grundy SM, Blackburn G, Higgins M, et al. Consensus statement physical activity in the prevention and treatment of obesity and its comorbidities. Med Sci Sports Exerc 1999; 31: S502–8PubMedCrossRef
31.
Bouchard C. Physical activity and health: introduction to the dose-response symposium. Med Sci Sports Exerc 2001; 33: S347–50PubMedCrossRef
32.
Groop L. Genetics of the metabolic syndrome. Br J Nutr 2000; 83Suppl. 1: S39–48PubMed
33.
34.
Timar O, Sestier F, Levy E. Metabolic syndrome X: a review. Can J Cardiol 2000; 16: 779–89PubMed
35.
36.
Reaven GM. Syndrome X: past, present, and future. In: Draznin B, Rizza R, editors. Clinical research in diabetes and obesity. Vol 2. Totowa (NJ): Humana Press Inc., 1997: 357–82CrossRef
37.
Reaven GM. Role of insulin resistance in human disease (syndrome X): an expanded definition. Annu Rev Med 1993; 44: 121–31PubMedCrossRef
38.
De Fronzo RA, Ferrannini E. Insulin resistance: a multifaceted syndrome responsible for non-insulin dependent diabetes, obesity, hypertension, dyslipidemia and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: 173–94CrossRef
39.
40.
Kissebah AH, Vydelingum N, Murray R, et al. Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 1982; 54: 254–60PubMedCrossRef
41.
Krotkiewski M, Bjorntorp P, Sjostrom L, et al. Impact of obesity on metabolism in men and women: importance of regional adipose tissue distribution. J Clin Invest 1983; 72: 1150–62PubMedCrossRef
42.
Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout and uric calculous disease. Am J Clin Nutr 1956; 4: 20–34PubMed
43.
Kaplan NM. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med 1989; 149: 1514–20PubMedCrossRef
44.
Liese AD, Mayer-Davis EJ, Haffner SM. Development of the multiple metabolic syndrome: an epidemiological perspective. Epidemiol Rev 1998; 20: 157–72PubMedCrossRef
45.
Fagan TC, Deedwania PC. The cardiovascular dysmetabolic syndrome. Am J Med 1998; 105: 77S–82SPubMedCrossRef
46.
Sowers JR. Update on the cardiometabolic syndrome. Clin Cornerstone 2002; 4: 17–22CrossRef
47.
48.
Haffner SM, Ferrannini E, Hazuda HP, et al. Clustering of cardiovascular risk factors in confirmed prehypertensive individuals: does the clock for coronary heart disease start ticking before the onset of clinical diabetes? Hypertension 1992; 20: 38–45PubMedCrossRef
49.
Haffner SM, Valdez RA, Hazuda HP, et al. Prospective analysis of the insulin resistance syndrome (syndrome X). Diabetes 1992; 41: 715–22PubMedCrossRef
50.
Everson SA, Goldberg DE, Helmrich SP, et al. Weight gain and the risk of developing insulin resistance syndrome. Diabetes Care 1998; 21: 1637–43PubMedCrossRef
51.
Mykkanen L, Kuusisto J, Haffner SM, et al. Hyperinsulinemia predicts multiple atherogenic changes in lipoproteins in elderly subjects. Arterioscler Thromb 1994; 14: 518–26PubMedCrossRef
52.
Liese AD, Mayer-Davis EJ, Tyroler HA, et al. Development of the multiple metabolic syndrome in the ARIC cohort: joint contribution of insulin, BMI, and WHR. Ann Epidemiol 1997; 7: 407–16PubMedCrossRef
53.
Salonen JT, Lakka TM, Lakka HM, et al. Hyperinsulinemia is associated with the incidence of hypertension and dyslipidemia in middle-aged men. Diabetes 1998; 47: 270–5PubMedCrossRef
54.
Meigs JB, D’Agostino RB, Wilson PWF, et al. Risk variable clustering in the insulin-resistance syndrome. The Framingham Offspring Study. Diabetes 1997; 46: 1594–600PubMedCrossRef
55.
Hanson RL, Imperatore G, Bennett PH, et al. Components of the ‘metabolic syndrome’ and incidence of type 2 diabetes. Diabetes 2002; 51: 3120–7PubMedCrossRef
56.
Arya R, Blangero J, Williams K, et al. Factors of insulin resistance syndrome-related phenotypes are linked to genetic locations on chromosomes 6 and 7 in nondiabetic Mexican-Americans. Diabetes 2002; 51: 841–7PubMedCrossRef
57.
Gray RS, Fabsitz RR, Cowan LD, et al. Risk factor clustering in the insulin resistance syndrome: the Strong Heart Study. Am J Epidemiol 1998; 148: 869–78PubMedCrossRef
58.
Donahue RP, Bean JA, Donahue RD, et al. Does insulin resistance unite the separate components of the insulin resistance syndrome?: evidence from the Miami Community Health Study. Arterioscler Thromb Vasc Biol 1997; 17: 2413–7PubMedCrossRef
59.
Anderson PJ, Critchley JAJH, Chan JCN, et al. Factor analysis of the metabolic syndrome: obesity vs insulin resistance as the central abnormality. Int J Obes Relat Metab Disord 2001; 25: 1782–8PubMedCrossRef
60.
Hanley AJG, Karter AJ, Festa A, et al. Factor analysis of the metabolic syndrome using directly measured insulin sensitivity: the Insulin Resistance Atherosclerosis Study. Diabetes 2002; 51: 2642–7PubMedCrossRef
61.
Meigs JB. Invited commentary: insulin resistance syndrome?. Syndrome X? Multiple metabolic syndrome? A syndrome at all?: factor analysis reveals patterns in the fabric of correlated metabolic risk factors. Am J Epidemiol 2000; 152: 908–11PubMedCrossRef
62.
Zimmet P, Boyko EJ, Collier GR, et al. Etiology of the metabolic syndrome: potential role of insulin resistance, leptin resistance, and other players. Ann N Y Acad Sci 1999; 13: 25–44CrossRef
63.
Liese AD, Mayer-Davis EJ, Tyroler HA, et al. Familial components of the multiple metabolic syndrome: the ARIC study. Diabetologia 1997; 40: 963–70PubMedCrossRef
64.
Hong Y, Rice T, Gagnon J, et al. Familial clustering of insulin and abdominal visceral fat: the Heritage Family Study. J Clin Endocrinol Metab 1998; 83: 4239–45PubMedCrossRef
65.
Samaras K, Nguyen TV, Jenkins AB, et al. Clustering of insulin resistance, total and central fat: same genes or same environment. Twin Res 1999; 2: 218–25PubMed
66.
Mitchell BD, Kammerer CM, Mahaney MC, et al. Genetic analysis of the IRS: pleiotropic effects of genes influencing insulin levels on lipoprotein and obesity measures. Arterioscler Thromb Vasc Biol 1996; 16: 281–8PubMedCrossRef
67.
Nelson TL, Vogler GP, Pedersen NL, et al. Genetic and environmental influences on body fat distribution, fasting insulin levels and CVD: are the influences shared. Twin Res 2000; 3: 43–50PubMed
68.
