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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2013, Número 4

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Rev Invest Clin 2013; 65 (4)


Disminución del contenido de grasa hepática mediante ejercicio aeróbico comparado con metformina en mujeres con sobrepeso u obesidad

Sánchez-Muñoz V, Salas-Romero R, Del Villar-Morales A, Martínez-Coria E, Pegueros-Pérez A, Franco-Sánchez JG

Idioma: Español
Referencias bibliográficas: 46
Paginas: 307-317
Archivo PDF: 173.34 Kb.


RESUMEN

Introducción. La enfermedad de hígado graso no alcohólico (EHGNA) se caracteriza por un elevado contenido de triglicéridos intrahepáticos, su presencia incrementa la prevalencia de enfermedad cardiovascular, independientemente de los factores de riesgo cardiometabólicos comúnmente conocidos. La metformina se ha utilizado como tratamiento farmacológico; sin embargo, la adherencia es baja debido a los efectos adversos. El ejercicio aeróbico puede ser otra alternativa terapéutica; sin embargo, aún no se ha establecido su efectividad en la disminución del contenido de grasa hepática comparado con metformina. Objetivo. Establecer dicha efectividad así como su influencia sobre la disminución del riesgo cardiovascular en mujeres con sobrepeso u obesidad. Material y métodos. Mujeres de 25-60 años con IMC › 24.9 kg/m2, sedentarias, contenido de grasa hepática ‹ 50 UH. Se dividieron aleatoriamente en dos grupos paralelos: ejercicio (GE) o metformina (GM); el grupo GE realizó un programa de ejercicio aeróbico de 60 min/cinco días/semana a 60-85% de la frecuencia cardiaca de reserva; el grupo GM tomó 1 g/día por la mañana. La duración total del estudio fue de doce semanas. Se determinó el contenido de grasa hepática, así como parámetros metabólicos, de capacidad funcional y de riesgo cardiovascular al inicio y al final del programa. El estudio cumplió con los códigos de ética de Helsinki para la investigación con seres humanos. Resultados. Se conformó una muestra de 16 mujeres, ocho por grupo. Ambas intervenciones modificaron el contenido de grasa hepática en 14.6% (IC95% 0.92, 28.36) y 10.3% (IC95% -1.74, 22.48) para GE y GM, respectivamente. Los niveles de insulina y HOMA-IR disminuyeron significativamente en el grupo GE (P ‹ 0.05), además de disminuir parámetros de riesgo cardiovascular. Conclusión. Un programa de ejercicio aeróbico de doce semanas de duración con un volumen por semana de entrenamiento de 300 minutos y de intensidad moderada a vigorosa (60-85% VO2pico) modificó el contenido de grasa hepática y mejoró los factores de riesgo cardiovascular en esta muestra durante el tiempo de intervención. El ejercicio contribuyó a un abordaje más integral al modificar algunos componentes del síndrome metabólico, de capacidad funcional y de riesgo cardiovascular.


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