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Körperliche Aktivität und Fettstoffwechsel

Physical activity and lipid metabolism

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Summary

Studies in recent years have shown beneficial effects of physical activity on lipid metabolism. Both serum lipids and lipids in adipose tissue and in skeletal muscle are affected.

Serum triglycerides are lowered by physical training. Results concerning serum cholesterol and free fatty acids (FFA) are still controversal. The concentrations of very low density lipoproteins (VLDL) and low density lipoproteins (LDL) are reduced and those of high density lipoproteins (HDL) are elevated. Thus LDL:HDL ratios and risk for atherosclerotic diseases are diminished. Epidemiologic studies showing a negative correlation between physical activity and coronary heart disease are congruent with these metabolic effects.

Physical training can reduce total body fat mass, and this reduction traced to a decreased fat cell size. In vitro investigations on this have implicated an impairment in lipogenesis. Methodological problems have clouded the results concerning lipolysis.

Comparing training-induced adaptive mechanisms in adipose tissue and skeletal muscle, different changes are evident. Whereas uptake and storage of lipids in adipose tissue is rather reduced, uptake and oxidation of lipids in skeletal muscle are enhanced. Thus a higher turnover of lipids in muscle lowers serum triglycerides and transport lipoproteins in trained patients with lipid disorders.

Other considerations notwithstanding, physical training is to be recommended for the reduction of VLDL and LDL triglycerides and total body fat mass. Moreover, an increase in HDL-cholesterol can be achieved.

Zusammenfassung

Untersuchungen in den letzten Jahren haben gezeigt, daß der Fettstoffwechsel durch körperliche Aktivität günstig beeinflußt wird. Diese Veränderungen betreffen sowohl die Serumlipide als auch Lipide im Fettgewebe und in der Skelettmuskulatur.

Körperliches Training führt zu einer ausgeprägten Senkung der Serumtriglyzeride. Eine Erniedrigung des Serumcholesterins und der freien Fettsäuren ist umstritten. Die Konzentrationen der „very low density“ Lipoproteine (VLDL) und der „low density“ Lipoproteine (LDL) werden vermindert, die der „high density“ Lipoproteine (HDL) vermehrt. Dadurch erniedrigt sich der LDL:HDL-Quotient und nach derzeitigen Vorstellungen das Arterioskleroserisiko. Entsprechend zeigen epidemiologische Untersuchungen eine negative Korrelation zwischen körperlicher Aktivität und koronarer Herzkrankheit.

Die Körperfettmasse kann durch körperliches Training aufgrund einer Verminderung der Fettzellgröße reduziert werden. In vitro-Untersuchungen am Fettgewebe zeigen, daß die Lipogenese auf mehreren Stufen gehemmt wird. Untersuchungsergebnisse hinsichtlich der Lipolyse sind aufgrund methodischer Probleme nicht einheitlich.

Beim Vergleich trainingsbedingter Adaptationsmechanismen im Fettgewebe und in der Skelettmuskulatur finden sich divergierende Stoffwechselveränderungen. Während im Fettgewebe Fetteinbau und Fettspeicherung eher vermindert sind, ist die Aufnahme und Oxydation von Lipiden in der Skelettmuskulatur des Trainierten beschleunigt. Dadurch kommt es bei trainierten Patienten mit Fettstoffwechselstörungen über einen beschleunigten Umsatz von Lipiden in der Muskulatur zu einer Senkung der Serumtriglyzeride und der Transportlipoproteine.

Körperliches Training kann bei Patienten empfohlen werden, bei denen eine Senkung der Triglyzeride in den VLDL und LDL, eine Erhöhung der HDL und eine Reduktion der Fettmasse wünschenswert ist, sofern keine Kontraindikationen gegen eine Bewegungstherapie bestehen.

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  1. Klinisches Institut für Herzinfarktforschung an der Medizinischen Universitätsklinik Heidelberg, Germany

    A. Wirth, G. Schlierf &  G. Schettler

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Wirth, A., Schlierf, G. & Schettler, G. Körperliche Aktivität und Fettstoffwechsel. Klin Wochenschr 57, 1195–1201 (1979). https://doi.org/10.1007/BF01489246

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