Hong Y, Pedersen NL, Brismar K, et al. Genetic and environmental architecture of the features of the insulin-resistance syndrome. Am J Hum Genet 1997; 60: 143–52PubMed
69.
Brunner EJ, Marmot MG, Nanchahal K, et al. Social inequality in coronary disease risk: central obesity and the metabolic syndrome: evidence from the Whitehall II Study. Diabetologia 1997; 40: 1341–9PubMedCrossRef
70.
Imperatore G, Riccardi G, Iovine C, et al. Plasma fibrinogen: a new factor of the metabolic syndrome: a population-based study. Diabetes Care 1998; 21: 649–54PubMedCrossRef
71.
Trevisan M, Liu J, Bahsas FB, et al. Syndrome X and mortality: a population-based study: For the Risk Factor and Life Expectancy Research Group. Am J Epidemiol 1998; 148: 958–66PubMedCrossRef
72.
73.
Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–9PubMedCrossRef
74.
Hulthe J, Bokemark L, Wikstrand J, et al. The metabolic syndrome, LDL particle size, and atherosclerosis. Arterioscler Thromb Vasc Biol 2000; 20: 2140–7PubMedCrossRef
75.
Okosun IE, Liao Y, Rotimi CN, et al. Abdominal adiposity and clustering of multiple metabolic syndrome components in White, Black and Hispanic Americans. Ann Epidemiol 2000; 10: 263–70PubMedCrossRef
76.
Rantala AO, Kauma H, Lilja M, et al. Prevalence of the metabolic syndrome in drug treated hypertensive patients and control subjects. J Intern Med 1999; 245: 163–74PubMedCrossRef
77.
Whaley MH, Kampert JB, Kohl HW, et al. Physical fitness and clustering of risk factors associated with the metabolic syndrome. Med Sci Sports Exerc 1999; 31: 287–93PubMedCrossRef
78.
Wannamethee SG, Shaper AG, Durrington PN, et al. Hypertension, serum insulin, obesity, and the metabolic syndrome. J Hum Hypertens 1998; 12: 735–41PubMedCrossRef
79.
Yarnell JWG, Patterson CC, Bainton D, et al. Is metabolic syndrome a discrete entity in the general population?: evidence from the Caerphilly and Speedwell population studies. Heart 1998; 79: 248–52PubMed
80.
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults. JAMA 2002; 287: 356–9PubMedCrossRef
81.
Lakka H-M, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709–16PubMedCrossRef
82.
Ford ES, Giles WH. A comparison of the prevalence of the metabolic syndrome using two proposed definitions. Diabetes Care 2003; 26: 575–81PubMedCrossRef
83.
Sattar N, Gaw A, Scherbakova O, et al. Metabolic syndrome with and without C-Reactive Protein as a predictor of coronary heart disease and diabetes in the West of Scotland Prevention Study. Circulation 2003; 108: 414–9PubMedCrossRef
84.
Meigs JB, Wilson PWF, Nathan DM, et al. Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies. Diabetes 2003; 52: 2160–7PubMedCrossRef
85.
Bonora E, Kiechl S, Willeit J, et al. Metabolic syndrome: epidemiology and more extensive phenotypic description: cross-sectional data from the Bruneck Study. Int J Obes 2003; 27: 1283–9CrossRef
86.
Yarborough DE, Barrett-Connor E, Kritz-Silverstein D, et al. Birth weight, adult weight and girth as predictors of the metabolic syndrome in postmenopausal women. Diabetes Care 1998; 21: 1652–8CrossRef
87.
Ridker PM, Buring JE, Cook NR, et al. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003; 107: 391–7PubMedCrossRef
88.
Reilly MP, Rader DJ. The metabolic syndrome: more than the sum of its parts? Circulation 2003; 108: 1546–51PubMedCrossRef
89.
Hanley AJ, Wagenknecht LE, D’Agostino Jr RB, et al. Identification of subjects with insulin resistance and beta-cell dysfunction using alternative definitions of the metabolic syndrome. Diabetes 2003; 52: 2740–7PubMedCrossRef
90.
World Health Organisation (1998) Obesity. Preventing and managing the global epidemic. Report of the WHO consultation on obesity [WHO/NUT/NCD/981]. Geneva: WHO, 1997 Jun 3–5
91.
Laaksonen DE, Lakka HM, Niskanen LK, et al. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 2002; 156: 1070–7PubMedCrossRef
92.
Kekalainen P, Sarlund H, Pyorala K, et al. Hyperinsulinemia cluster predicts development of type 2 diabetes independently of family history of diabetes. Diabetes Care 1999; 22: 86–92PubMedCrossRef
93.
Pyorala M, Miettinen H, Halonen P, et al. Insulin resistance syndrome predicts the risk of coronary heart disease and stroke in healthy middle-aged men: the 22 year follow-up results of the Helsinki Policemen Study. Arterioscler Thromb Vasc Biol 2000; 20: 538–44PubMedCrossRef
94.
Howard BV, Criqui MH, Curb JD, et al. Risk factor clustering in the insulin resistance syndrome and its relationship to cardiovascular disease in postmenopausal White, Black, Hispanic, and Asian/Pacific Islander women. Metabolism 2003; 52: 362–71PubMedCrossRef
95.
Lempiainen P, Mykkanen L, Pyorala K, et al. Insulin resistance syndrome predicts coronary heart disease events in elderly nondiabetic men. Circulation 1999; 100: 123–8PubMedCrossRef
96.
Lehto S, Ronnemaa T, Pyorala K, et al. Cardiovascular risk factor clustering with endogenous hyperinsulinemia predict death from coronary heart disease in patients with type II diabetes. Diabetologia 2000; 43: 148–55PubMedCrossRef
97.
Kuusisto J, Lempiainen P, Mykkanen L, et al. Insulin resistance syndrome predicts coronary heart disease events in elderly type 2 diabetic men. Diabetes Care 2001; 24: 1629–33PubMedCrossRef
98.
Girman CJ, Rhodes T, Mercuri M, et al. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/Tex-CAPS). Am J Cardiol 2004 93(2): 136–41PubMedCrossRef
99.
Bjorntorp P, Rosmond R. The metabolic syndrome: a neuroendocrine disorder? Br J Nutr 2000; 83Suppl. 1: S49–57PubMed
100.
Hedman A, Byberg L, Reneland R, et al. Muscle morphology, self-reported physical activity and insulin resistance syndrome. Acta Physiol Scand 2002; 175: 325–32PubMedCrossRef
101.
Goodpaster BH, Kelley DE. Role of muscle in triglyceride metabolism. Curr Opin Lipidol 1998; 9: 231–6PubMedCrossRef
102.
Simoneau J-A, Veerkamp JH, Turcotte LP, et al. Markers of capacity to utilise fatty acids in human skeletal muscle: relation to insulin resistance and obesity and effects of weight loss. FASEB J 1999; 13: 2051–60PubMed
103.
