gms | German Medical Science

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Österreich

Obesity at ex-sportsmen case presentation

Meeting Abstract

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7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm198

DOI: 10.3205/11esm198, URN: urn:nbn:de:0183-11esm1982

Veröffentlicht: 24. Oktober 2011

© 2011 Pentiuc.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Obesity nowadays is a very important health problem. Obesity is associated with high mortality risks due to increased rates of cardiovascular diseases, diabetes.The association of obesity with other pathologys like cancer are in research. In obesity treatment and obesity prevention sport is almost always indicated.

Our goal is to studing obese ex-sportsmen to determin if the past intense sport activity has a long time beneficial influence (independent of eating) on obesity risks - cardiovascular and diabetes pathology, plasma lipoprotein levels, insulin sensitivity and inflammation markers, studing also the distribution of body fat (visceral versus abdominal fat), regarding the difference in associated pathology of one versus another.

Visceral adipocity more then subcutaneous fat has been being associated with systemic metabolic variables like: alterations in plasma lipoprotein-lipid levels particularly increased plasma triglyceride and lowering high-density lipoprotein concentrations [1], elevated of blood glucose levels and decrease in insulin sensitivity at young men measured by an euglycemic hyperinsulinemic glucose clamp [2], link between the many facets of the metabolic syndrome: glucose intolerance, hypertension, dyslipidemia, and insulin resistance [3].

Obesity has also a negative impact on the hormonal levels, decresing the total and free testosterone and FSH and LH levels in morbidly obese men (BMI>40) indicating a functional impairment of the gonadostat suggesting hypogonadotropic hypogonadism sindrom [4].

Material/Methods: We studied an young obese male after a 8 years period of sports activity interruption.

We fallowed body fat, distribution of body fat, plasma lipoprotein levels, insulin sensitivity, blood glucose levels, inflammation markers, cardiology consult, testosterone, psychological evaluation.

The psychological evaluation aimed for detecting eating behavior, eating disorders, factors that maintain the fat accumulation.

Male 28 years old ex-sportsmen (played rugby for 9 years), 194 kg and 187 cm (BMI 55,92) with 63 kg of muscle mass and a 133 kg of fat (measured with bioelectrical impendance), with no associated pathology other then morbidity obesity. He’s father has diabetes mellitus type 2 so he had a genetical risk factor

He practice rugby from 11 years old until 20 years old.

After finishing the sport career he began adding kilos. At 20 (when he finished playing rugby) he had 120.

At cardiology consultation he had 130/80 mmHg with 87 beet/min without any other problems.

At psychological evaluation he was diagnosed with compulsive eating disorder.

Evaluation of plasma lipoprotein levels showed a total cholesterol of 200 with a low HDL of 42, a high VLDL of 41 and increased plasma triglyceride of 203.

For inflammation we evaluated he’s fibrinogen that was high 355.

He’s blood glucose was 100 and the glycated hemoglobin was at the maximum stage of 6.20 with high blood insulin levels of 19.90.

Gonad function is decreased with low LH of 2.63, low FSH of 1.56 and low free testosterone of 2.07.

At MRI the amount of visceral fat was bigger then subcutaneus fat.

Results: This case is part of a larger study in progres. It can not draw conclusion is more of initiating a question on quality of life for ex performance athlets, especialy in heavy sports like rugby, lifting weights etc.

We also want to initiate a warning signal that continuing practicing sport and controling eating behavior is necesarry all the time even for an ex sportman.

Our patients had atheromatosis and cardiovascular risk (low HDL and boundary high cholesterol, high triglyceride levels), insulin resistant and poor control of blood glucose levels (boundary high levels of insulin and glicated hemoglobin), protrombotic state (high fibrinogen) and gonad function affected.

The risks of pathology associated with visceral fat present.

Conclusion: So in this case the practice of sport even if it was of high intensity did not not offer a long term protection, considering also the fact that he has morbidity obesity.

Even if in our case the patient was young and had no other diseases he had risks of cardiovascular diseases, diabetes, metabolic syndrom and hipogonadism.


References

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Desprès JP. Lipoprotein metabolism in visceral obesity. Int J Obes. 1991;15:45–52.
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Park KS, Rhee BD, Lee KU, Kim SY, Lee HK, Koh CS, Min HK. Intra-abdominalfat is associated with decreased insulin sensitivity in healthy young men. Metabolism. 1991;40:600–3.
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Angel A, Anderson H, Bouchard C, Lau D, Leiter L, Mendelson R. Progress in Obesity Research: Proceedings of the Seventh International Congress on Obesity (Toronto, Canada, August 20–25, 1994). London: John Libbey & Company; 1994. Vol 7. p. 525–32.
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Kley HK, Deselaers T, Peerenboom H. Evidence of hypogonadism in massively obese males due to decreased free testosterone. Horm Metab Res. 1981;13:639–41.
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