Abstract des Autors

The relationships of central obesity and physical fitness to indexes of hemostatic, lipid and glucose metabolism both at baseline and after 1 year of diet and exercise intervention were examined in 209 sedentary middle-aged men and women with increased coronary risk factor levels. Central obesity was measured as either waist circumference or waist/hip ratio. Maximal oxygen uptake was used as a measure of physical fitness. The cross-sectional results show that there were significant correlations between waist circumference and euglobuline clot lysis time (r=0.23), factor VII (r=0.16), glucose and insulin before and after 1 h glucose load (r ranging from 0.32 to 0.50). The 1-year intervention gave the following associations between changes in waist circumference and changes in: euglobuline clot lysis time (r=0.27), factor VII (r=0.19), carbohydrate variables and lipids (ranging from 0.19 to 0.43). Also the other indexes of obesity and physical fitness showed significant correlations to indexes of hemostatic, lipid and glucose variables, both cross-sectionally and for changes after the 1-year intervention. The associations between changes in central obesity and changes in indexes of hemostatic, carbohydrate and lipids were generally stronger during 1 year of diet and exercise intervention than those found at baseline. Multiple regression analyses with waist circumference, waist/hip ratio, percent body fat and VO2max as independent variables and indexes of hemostatic, carbohydrate and lipid metabolism as dependent variables showed that waist circumference was a significant predictor for indexes of the hemostatic, carbohydrate and lipid metapolism, mostly independent of physical fitness. The cross-sectional and 1-year change results support each other and therefore underscore the importance of abdominal obesity as an important risk factor for cardiovascular disease. Verf.-Referat