Radzuik J, Pye S. The role of the liver in insulin action and resistance. In: Reaven G, Laws A, editors. Contemporary endocrinology. Insulin resistance: the metabolic syndrome X. Totowa (NJ): Humana Press Inc., 1999: 197–231
104.
Ansell BJ. The metabolic syndrome: an interplay of multiple subtle cardiovascular risk factors: case study and commentary. JCOM 2002 [online]. Available from URL: http://​www.​turnerwhite.​com [Accessed 2003 Oct 1]
105.
Despres J-P. Abdominal obesity as important component of insulin resistance syndrome. Nutrition 1993; 9: 452–9PubMed
106.
Juhan-Vague I, Alessi MC, Vague P. Increased plasminogen activator inhibitor 1 levels: a possible link between insulin resistance and atherothrombosis. Diabetologia 1991; 34: 457–62PubMedCrossRef
107.
McFarlane SI, Banerji M, Sowers JR. Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab 2001; 86: 713–8PubMedCrossRef
108.
Corry DB, Tuck ML. Selective aspects of the insulin resistance syndrome. Curr Opin Nephrol Hypertens 2001; 10: 507–14PubMedCrossRef
109.
Bjorntorp P. Visceral obesity: a ‘civilisation syndrome’. Obes Res 1993; 1: 216–22
110.
Bonara E, Kiechl S, Willeit J, et al. Prevalence of insulin resistance in metabolic disorders. Diabetes 1998; 47: 1643–9CrossRef
111.
Despres J-P, Lemieux I, Prud’homme D. Treatment of obesity: need to focus on high risk abdominally obese patients. BMJ 2001; 322: 716–20PubMedCrossRef
112.
Abate N. Obesity and cardiovascular disease: pathogenetic role of the metabolic syndrome and therapeutic implications. J Diabet Complications 2000; 14: 154–74CrossRef
113.
Verdecchia P, Reboldi G, Schillaci G, et al. Circulating insulin and insulin growth factor-1 are independent determinants of left ventricular mass and geometry in essential hypertension. Circulation 1999; 100: 1802–7PubMedCrossRef
114.
Ferrannini E. Insulin resistance and blood pressure. In: Reaven G, Laws A, editors. Contemporary endocrinology. Insulin resistance: the metabolic syndrome X. Totowa (NJ): Humana Press Inc., 1999
115.
Landsberg L. Insulin-mediated sympathetic stimulation: role in the pathogenesis of obesity-related hypertension (or how insulin affects blood pressure, and why).) J Hypertens 2001; 19: 523–8PubMedCrossRef
116.
Sundstrom J, Lind L, Nystrom N, et al. Left ventricular concentric remodelling rather than left ventricular hypertrophy is related to the insulin resistance syndrome in elderly men. Circulation 2000; 101: 2595–600PubMedCrossRef
117.
Reaven GM, Lithell H, Landsberg L. Hypertension and associated metabolic abnormalities-the role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996; 334: 374–81PubMedCrossRef
118.
Juhan-Vague I, Alessi MC. PAI-1, obesity, insulin resistance and risk of cardiovascular events. Thromb Haemost 1997; 78: 656–60PubMed
119.
Kohler HP, Grant PJ. Plasminogen-activator inhibitor type 1 and coronary artery disease. N Engl J Med 2000; 342: 1792–801PubMedCrossRef
120.
Meigs JB, Mittleman MA, Nathan DM, et al. Hyperinsulinemia, hyperglycaemia, and impaired hemostasis. JAMA 2000; 283: 221–8PubMedCrossRef
121.
122.
Chrousos GP. The role of stress and the hypothalamic-pituitary-adrenal axis in the pathogenesis of the metabolic syndrome: neuroendocrine and target tissue related causes. Int J Obes Relat Metab Disord 1999; 24Suppl. 2: S50–5
123.
Das UN. Is metabolic syndrome x an inflammatory condition. Exp Biol Med (Maywood) 2002; 227: 989–7
124.
Festa A, D’Agostino R, Howard G, et al. Inflammation and microalbuminuria in nondiabetic subjects: the Insulin Resistance Atherosclerosis Study. Kidney Int 2000; 58: 1703–10PubMedCrossRef
125.
Frolich M, Imhof A, Berg G, et al. Association between C-reactive protein and features of the metabolic syndrome: a population-based study. Diabetes Care 2000; 23: 1835–9CrossRef
126.
Hak AE, Stehouwer CD, Bots ML, et al. Associations of C-reactive protein with measures of obesity, insulin resistance and atherosclerosis in healthy middle-aged women. Arterioscler Thromb Vasc Biol 2000; 19: 1986–91CrossRef
127.
Hotamisligil GS, Spiegelman BM. Tumor necrosis factor alpha: a key component of the obesity-diabetes link. Diabetes 1994; 43: 1271–8PubMedCrossRef
128.
McLaughlin T, Abbasi F, Lamendola C, et al. Differentiation between obesity and insulin resistance in the association with C-reactive protein. Circulation 2002; 106: 2908–12PubMedCrossRef
129.
Pinkney JH, Stehouwer CDA, Coppack SW, et al. Endothelial dysfunction: cause of the insulin resistance syndrome. Diabetes 1997; 46Suppl. 2: S9–S13PubMed
130.
Tooke JE, Hanneman MM. Adverse endothelial function in the insulin resistance syndrome. J Intern Med 2000; 247: 425–31PubMedCrossRef
131.
Baron AD, Quon MJ. Insulin action and endothelial function. In: Reaven G, Laws A, editors. Contemporary endocrinology. Insulin resistance: the metabolic syndrome X. Totowa (NJ): Humana Press Inc., 1999: 247–63
132.
Bjorntorp P. Androgens, the metabolic syndrome and non-insulin dependent diabetes. Ann N Y Acad Sci 1993; 676: 242–52PubMedCrossRef
133.
Rantala AO, Kauma H, Lilja M, et al. Gamma-glutamyl transpeptidase and the metabolic syndrome. J Intern Med 2000; 248: 230–8PubMedCrossRef
134.
Reaven GM. The kidney: an unwilling accomplice in syndrome X. Am J Kidney Dis 1997; 30: 928–31PubMedCrossRef
135.
Simoneau J-A, Colberg SR, Thaete FL, et al. Skeletal muscle glycolytic and oxidative enzyme capacities and determinants of insulin sensitivity and muscle composition in obese women. FASEB J 1995; 9: 273–8PubMed
136.
Kelley DE, Mandriano LJ. Fuel selection in human skeletal muscle in insulin resistance. Diabetes 2000; 49: 677–83PubMedCrossRef
137.
Pan DA, Lillioja S, Kritetos AD, et al. Skeletal muscle triglyceride levels are inversely related to insulin action in man. Diabetes 1997; 46: 983–8PubMedCrossRef
138.
Lillioja S, Young AA, Cutler CL, et al. Skeletal muscle capillary density and fibre type are possible determinants of in vivo insulin resistance in man. J Clin Invest 1987; 80: 415–24PubMedCrossRef
139.
