Razi Journal of Medical Sciences

fa تأثیر هشت هفته تمرین ترکیبی (هوازی، مقاومتی) بر میزان هموسیستئین سرم با تاکید بر پلی مورفیسم C677T ژن متیلن تترا هیدروفولات ردوکتاز مردان چاق مبتلا به کبد چرب غیرالکلی The effect of eight weeks compound exercises (aerobic and resistance) on homocysteine serum level on NAFLD obese male subjects with emphasis on Methylenetetrahydrofolate reductase gene's polymorphism (MTHFR) فیزیولوژی ورزش Exercise Physiology پژوهشي Research زمینه و هدف: بیماری کبد چرب غیر الکلی شایع‌ترین بیماری کبدی در دنیا است. عوامل ژنتیکی، پیدایش و توسعه بیماری را تحت تاثیر قرار می‌دهد. مطالعه حاضر به منظور بررسی تأثیر هشت هفته تمرین ترکیبی (هوازی، مقاومتی) بر میزان هموسیستئین سرم سه ژنوتیپ (TT،CT،CC) پلی مورفیسم C677T ژن متیلن تترا هیدروفولات ردوکتازMTHFR  بود. روش کار: در این پژوهش نیمه تجربی میزان هموسیستئین سرم60 بیمار مرد چاق 30 تا 40 ساله با BMI بین k/m230 الی 35 مبتلا به کبد چرب غیرالکلی گرید 1 در شش گروه (سه گروه تجربی و سه گروه کنترل) قبل و پس از 8 هفته تمرین ترکیبی تحت بررسی قرارگرفتند. تمرین ترکیبی به صورت ترکیب تمرینات هوازی و  مقاومتی در سه روز غیر متوالی به طوری که در نیمه ابتدای هر جلسه تمرینات هوازی و در نیمه دوم تمرین مقاومتی اجرا شد. تمرینات هوازی با  شدت 65 درصد حداکثر ضربان قلب ذخیره در جلسه اول و شدت 75 درصد حداکثر ضربان قلب ذخیره در جلسه آخر و نیز <a name="_Hlk58446591">تمرینات مقاومتی بر مبنای غیرخطی با تأکید بر استقامت و آمادگی عمومی به وسیله کرامر و فلک </a>با شدت تمرین 45 درصد در جلسه اول و 60 درصد در جلسه آخر انجام گردید. به منظور مقایسه گروه‌ها ازروش آماری تحلیل واریانس با اندازه‌های تکراری و در صورت وجود تفاوت بین گروه‌ها به منظور انجام مقایسه‌های جفتی از آزمون تعقیبی LSD استفاده  و میزان خطا (05/0˂α) درنظرگرفته و با استفاده از نرم افزارSPSS19 تجزیه و تحلیل داده‌ها انجام شد. یافته‌ها: در پایان 8 هفته نتایج نشان داد که گروههای مختلف تمرینی در شاخصهای سطح غلظت هموسیستئین (000/0p=) تفاوت معنی‌داری را نشان داد. با عنایت بهوجود تفاوت بین گروهها مشخص شد که غلظت هموسیستئین در گروه ژنوتیپ TT نسبت به هر دو گروه ژنوتیپ CT (000/0 = P) و CC (026/0 = P) به کاهش معنیدار منجر شده است، در صورتیکه گروه ژنوتیپ CT نسبت به گروه ژنوتیپ CC تفاوت معنیداری  مشاهده نشد (815/0 = P). نتایج بعدی برای هر گروه نشان داد که در گروه تمرین TT بین پیشآزمون و پسآزمون تفاوت معنیداری وجود داشت (025/0= P) و همچنین گروه تمرین CT بین پیشآزمون و پسآزمون تفاوت معنیداری وجود داشت (041/0p=)، اما در گروه CC تفاوت بین پیشآزمون و پسآزمون معنیدار نیست. نتیجه‌گیری: بعد از هشت هفته تمرین ترکیبی (هوازی، مقاومتی) میزان هموسیستئین سرم در بیماران کبد چرب کاهش داشته و این تاثیر در ژنوتیپ TT نسبت به دو ژنوتیپ CT و  CC کاهش بیشتری را نشان داد .لازم به ذکر است با توجه به یافته‌های این پژوهش در رابطه با کاهش سطح هموسیستئین سرم متعاقبا احتمال بهبود عملکرد کبد در بیماران کبد چرب غیر الکلی نیز حاصل گردد. Background & Aims: The Liver is one of the most important body organs. Some of its most important functions include, detoxing the taken medications, expulsion of the remains of destruction of the red blood cells in form of bile, producing blood coagulation components, preserving sugar in the form of glycogen and also preserving and burning of the fat and sugar in body. There are two kinds of fatty liver diseases, namely, alcoholic, and non-alcoholic fatty liver. The most common liver ailment is non-alcoholic fatty liver disease which happens when more than 5%-10% of the liver weight would consist of fat. This disease can be categorized into three different levels, 1,2 and 3. Emergence and development of such disease is affected by genetic factors in addition to having a low activity lifestyle and bad eating habits. Genetic factors play an important role in being overweight and having NAFLD. 16%-50% of the NAFLD patients are affected by the genetic factors. One of the genetic factors is the Methylene tetrahydrofolate reductase gen (MTHFR). This is the coding gen of the Methylene tetrahydrofolate reductase enzyme which it’s common polymorphismis C677T. Gen MTHFR is one of the effective genes in producing active oxidants and therefore, effective in Steatosis, inflammation and fibrosis. It is possible that in case of an increase in C677T which will result in decreasing the functionality of MTHFR in a fatty liver, and considering that the considered enzyme is only functional in high temperatures, would result in an increase in this enzyme function and hence, increase of the temperature during an exercise. In case of an increase in C677T, a less functioning MTHFR is produced which will result in an increase in blood Homocysteine.In order to study the effect of eight week's compound exercises (aerobic and resistance) on homocysteine serum level on three genotypes (CC, CT, TT) of C677T polymorphism of Methylenetetrahydrofolate