Sport bei Adipositas – Welche kardiovaskulären Effekte können wir erwarten?

Zusammenfassung

Adipositas ist weltweit eine der Hauptursachen für die Entwicklung kardiovaskulärer Erkrankungen. Der Anstieg der Adipositasprävalenz ist mit einem Mangel an körperlicher Aktivität assoziiert. Körperliche Inaktivität wurde als ein unabhängiger Prädiktor der kardiovaskulären Sterblichkeit identifiziert. Adipositas und körperliche Inaktivität tragen zur Entwicklung einer generalisierten Endotheldysfunktion als Initialstadium der Arteriosklerose bei, wobei diese bereits viele Jahre vor makroskopisch sichtbarer Manifestation arteriosklerotischer Plaques auftreten kann. Eine Imbalance zwischen Produktion und Abbau von endothelial synthetisiertem Stickstoffmonoxid, des wichtigsten endogenen Vasodilatators, führt zu einer Alteration der normalen Vasomotion hin zur Vasokonstriktion. Die Endotheldysfunktion stellt einen starken Prädiktor für das Auftreten späterer kardiovaskulärer Ereignisse dar. Interventionsprogramme zur Steigerung der körperlichen Aktivität zielen daher auch darauf ab, durch eine Verbesserung oder zumindest Stabilisierung der Endothelfunktion die kardiovaskuläre Morbidität und Mortalität zu senken. Der zumindest partiellen Korrektur der Endotheldysfunktion durch körperliches Training via regulatorische Prozesse direkt am Endothel sowie über Modulation der im Fettgewebe sezernierten Adipozytokine kommt daher eine zentrale Rolle im Langzeitverlauf der Erkrankung zu.

Abstract

Obesity is a leading cause of the development of cardiovascular diseases worldwide. A marked decline in physical activity plays a major role in the dramatically increasing rates of obesity all around the world and acts also as an independent predictor for future heart diseases. The occurrence of generalized endothelial dysfunction in subjects with obesity is considered to be the earliest stage of atherosclerosis and can be present years before an atherosclerotic lesion will be detectable. The availability of nitric oxide – the major endothelium-derived relaxing factor – is critically influenced by the above-mentioned risk factors as well as other diseases like type 2 diabetes leading to a mismatch between relaxation and contraction of the vessels. Since endothelial function could be identified as a strong predictor for the occurrence of future cardiovascular events, intervention programs including exercise training or leisure time activities aim to maintain or improve vascular function and thereby contribute to a reduction of cardiovascular mortality and morbidity. Exercise-induced endothelial regulation and modulation of adipose tissue thereby play a major role in long-term progress of the disease.

Schlüsselwörter

Endotheldysfunktion - Arteriosklerose - Adipozytokine - körperliches Training

Key words

Endothelial dysfunction - atherosclerosis - adipocytokines - physical exercise training

Publication History

Article published online:
12 March 2021

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