Vessby B, Tengblad S, Lithell H. The insulin sensitivity is related to the fatty acid composition of the serum lipids and skeletal muscle phospholipids in 70 year old men. Diabetologia 1994; 37: 1044–50PubMedCrossRef
140.
Frayn KN. Insulin resistance, impaired postprandial lipid metabolism and abdominal obesity: a deadly triad. Med Princ Pract 2002; 11Suppl. 2: 31–40PubMedCrossRef
141.
Bonora E. Relationship between regional fat distribution and insulin resistance. Int J Obes Relat Metab Disord 2000; 24Suppl. 2: S32–5PubMedCrossRef
142.
Lewis GF, Carpentier A, Khosrow A, et al. Disordered fat storage and mobilisation in the pathogenesis of insulin resistance and type 2 diabetes. Endocrine Rev 2002; 23: 201–29CrossRef
143.
de Courten M, Zimmet P, Hodge A, et al. Hyperleptinaemia: the missing link in the metabolic syndrome? Diabetes Med 1997; 14: 200–8CrossRef
144.
Poppitt SD, Keogh GF, Prentice AM, et al. Long-term effects of ad libitum low fat, high carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. Am J Clin Nutr 2002; 75: 11–20PubMed
145.
Lehtovirta M, Kaprio J, Forsblom C, et al. Insulin secretion and insulin sensitivity in monozygotic and dizygotic twins. Diabetologia 2000; 43: 285–93PubMedCrossRef
146.
McKeigue PM. Fetal effects on insulin resistance and glucose tolerance. In: Reaven G, Laws A, editors. Contemporary endocrinology. Insulin resistance: the metabolic syndrome X. Totowa (NJ): Humana Press Inc., 1999
147.
Ruderman N, Chisholm D, Pi-Sunyer X, et al. The metabolically obese, normal weight individual revisited. Diabetes 1998; 47: 699–713PubMedCrossRef
148.
Laaksonen DE, Lakka HM, Lynch J, et al. Cardiorespiratory fitness and vigorous leisure-time physical activity modify the association of small size at birth with the metabolic syndrome. Diabetes Care 2003; 26: 2156–64PubMedCrossRef
149.
Martyn CN, Hales CN, Barker DJ, et al. Fetal growth and hyperinsulinemia in adult life. Diabet Med 1998; 15: 688–94PubMedCrossRef
150.
Phillips DI, Barker DJ, Hales CN, et al. Thinness at birth and insulin resistance in adult life. Diabetologia 1994; 37: 150–4PubMedCrossRef
151.
Phipps K, Barker DJ, Hales CN, et al. Fetal growth and impaired glucose tolerance in men and women. Diabetologia 1993; 36: 225–8PubMedCrossRef
152.
Davey Smith G, Hart C. Insulin resistance syndrome and childhood social conditions. Lancet 1997; 349: 284–5PubMedCrossRef
153.
Vanhala MJ, Vanhala PT, Keinanen-Kiukaanniemi SM, et al. Relative weight gain and obesity as a child predict metabolic syndrome as an adult. Int J Obes Relat Metab Disord 1999; 23: 656–9PubMedCrossRef
154.
Chen W, Bao W, Begum S, et al. Age-related patterns of the clustering of cardiovascular risk variables of syndrome X from childhood to young adulthood in a population made up of Black and White subjects: the Bolalusa Heart Study. Diabetes 2000; 49: 1042–8PubMedCrossRef
155.
Chan JM, Rimm EB, Colditz GA, et al. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994; 17: 961–7PubMedCrossRef
156.
Colditz GA, Willett WC, Rotnitzky A, et al. Weight gain as a risk factor for clinical diabetes in women. Ann Intern Med 1995; 122: 481–6PubMed
157.
Mayer-Davis J, Monaco JH, Hoen HM, et al. Dietary fat and insulin sensitivity in a triethnic population: the role of obesitas. The Insulin Resistance Atherosclerosis Study (IRAS). Am J Clin Nutr 1997; 65: 79–87PubMed
158.
Tremblay A. Nutritional determinants of the insulin resistance syndrome. Int J Obes Relat Metab Disord 1995; 19Suppl. 1: S60–8PubMed
159.
Wirfalt E, Hedblad B, Gullberg B, et al. Food patterns and components of the metabolic syndrome in men and women: a cross-sectional study within the Malmo Diet and Cancer Cohort. Am J Epidemiol 2001; 154: 1150–9PubMedCrossRef
160.
Vessby B. Dietary fat and insulin action in humans. Br J Nutr 2000; 83Suppl. 1: S91–6PubMed
161.
Wolever TMS. Dietary carbohydrates and insulin action in humans. Br J Nutr 2000; 83Suppl. 1: S97–102PubMed
162.
Zavaroni I, Bonini L, Gasparini P, et al. Cigarette smokers are relatively glucose intolerant, hyperinsulinemic and dyslipidemic. Am J Cardiol 1994; 73: 904–5PubMedCrossRef
163.
Facchini F, Hollenbeck CB, Jeppesen J, et al. Insulin resistance and cigarette smoking. Lancet 1992; 339: 1128–30PubMedCrossRef
164.
Eliasson B, Attvall S, Taskinen MR, et al. The insulin resistance syndrome in smokers is related to smoking habits. Arterioscler Thromb 1994; 14: 1946–50PubMedCrossRef
165.
Rosmond R, Bjorntorp P. Occupational status, cortisol secretory pattern, and visceral obesity in middle-aged men. Obes Res 2000; 8: 445–50PubMedCrossRef
166.
Horsten M, Mittleman MA, Wamala SP, et al. Social relations and the metabolic syndrome in middle-aged Swedish women. J Cardiovasc Risk 1999; 6: 391–7PubMed
167.
Raikkonen K, Matthews KA, Kuller LH. The relationship between psychological risk attributes and the metabolic syndrome in healthy women: antecedent or consequence? Metabolism 2002; 51: 1573–7PubMedCrossRef
168.
Raikkonen K, Matthews KA, Kuller LH, et al. Anger, hostility, and visceral adipose tissue in healthy postmenopausal women. Metabolism 1999; 48: 1146–51PubMedCrossRef
169.
Keltikangas-Jarvinen L, Raikkonen K, Hautanen A, et al. Vital exhaustion, anger expression, and pituitary and adrenocortical hormones: implications for the insulin resistance syndrome. Arterioscler Thromb Vasc Biol 1996; 16: 275–80PubMedCrossRef
170.
Keltikangas-Jarvinen L, Ravaja N, Viikari J. Identifying Cloninger’s temperament profiles as related to the early development of the metabolic cardiovascular syndrome in young men. Arterioscler Thromb Vasc Biol 1996; 19: 1998–2006CrossRef
171.
Lakka TA, Venalainen JM, Rauramaa R, et al. Relation of leisure time physical activity and cardiorespiratory fitness to risk of acute myocardial infarction. N Engl J Med 1994; 330: 1549–54PubMedCrossRef
172.
Folsom AR, Arnett DK, Hutchinson RG, et al. Physical activity and incidence of coronary heart disease in middle-aged women and men. Med Sci Sports Exerc 1997; 29: 901–9PubMedCrossRef
173.
