The Effects of Land vs. Water Combined Exercise Training on ANGPTL۴ and Postural Control in Elderly Men with Metabolic Syndrome

Background and Purpose: Metabolic Syndrome (MetS) is a cluster of disorders increasing cardiovascular risk. Exercise is a key intervention, but the optimal environment (land vs. water) for modulating metabolic hepatokines like angiopoietin-like protein ۴ (ANGPTL۴) and improving functional outcomes like balance in the elderly with MetS remains unclear. This study compared the effects of eight-week combined (aerobic + resistance) exercise programs performed on land versus in water on ANGPTL۴ levels, balance, and anthropometric indices in elderly men with MetS. Materials and Methods: In this quasi-experimental study, ۴۵ elderly men (age:  ۶۳. ۱۴ ± ۳.۲۳) with MetS were assigned to three groups: water exercise (WE), land exercise (LE), and a control group (CG). The exercise interventions consisted of three sessions per week for eight weeks. Fasting serum ANGPTL۴ levels, functional balance (static and dynamic), and anthropometric indices were assessed pre- and post-intervention. Data were analyzed using repeated measures ANOVA, Friedman, and appropriate Bonferroni and Games-Howell post-hoc tests. Results: While ANGPTL۴ levels decreased slightly in the exercise groups and increased in the CG, these changes were not statistically significant (p > ۰.۰۵). Both exercise groups showed significant within-group improvements in dynamic balance and static balance with eyes open (p < ۰.۰۵), but no significant between-group differences were found. Body mass index (BMI) decreased significantly only in the WE group (p < ۰.۰۵). Conclusion: Eight weeks of combined exercise training, whether on land or in water, improved balance performance but did not significantly alter serum ANGPTL۴ levels in elderly men with MetS. Water-based exercise may offer a superior advantage for reducing BMI. The lack of significant change in ANGPTL۴ may suggest a complex relationship influenced by age, training duration, and measurement specificity, warranting further investigation.

کلیدواژه ها:

Metabolic Syndrome ، Middle Aged ، Exercise Therapy ، Postural Balance ، Angiopoietin-like ​​​​​​​