reductase gene's (MTHFR) was conducted. Methods: In this semi-experimental study, the homocysteine serum level of 60 obese male between the age of 30 to 40 with the BMI of 30 to 35(K&frasl;m^2 ) whom were diagnoests with grade 1 NAFLD which also were devided in six groups (3 control groups, 3 experimental groups), before and after of eight weeks of compound exercises were observed. The compound exercises were executed as the combination of aerobic and resistance exercieses for 3 seperated (non- consecutive) days in the way that at the first half of the session the aerobic exercieses were took place and in the second half the resistance exercieses. The aerobic exercises with the intensity of 65 percent of the maximum Save heart rate in the first sesseion and 75 percent of the maximum Save heart rate of the last session and the resistance exercises were based on non-linear base with emphasis on endurances and total readiness with the mean of Kramer and Flak with the intensity of 45 percent of the first session and the 60 percent of the last session have had happened. To compare the groups with eachother, the Statistical method of analysis of variance method, with repetitious size was used. If there were ment to be a difference between the groups for the means to compare them with eachother the Post hoc test LSD method, with errore of (05/0 ˂α) was considered, and the SPSS19 softwear was used to analyzing the experiment data. Results: After 8 weeks, the results have shown that the different exercise groups have a noticeable variation in Homocysteine index(p=0/000). By analyzing the variance of the data, we can see that there is a meaningful difference between different groups. There is a meaningful difference between the groups, even disregarding the test cases (p=0/000). Due to the difference between the groups, the LSD test method is used to find the difference position. Based on this method, it have been resulted that the density of Homocysteine in TT genotype group was meaningfully reducted in comparison to other genotype groups, such as CT genotype group(p=0/000) and CC genotype group(p=0/026), however the CT genotype group did not show a noticeable differenc rather than CC genotype group(p=0/815), further result suggest that there is a noticeable difference between pre-test and post-test in TT genotype group(p=0/025) and also the same situation was happened with the CT exercise group(p=0/041), but there was no meaningful differences between pre-test and post-test of the CC group. Conclusion:  after eight week's compound exercises (aerobic and resistance) level homocysteine serum on genotype reduction performance of TT was better in reduction comparison to genotype CT and CC. this finding shows that, because of the reduction level of the homocysteine serum, probably the function of the liver in non-alcoholic fatty liver patients will improve.Overall conclusion: Eight week's compound exercises (aerobic and resistance) can significantly reduce the level of Homocysteine.considering the results of this study, it can be concluded that combined exercise of aerobic and resistance exercise could be used in curing the non-alcoholic fatty liver in the obese male patience in order to avoid wight gain and it’s comorbidities and also the lack of exercise in addition to curing the disease. These results also indicate that a reduced level of Homocysteine serum will probably result in better functionality of a fatty liver in the patience.   کبد چرب غیر الکلی, چاقی, هموسیستئین, ژن MTHFR, پلی مورفیسمهای C677T Non-alcoholic fatty liver,Obest,MTHFR,Homocysteine serum,C667T,exercises (aerobic and resistance) 90 103 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5556-1&slc_lang=fa&sid=1 Amir Falahnezhad Mojarad امیر فلاح نژاد مجرد amirfalah.sport@gmail.com 3900319475328460060172 3900319475328460060172 No Islamshahr Branch, Islamic Azad university دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، واحد اسلامشهر، ایران Laleh Behboudi لاله بهبودی behbudi@gmail.com 3900319475328460060173 3900319475328460060173 Yes Islamshahr Branch, Islamic Azad University, Islamshahr, Iran دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، واحد اسلامشهر، ایران Sanaz Mirzaiyan Shanjani ساناز میرزایان شانجانی san_mir2000@yahoo.com 3900319475328460060174 3900319475328460060174 No Islamshahr Branch, Islamic Azad university دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، واحد اسلامشهر، ایران Mojtaba Izadi مجتبی ایزدی izadimojtaba2006@yahoo.com 3900319475328460060175 3900319475328460060175 No saveh Branch, Islamic Azad university دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، واحد ساوه، ایران