James SA, Jamjoum L, Raghunathan TE, et al. Physical activity and NIDDM in African-Americans: the Pitt County Study. Diabetes Care 1998; 21: 555–62PubMedCrossRef
174.
Hu FB, Sigal RJ, Rich-Edwards JW, et al. Walking compared with vigorous activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999; 282: 1433–49PubMedCrossRef
175.
Lynch J, Helmrich SP, Lakka TA, et al. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 1996; 156: 1307–14PubMedCrossRef
176.
Wei M, Gibbons LW, Mitchell TL, et al. The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men. Ann Intern Med 1998; 130: 89–96
177.
Wannamethee SG, Shaper AG, Walker M, et al. Lifestyle and 15-year survival free of heart attack, stroke, and diabetes in British middle-aged men. Arch Intern Med 1998; 158: 2433–40PubMedCrossRef
178.
Kohl HW. Physical activity and cardiovascular disease: evidence for a dose response. Med Sci Sports Exerc 2001; 33: S472–83PubMedCrossRef
179.
Kelley DE, Goodpaster BH. The effects of exercise on glucose homeostasis in type 2 diabetes mellitus. Med Sci Sports Exerc 2001; 33: S495–501PubMedCrossRef
180.
Laaksonen DE, Lakka H-M, Salonen JT, et al. Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes Care 2002; 25: 1612–8PubMedCrossRef
181.
Zimmet PZ, Collins VR, Dowse GK, et al. The relation of physical activity to cardiovascular disease risk factors in Mauritians. Am J Epidemiol 1991; 134: 862–75PubMed
182.
Byberg L, Zethelius B, McKeigue PM, et al. Changes in physical activity are associated with changes in metabolic cardiovascular risk factors. Diabetologia 2001; 44: 2134–9PubMedCrossRef
183.
Wannamethee SG, Shaper AG, Alberti KGMM. Physical activity, metabolic factors, and the incidence of coronary heart disease and type 2 diabetes. Arch Intern Med 2000; 160: 2108–16PubMedCrossRef
184.
Clausen JO, Borch-Johnsen K, Ibsen H, et al. Insulin sensitivity index, acute insulin response, and glucose effectiveness in a population-based sample of 380 young healthy Caucasians: analysis of the impact of gender, body fat, physical fitness, and lifestyle factors. J Clin Invest 1996; 98: 1195–209PubMedCrossRef
185.
Mayer-Davis EJ, D’Agostino Jr R, Karter AJ, et al. For the IRAS Investigators. Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. JAMA 1998; 279: 669–74PubMedCrossRef
186.
Siscovick DS, Fried L, Mittlemark M, et al. Exercise intensity and subclinical cardiovascular disease in the elderly: the Cardiovascular Health Study. Am J Epidemiol 1997; 145: 977–86PubMedCrossRef
187.
Mensink GBM, Heerstrass DW, Neppelenbroek SE, et al. Intensity, duration and frequency of physical activity and coronary risk factors. Med Sci Sports Exerc 1997; 29: 1192–8PubMedCrossRef
188.
Thune I, Njolstad I, Lochen M-L, et al. Physical activity improves the metabolic risk profiles in men and women: the Tromso Study. Arch Intern Med 1998; 158: 1633–40PubMedCrossRef
189.
Wareham NJ, Hennings SJ, Byrne CD, et al. A quantitative analysis of the relationship between habitual energy expenditure, fitness and the metabolic cardiovascular syndrome. Br J Nutr 1998; 80: 235–41PubMedCrossRef
190.
Carroll S, Cooke CB, Butterly RJ. Metabolic risk factor clustering, associations of both physical activity and cardiorespiratory fitness in middle-aged men. Med Sci Sports Exerc 2000; 32: 2079–86PubMedCrossRef
191.
Irwin ML, Ainsworth BE, Mayer-Davis EJ, et al. Physical activity and the multiple metabolic syndrome in a tri-ethnic sample of women. Obes Res 2002; 10: 1030–7PubMedCrossRef
192.
Kullo IJ, Hensrud DD, Allison TG. Relation of low cardiorespiratory fitness to the metabolic syndrome in middle-aged men. Am J Cardiol 2002; 90: 795–7PubMedCrossRef
193.
Lakka TA, Laaksonen DE, Lakka H-M, et al. Sedentary lifestyle, poor cardiorespiratory fitness and the metabolic syndrome. Med Sci Sports Exerc 2003; 35: 1279–86PubMedCrossRef
194.
Bevis LC, Blackburn G. The obesity epidemic: prevention and treatment of the metabolic syndrome. Medscape 2002 [online]. Available from URL: http://​www.​medscape.​com [Accessed 2003 Oct 1]
195.
Despres J-P. Visceral obesity, insulin resistance, and dyslipidemia: contribution of endurance exercise training to the treatment of the plurimetabolic syndrome. Exerc Sport Sci Rev 1997; 25: 271–300PubMed
196.
197.
Denke MA, Pasternack RC. Defining and treating the metabolic syndrome: a primer from the Adult Treatment Panel III. Curr Treat Options Cardiovasc Med 2001; 3: 251–3PubMedCrossRef
198.
Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord 1997; 21: 941–7PubMedCrossRef
199.
200.
Pescatello LS, Van Heest JL. Physical activity mediates a healthier body weight in the presence of obesity. Br J Sports Med 2000; 34: 86–93PubMedCrossRef
201.
Smutock MA, Reece PF, Kokkinos PF, et al. Aerobic versus strength training for risk factor intervention in middle-aged men at high risk for coronary heart disease. Metabolism 1993; 42: 177–84CrossRef
202.
Katzel LI, Bleecker ER, Rogus EM, et al. Sequential effects of aerobic exercise training and weight loss on risk factors for coronary disease in healthy, obese middle-aged and older men. Metabolism 1997; 46: 1441–7PubMedCrossRef
203.
Torjesen PA, Birkeland KI, Anderssen SA, et al. Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial. Diabetes Care 1997; 20: 26–31
204.
Anderssen SA, Holme I, Urdal P, et al. Associations between central obesity and indexes of hemostatic, carbohydrate and lipid metabolism: results of a 1-year intervention from the Oslo Diet and Exercise Study. Scand J Med Sci Sports 1998; 8: 109–15PubMedCrossRef
205.
Dengel DR, Hagberg JM, Pratley RE, et al. Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men. Metabolism 1998; 47: 1075–82PubMedCrossRef
206.
Watkins LL, Sherwood A, Feinglos M, et al. Effects of exercise and weight loss on cardiac risk factors associated with syndrome X. Arch Intern Med 2003; 163: 1889–95PubMedCrossRef
207.
Katzmarzyk PT, Leon AS, Wilmore JH, et al. Targeting the metabolic syndrome with Exercise: evidence from the HERITAGE Family Study. Med Sci Sports Exerc 2003; 35(10): 1703–9PubMedCrossRef
208.
