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Ehokardiografska študija športnega srca in presnova inzulina pri moških in ženskah
Avtor: Polona Rogel
Mentor: prof., dr. Aleš Žemva, dr. med
Namen študije je bil raziskati vplive inzulina, spola in spolnih hormonov na razvoj športnega srca in spremembe krvnega tlaka pri parih športnega plesa.
V šudijo smo vkljucili 30 športnih plesalcev (15 moških in 15 žensk) ter ter 30 kontrolnih oseb nešportnikov (15 moških in 15 žensk), ki se od preiskovane skupine niso razlikovali glede na telesno težo in višino ter starost.Pri športnikih smo ugotavljali koliko let trenirajo in koliko ur tedensko preživijo na treningu. Merili smo kožne gube, razmerje med trebuhom in boki, srcni utrip in sistolicni ter diastolicni krvni tlak sede. Dolocili smo koncentracijo inzulina in C- peptida na tešce ter koncentracijo celotnega in prostega testosterona ter SHBG (sex hormone binding globulin). Ob tem smo bolnikom napravili obremenilni glukozni test pri katerem smo poleg glukoze merili tudi koncentracijo inzulina. Vsi preiskovanci so pravili obremenilno testiranje na cikloergometru. Obremenjeni so bili do izcrpanja. Ugotavljali smo maksimalno zmogljivostm maksimalno porabo kisika ter maksimalen krvni tlak. S pomocjo ehokardiografije smo ugotavljali maso levega prekata po ASE in po Devereuxu ter merili premere srcnih votlin in, ter sistolicno in diastolicno funkcijo.
Športniki (Š) so imeli v primerjavi z nešportniki (NŠ) signifikantno manjšo (p<0,000) vsoto kožnih gub v mm (Š:41±7, NŠ:61±14). Pri športnikih smo ugotavljali signifikantno nižji (p< 0,015) srcni utrip (Š:59±9, NŠ:70±8) ter diastolicni krvni tlak sede v mmHg (Š:68±7, NŠ: 75±10, p<0,007). Ugotavljali smo vecjo maksimalno zmogljivost športnikov v MET (Š:16±1, NŠ:14±2, p<0,001), vecjo maksimalno porabo kisika v l O2 /min/kg (Š:56±6, NŠ:47±5, p<0,000) . Pri športnikih smo ugotavljali vecji indeks mase levega prekata v g/m2 (Š:107±19, NŠ: 93±17, p<0,009) ter nižji inzulin 120 minut po obremenitvi z glukozo v pmol/l (Š:16±12, NŠ:27±16, p<0,005), kar govori za boljšo odzivnost na inzulin pri športnikih.
Linearna in multipla regresija nista pokazali nobene signifikantne povezave med parametri športnega srca ter odzivnostjo na inzulin in moškimi spolnimi hormoni. Prav tako nismo našli povezave med nižjim krvnim tlakom ter odzivnostjo na inzulin in moškimi spolnimi hormoni.
Menimo, da odzivnost na inzulin, spol in moški spolni hormoni nimajo vpliva na razvoj športnega srca in nižji krvni tlak pri športnikih.
[Abstract / English version]
Echocardiographic study of athlete's heart and insulin metabolism in men and women
Author: Polona Rogel
Mentor: prof., dr. Aleš Žemva, dr. med
The purpose of the study was to evaluate the role of insulin, gender, and male sex hormones in the development of athelete's heart and decreased blood pressure in dancing sport. Thirty members of national dancing team (15 males, 15 females) and 30 control subjects (15 males, 15 females) who were not active in sports participated in the study. Both groups were matched for age, body weight and height.We evaluated the duration of dancing activity (in years) and how many hours per week they practising dance. Skin folds, waist : hip ratio, heart rate, systolic and diastolic blood pressure were measured. Fasting insulin and C-peptide, total and free testosterone and sex hormone binding globulin were determined by radioimmuno-assay. 75g oral glucose tolerance test with simultaneous determination of insulin was performed. All subjects were tested on cycloergometer. By the means of maximal protocol we measured maximal work load, maximal oxygen consumption and maximal blood pressure. Left ventricular mass and dimensiones of left ventricular walls and cavites, and systolic and diastolic function were measured by echocardiography.
Sportsmen (S) in comparison to subjects not active in sports (NS) had significantly lower (p<0,000) sum of skin folds in mm (S:41±7, NS:61±14). Sportsmen had significantly lower (p< 0,015) heart rate (S:59±9, NS:70±8) and sitting diastolic blood pressure in mmHg (S:68±7, NS: 75±10, p<0,007). Sportsmen achieved significantly higher work load in MET (S:16±1, NS:14±2, p<0,001),higher oxygen consumption in l O2 /min/kg (S:56±6, NS:47±5, p<0,000) . Left ventricular mass index in g/m2 was in sportsmen significantly greater (Š:107±19, NŠ: 93±17, p<0,009) and insulin 120 minutes after glucose load in pmol/l was significantly lower (S:16±12, NS:27±16, p<0,005), which reveals improved insulin sensitivity.
Linear and multiple logistic regression did not show any significant correlation between parameters of athelete's heart and insulin sensitivity and male sex hormones. No correlations between lower blood pressure in sportsmen and insulin sensitivity and male sex hormones were found as well.
Therefore we conclude, that insulin sensitivity, gender and male sex hormones do not play any role in development of athelete's heart snd lower blood pressure in sportsmen.