Diabetes Prevention Program Research Group. The effect of intensive lifestyle Intervention (ILS) and metformin (MET) on the incidence of metabolic syndrome among the participants in the Diabetes Prevention Program. American Diabetes Association 63rd Scientific Session. Epidemiology: Predictors of Diabetes; 2003 Jun 16; New Orleans, abstract no. 250-OR
209.
Minehira K, Tappy L. Dietary and lifestyle interventions in the management of the metabolic syndrome: present status and future perspective. Eur J Clin Nutr 2002; 56: 1262–9CrossRef
210.
Ryan DH, Diabetes Prevention Program Research Group. Diet and exercise in the prevention of diabetes. Int J Clin Pract Suppl 2003; 134: 28–35PubMed
211.
Goodpaster BH, Kelley DE, Wing RR, et al. Effects of weight loss on regional fat distribution and insulin sensitivity in obesity. Diabetes 1999; 48: 839–47PubMedCrossRef
212.
Borghouts LB, Keizer HA. Exercise and insulin sensitivity: a review. Int J Sports Med 1999; 20: 1–12CrossRef
213.
Henriksen EJ. Exercise effects of muscle insulin signalling and action. Invited review: effects of acute exercise and exercise training on insulin resistance. J Appl Physiol 2002; 93: 788–96PubMed
214.
Katzel LI, Bleeker ER, Colman EG, et al. Effects of weight loss vs aerobic exercise training on risk factors for coronary artery disease in healthy, obese, middle-aged and older men. JAMA 1995; 274: 1915–21PubMedCrossRef
215.
Ross R, Dagone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight-loss or exercise induced weight loss. Ann Intern Med 2000; 133: 92–103PubMed
216.
Dengel DR, Pratley RE, Hagberg JM, et al. Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men. J Appl Physiol 1996; 8: 318–25
217.
218.
McAuley KA, Williams SM, Mann JI, et al. Intensive lifestyle changes are necessary to improve insulin sensitivity: a randomised controlled trial. Diabetes Care 2002; 25: 445–52PubMedCrossRef
219.
Houmard JA, Tanner CJ, Slentz CA, et al. The effect of the volume and intensity of exercise training on insulin sensitivity. J Appl Physiol 2004; 96(1): 101–6PubMedCrossRef
220.
Short KR, Vittone JL, Bigelow ML, et al. Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. Diabetes 2003; 52: 1888–96PubMedCrossRef
221.
Despres J-P, Marette A. Obesity and insulin resistance: epidemiological, metabolic and molecular aspects. In: Reaven G, Laws A, editors. Contemporary endocrinology. Insulin resistance: the metabolic syndrome X. Totowa (NJ): Humana Press Inc., 1999
222.
Smith SR, Zachwieja JJ. Visceral adipose tissue: a critical review of intervention strategies. Int J Obes Relat Metab Disord 1999; 23: 329–35PubMedCrossRef
223.
Ross R, Freeman JA, Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exerc Sport Sci Rev 2000; 28: 165–70PubMed
224.
Di Pietro L, Seeman TE, Stachenfield NS, et al. Moderate-intensity aerobic exercise training improves glucose tolerance in aging independent of abdominal adiposity. J Am Geriatr Soc 1998; 46: 875–9
225.
Torjesen PA, Birkeland KI, Anderssen SA, et al. The Oslo Diet and Exercise Study: a randomised trial: lifestyle changes may reverse development of the insulin resistance syndrome. Diabetes Care 1997; 20: 26–31PubMedCrossRef
226.
Irwin ML, Yasui Y, Ulrich CM, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomised controlled trial. JAMA 2003; 289: 323–30PubMedCrossRef
227.
Liao D, Asberry PJ, Shofer JB, et al. Improvement of BMI, body composition, and body fat distribution with lifestyle modification in Japanese Americans with impaired glucose tolerance. Diabetes Care 2002; 25: 1504–10PubMedCrossRef
228.
Borch-Johnsen K. The new classification of diabetes mellitus and IGT: a critical approach. Exp Clin Endocrinol Diabetes 2001; 109Suppl. 2: S86–93PubMedCrossRef
229.
Unwin N, Shaw J, Zimmet P, et al. International Diabetes Federation IGT/IFG Consensus Statement. Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med 2002; 19: 708–23PubMedCrossRef
230.
Davies MJ, Raymond NT, Day JL, et al. Impaired glucose tolerance and fasting hyperglycaemia have different characteristics. Diabet Med 2000; 17: 433–40PubMedCrossRef
231.
Larsson H, Berglund G, Lindgarde F, et al. Comparison of WHO and ADA criteria for diagnosis of diabetes and glucose intolerance. Diabetologia 1998; 41: 1124–5PubMedCrossRef
232.
Rathman W, Giani G, Mielck A. Cardiovascular risk factors in newly diagnosed abnormal glucose tolerance: comparison of 1997 ADA and 1985 WHO criteria. Diabetologia 1999; 42: 1268–9CrossRef
233.
Hanefeld M, Temelkova-Kurktschiev T, Schaper F, et al. Impaired fasting glucose is not a risk factor for atherosclerosis. Diabet Med 1999; 16: 212–8PubMedCrossRef
234.
DECODE Study Group. Glucose tolerance and mortality: comparison of the WHO and ADA diagnostic criteria. Lancet 1999; 354: 617–21CrossRef
235.
Potteiger JA, Jacobsen DJ, Donnelly JE. A comparison of methods for analysing glucose and insulin areas under the curve following nine months of exercise in overweight adults. Int J Obes Relat Metab Disord 2002; 26: 87–9PubMedCrossRef
236.
Dengel DR, Galecki AT, Hagberg JM, et al. The independent and combined effects of weight loss and aerobic exercise on blood pressure and oral glucose tolerance in older men. Am J Hypertens 1998; 11: 1405–12PubMedCrossRef
237.
Stefanick ML, Mackey S, Sheehan M, et al. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N Engl J Med 1998; 339: 12–20PubMedCrossRef
238.
Blumenthal JA, Sherwood A, Gullette ECD, et al. Exercise and weight loss reduce blood pressure in men and women with mild hypertension. Arch Intern Med 2000; 160: 1947–58PubMedCrossRef
239.
Hellenius ML, Brismar KE, Berglund BH, et al. Effects on glucose tolerance, insulin secretion, insulin-like growth factor 1 and its binding protein, IGFBP-1, in a randomised controlled diet and exercise study in healthy middle-aged men. J Intern Med 1995; 238: 121–30PubMedCrossRef
240.
Pan X, Li G, Hu Y-H, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT Diabetes Study. Diabetes Care 1997; 20: 537–44
241.
Li G, Hu Y, Yang W, et al. Effects of insulin resistance and insulin secretion on the efficacy of interventions to retard development of type 2 diabetes mellitus: the Da Qing IGT and Diabetes Study. Diabetes Res Clin Pract 2002; 58: 193–200PubMedCrossRef
242.
Toumilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–50CrossRef
243.
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403PubMedCrossRef
244.
Grundy SM. Hypertriglyceridemia, atherogenic dyslipidemia, and the metabolic syndrome. Am J Cardiol 1998; 81: 18B–25BPubMedCrossRef
245.
Howard BV, Mayer-Davis EJ, Goff D, et al. Relationships between insulin resistance and lipoproteins in nondiabetic African Americans, Hispanics, and non-Hispanic Whites: the Insulin Resistance Atherosclerosis Study. Metabolism 1998; 47: 1174–9PubMedCrossRef
246.
Reaven GM, Chen Y-DI, Jeppesen J, et al. Insulin resistance and hyperinsulinemia in individuals with small, dense, low density lipoprotein particles. J Clin Invest 1993; 92: 141–6PubMedCrossRef
247.
Sattar N, Tan CE, Han TS, et al. Associations of indicies of adiposity with atherogenic lipoprotein subfractions. Int J Obes Relat Metab Disord 1998; 22: 432–9PubMedCrossRef
248.
Abbassi F, McLaughlin T, Lamendola C, et al. Insulin regulation of plasma free fatty acid concentrations is abnormal in healthy subjects with muscle insulin resistance. Metabolism 2000; 49: 151–4CrossRef
249.
Bjorntorp P. ‘Portal’ adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arterioscler Thromb 1990; 10: 493–6CrossRef
250.
Laws A. Insulin resistance and dyslipidemia: implications for coronary heart disease risk. In: Reaven G, Laws A, editors. Contemporary endocrinology. Insulin resistance: the metabolic syndrome X. Totowa (NJ): Humana Press Inc., 1999
251.
Taskinen MR. Insulin resistance and lipoprotein metabolism. Curr Opin Lipidol 1995; 6: 153–601PubMedCrossRef
252.
Durstine JL, Grandjean PW, Davis PG, et al. Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med 2001; 31: 1033–62PubMedCrossRef
253.
Leon AS, Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001; 33: S502–15PubMedCrossRef
254.
Haibert JA, Silagy CA, Finucane P, et al. Exercise training and blood lipids in hyperlipidemia and normolipidemic adults: a meta-analysis of randomised, controlled trials. Euro J Clin Nutr 1999; 53: 514–22CrossRef
255.
Gallagher D, Heymsfield SB, Heo M, et al. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr 2000 Sep; 72(3): 694–701PubMed
256.
Zhu S, Wang Z, Shen WS, et al. Percentage body fat ranges associated with metabolic syndrome risk: results based on the third National Health and Nutrition Examination Survey (1988–1994). Am J Clin Nutr 2003; 78: 228–35PubMed
257.
Kiens B, Jorgensen I, Lewis S, et al. Increased plasma HDL-cholesterol and aop A-1 in sedentary middle-aged men after physical conditioning. Euro J Clin Invest 1980; 10: 203–9CrossRef
258.
Juneau M, Rogers F, De Santos V, et al. Effectiveness of self-monitored, home-based, moderate-intensity exercise training in middle-aged men and women. Am J Cardiol 1987; 60: 66–70PubMedCrossRef
259.
Wood PD, Stefanick ML, Dreon DM, et al. Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med 1988; 319: 1173–9PubMedCrossRef
260.
King AC, Haskell WL, Taylor B, et al. Group- vs home-based exercise training in healthy older men and women: a community-based clinical trial. JAMA 1991; 266: 1535–42PubMedCrossRef
261.
Nieman DC, Warren BJ, O’Donnell KA, et al. Physical activity and serum lipids in elderly women. J Am Geriatr Soc 1993; 41: 1339–44PubMed
262.
Anderssen SA, Haaland A, Hjermann I, et al. Oslo Diet and Exercise Study: a one-year randomised intervention trial: effect on hemostatic and other coronary risk factors. Nutr Metab Cardiovasc Dis 1995; 5: 189–200
263.
Ready EA, Drinkwater D, Ducas J, et al. Walking program reduces elevated cholesterol in women postmenopause. Can J Cardiol 1995; 11: 905–12PubMed
264.
Eriksson J, Tuominen J, Valle T, et al. Aerobic endurance exercise or circuit-type resistance training for individuals with impaired glucose tolerance. Horm Metab Res 1998; 30: 37–41PubMedCrossRef
265.
Wing RR, Venditti EV, Jakicic JM, et al. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 1998; 21: 350–9PubMedCrossRef
266.
Kokkinos PF, Narayan P, Colleran J, et al. Effects of moderate intensity exercise on serum lipids in African-American men with severe systemic hypertension. Am J Cardiol 1998; 81: 732–5PubMedCrossRef
267.
Lavrencic A, Salobir BG, Keber I. Physical training improves flow-mediated dilation in patients with the polymetabolic syndrome. Arterioscler Thromb Vasc Biol 2000; 20: 551–60PubMedCrossRef
268.
Nieman DC, Brock DW, Butterworth D, et al. Reducing diet and/or exercise training decreases the lipid and lipoprotein risk factors of moderately obese women. J Am Coll Nutr 2002; 21: 344–50PubMed
269.
Kraus WE, Houmard JA, Duscha BD, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med 2002; 347: 1483–92PubMedCrossRef
270.
Schuit AJ, Schouten EG, Miles TP, et al. The effect of six months training on weight, body fatness and serum lipids in apparently healthy elderly Dutch men and women. Int J Obes Relat Metab Disord 1998; 22: 847–53PubMedCrossRef
271.
272.
Sutton AJ, Abrams KR, Jones DR, et al. Methods for meta-analysis in medical research. Chichester: John Wiley & Sons, 2001
273.
Follmann D, Elliott P, Suh I, et al. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol 1992; 45: 769–73PubMedCrossRef
274.
275.
Jüni P, Altman DG, Egger M. Assessing the quality of controlled clinical trials. In: Egger M, Davey Smith G, Altman DG, editors. Systematic reviews in health care: meta-analysis in context. 2nd ed. London: BMJ Books, 2001
276.
Hedges LV, Olkin I. Statistical methods for meta-analysis. Orlando (FL): Academic Press, 1985
277.
Deeks JJ, Altman DG, Bradburn MJ. Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Davey Smith G, Altman DG, editors. Systematic reviews in healthcare: meta-analysis in context. 2nd ed. London: BMJ Books, 2001: 285–312
278.
Higgins JPT, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–60PubMedCrossRef
279.
Sterne JAC, Egger M, Davey Smith G. Meta-analysis: investigating and dealing with publication and other bias. In: Egger M, Davey Smith G, Altman DG, editors: Systematic reviews in health care: meta-analysis in context. 2nd ed. London: BMJ Books, 2001: 189–210CrossRef
280.
Sterne JAC, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 2001; 54: 1046–55PubMedCrossRef
281.
Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–34PubMedCrossRef
282.
Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50: 1088–99PubMedCrossRef
283.
Oja P. Dose response between total volume of physical activity and health and fitness. Med Sci Sports Exerc 2001; 33: S428–34PubMedCrossRef
284.
Wing RR. Physical activity in the treatment of adulthood overweight and obesity: current evidence and research issues. Med Sci Sports Exerc 1999; 31 (11 Suppl.): S547–52PubMed
285.
Couillard C, Despres J-P, Lamarche B, et al. Effects of endurance exercise training on plasma HDL cholesterol levels depend on levels of triglycerides: evidence from men of the Health Risk Factors Exercise Training and Genetics (HERITAGE) Family Study. Arterioscler Thromb Vasc Biol 2001; 21: 1226–32PubMedCrossRef
286.
Williams PT, Krauss RM, Vranizan KM, et al. Changes in lipoprotein subfractions during diet-induced and exercise-induced weight loss in moderately overweight men. Circulation 1990; 81: 1293–304PubMedCrossRef
287.
Williams PT, Krauss KM, Vranizan KM, et al. Effects of exercise-induced weight loss on LDL subfractions in healthy men. Arteriosclerosis 1989; 9: 623–32PubMedCrossRef
288.
Doria A, Fioretto P, Avogaro A, et al. Insulin resistance is associated with high sodium-lithium countertransport activity in essential hypertension. Am J Physiol 1991; 261: E691–4
289.
Sowers JR, Epstein M, Frolich ED. Diabetes, hypertension and cardiovascular disease: an update. Hypertension 2001; 37: 1053–9PubMedCrossRef
290.
The sixth report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. Arch Intern Med 1997; 157: 2413–46
291.
World Health Organisation. International Society of Hypertension Guidelines for the Management of Hypertension: Guidelines Subcommittee. J Hypertens 1999; 17: 151–83
292.
Staessen J, Fagard R, Amery A. The relationship between body weight and blood pressure. J Hypertens 1988; 2: 207–17
293.
Brand MB, Mulrow CD, Chiquette E, et al. Dieting to reduce body weight for controlling hypertension in adults. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 1. Oxford: Update Software, 2000
294.
Hermansen K. Diet, blood pressure and hypertension. Br J Nutr 2000; 83Suppl. 1: S113–9PubMed
295.
Hagberg JM, Park JJ, Brown MD. The role of exercise training in the treatment of hypertension: an update. Sports Med 2000; 30: 193–206PubMedCrossRef
296.
Fagard RH. Exercise characteristics and blood pressure response to dynamic physical training. Med Sci Sports Exerc 2001; 33: S484–92PubMedCrossRef
297.
Fagard RH. Physical activity in the prevention and treatment of hypertension in the obese. Med Sci Sports Exerc 1999; 31 (11 Suppl.): S624–30PubMed
298.
Niedfeldt MW. Managing hypertension in athletes and physically active patients. Am Fam Physician 2002; 66: 445–52PubMed
299.
Gordon N. Hypertension. In: Durstine JL, Moore GE, editors. ACSM’s exercise management for persons with chronic diseases and disabilities. 2nd ed. American College of Sports Medicine. Champaign (IL): Human Kinetics, 2003: 76–80
300.
Miller ED, Erlinger TP, Young DR, et al. Results of the diet, exercise, and weight loss intervention trial. Hypertension 2002; 40: 612–8PubMedCrossRef
301.
Devereux RB, Roman MJ. Hypertensive cardiac hypertrophy: pathophysiologic and clinical characteristics. In: Laragh JH, Brenner BM, editors. Hypertension: pathophysiology, diagnosis and management. 2nd ed. New York (NY): Reaven Press Ltd, 1995: 409–24
302.
Rutter MK, Parise H, Benjamin EJ, et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study. Circulation 2003; 107: 448–54PubMedCrossRef
303.
Lind L, Anderssen PE, Andren B, et al. Left ventricular hypertrophy in hypertension is associated with the insulin resistance syndrome. J Hypertens 1995; 13: 433–8PubMed
304.
Morricone L, Malavazos AE, Coman C, et al. Echocardiographic abnormalities in normotensive obese patients: relationship with visceral fat. Obes Res 2002, 98
305.
Kannel WB. Risk stratification in hypertension: new insights from the Framingham study. Am J Hypertens 2000; 13: 3S–10SPubMedCrossRef
306.
Vakili BA, Okin PM, Devereux RB. Prognostic implications of left ventricular hypertrophy. Am Heart J 2001; 141: 334–41PubMedCrossRef
307.
Weber MA, Smith DH, Neutel JM, et al. The therapeutic implications of left ventricular hypertrophy in the hypertensive patient. Am J Ther 1995; 2: 972–7PubMedCrossRef
308.
MacMahon SW, Wilcken DEL, Macdonald GJ. The effect of weight reduction on left ventricular mass: a randomised controlled trial in young overweight hypertensive patients. N Engl J Med 1986; 314: 334–9PubMedCrossRef
309.
Farerberg B, Berglund A, Anderssen OK, et al. Cardiovascular effects of weight reduction versus antihypertensive drug treatment: a comparative, randomised, 1-year study of obese men with mild hypertension. J Hypertens 1991; 9: 431–9CrossRef
310.
Hiemeno E, Nishino K, Okazaki T, et al. A weight reduction and weight maintenance program with long-lasting improvement in ventricular mass and blood pressure. Am J Hypertens 1999; 12: 682–90CrossRef
311.
Hinderlitter A, Sherwood A, Gullette ECD, et al. Reduction of left ventricular hypertrophy after exercise and weight loss in overweight patients with mild hypertension. Arch Intern Med 2002; 162: 1333–9CrossRef
312.
Lalonde L, Gray-Donald K, Lowensteyn I, et al. Comparing the benefits of diet and exercise in the treatment of dyslipidemia. Prev Med 2002; 35: 16–24PubMedCrossRef
313.
Andersen RE, Wadden TA, Bartlett SJ, et al. Effects of lifestyle activity vs structured aerobic exercise in obese women: a randomised trial. JAMA 1999; 281: 335–40PubMedCrossRef
314.
Snyder KA, Donnelly JE, Jabobsen DJ, et al. The effects of long-term, moderate intensity, intermittent exercise on aerobic capacity, body composition, blood lipids, insulin and glucose in overweight females. Int J Obes Relat Metab Disord 1997; 21: 1180–9PubMedCrossRef
315.
Purnell JQ, Brunzell JD. The central role of dietary fat, not carbohydrate, in the insulin resistance syndrome. Curr Opin Lipidol 1997; 8: 17–22PubMedCrossRef
316.
Wolever TM, Mehling C. High carbohydrate-low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance. Br J Nutr 2002; 87: 477–87PubMedCrossRef
317.
Dumesnil JG, Turgeon J, Tremblay A, et al. Effect of a low-glycaemic index-low-fat-high protein diet on the atherogenic metabolic risk profile of abdominally obese men. Br J Nutr 2001; 86: 557–68PubMedCrossRef
Metadaten
Titel
What is the Relationship Between Exercise and Metabolic Abnormalities?
A Review of the Metabolic Syndrome
Publikationsdatum
01.05.2004
Erschienen in
Sports Medicine / Ausgabe 6/2004
Print ISSN: 0112-1642
Elektronische ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200434060-00004

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Ärztliche Empathie hilft gegen Rückenschmerzen

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

16.04.2024 | Spondylitis ankylosans | Nachrichten

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

15.04.2024 | Knie-TEP | Nachrichten

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger
weitere anzeigen

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise