不同强度抗阻训练对糖耐量受损老年人糖代谢的调节与强度无关
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摘要
为了探讨不同强度抗阻训练对糖代谢调节的作用,为糖耐量受损老年人运动处方的制定提供参考,本研究招募80名自愿参与本研究的糖耐量受损老年人,将其随机分为高强度抗阻训练组(high group,H组,n=20)、中强度抗阻训练组(medial group,M组,n=20)、低强度抗阻训练组(low group,L组,n=20)和对照组(control group,C组,n=20)。通过对所有受试者进行前测(身体成分,生长激素分泌指标,空腹血糖、胰岛素敏感性指标),前测结束后48 h内进行H组、M组、L组最大力量测试(1 RM测试),72 h后开始为期36周的运动干预,运动干预结束后进行后测(身体成分,生长激素分泌指标,胰岛素敏感性指标),本研究发现H组、M组、L组经过36周运动干预后BMI、体脂百分比、腰臀比(WHR)、OGTT、HOMA-IR、抵抗素的后测均显著低于前测(p<0.05);C组BMI、体脂百分比、腰臀比、空腹血糖、OGTT、HOMA-IR、抵抗素前后测无显著性差异(p>0.05);H组、M组、L组BMI、体脂百分比、腰臀比、OGTT、HOMA-IR、抵抗素后测均显著低于C组(p<0.05)。H组、M组、L组经过36周运动干预GH、IGF-1显著高于前测(p<0.05)且H组、M组、L组GH、IGF-1后测显著高于C组(p<0.05)。本研究表明,抗阻训练可以显著提高糖耐量受损人群胰岛素敏感性,改善糖代谢,其机制可能为非单一因素导致,应该与抗阻运动诱发的血清GH、IGF-1上升和抵抗素降低有关。
To explore the effect of different intensity resistance training on the regulation of glucose metabolism and provide reference for the formulation of exercise prescription for impaired glucose tolerance,eighty children with impaired glucose tolerance were enrolled in this study.They were randomly divided into high-intensity anti-resistance training gr oup(high group,H group,n =20),medium-intensity resistance training group(medial group,A group,n=20),low-intensity anti-resistance training group(low group,L group,n=20),and control group(control group,C group,n =20).By pre-testing the body composition,growth hormone secretion index,fasting blood glucose and insulin sensitivity index of all the subjects,conducting the maximum strength test of H,M,L group within 48 hours after the end of pre-testing,after 72 hours starting a period of 36 weeks of exercise intervention and posttesting the body composition,growth hormone secretion index,fasting blood glucose and insulin sensitivity index of all the subjects again after the end of the intervention,we found that the levels of BMI,body fat percentage,waist-to-hip ratio(WHR),OGTT,HOMA-IR and resistin were significantly lower in the H group,M group and L group than those in the control group after 36 weeks of exercise intervention(p<0.05);There were no significant differences in BMI,body fat percentage,waist-to-hip ratio,fasting blood glucose,OGTT,HOMA-IR and resistin before and after treatment(p>0.05);Waist-to-hip ratio,OGTT,HOMA-IR and resistin were significantly lower than those in group C(p<0.05).The levels of GH and IGF-1 in group H,group M and group L were significantly higher than those in C group(p<0.05).Our research indicated that anti-resistance training can significantly improve insulin sensitivity and glucose metabolism in impaired glucose tolerance,and that its mechanism may be caused by non-single factor,which should be related to resistance to exercise-induced increase of serum GH,IGF-1 and resistin.
To explore the effect of different intensity resistance training on the regulation of glucose metabolism and provide reference for the formulation of exercise prescription for impaired glucose tolerance,eighty children with impaired glucose tolerance were enrolled in this study.They were randomly divided into high-intensity anti-resistance training gr oup(high group,H group,n =20),medium-intensity resistance training group(medial group,A group,n=20),low-intensity anti-resistance training group(low group,L group,n=20),and control group(control group,C group,n =20).By pre-testing the body composition,growth hormone secretion index,fasting blood glucose and insulin sensitivity index of all the subjects,conducting the maximum strength test of H,M,L group within 48 hours after the end of pre-testing,after 72 hours starting a period of 36 weeks of exercise intervention and posttesting the body composition,growth hormone secretion index,fasting blood glucose and insulin sensitivity index of all the subjects again after the end of the intervention,we found that the levels of BMI,body fat percentage,waist-to-hip ratio(WHR),OGTT,HOMA-IR and resistin were significantly lower in the H group,M group and L group than those in the control group after 36 weeks of exercise intervention(p<0.05);There were no significant differences in BMI,body fat percentage,waist-to-hip ratio,fasting blood glucose,OGTT,HOMA-IR and resistin before and after treatment(p>0.05);Waist-to-hip ratio,OGTT,HOMA-IR and resistin were significantly lower than those in group C(p<0.05).The levels of GH and IGF-1 in group H,group M and group L were significantly higher than those in C group(p<0.05).Our research indicated that anti-resistance training can significantly improve insulin sensitivity and glucose metabolism in impaired glucose tolerance,and that its mechanism may be caused by non-single factor,which should be related to resistance to exercise-induced increase of serum GH,IGF-1 and resistin.
引文
Boulton A.J.,Malik R.A.,Arezzo J.C.,and Sosenko J.M.,2004,Diabeticsomatic neuropathies,Diabetes Care,27(6):1458-1486
Cheng H.L.,Shi J.J.,Weng Y.J.,Li W.,and Xu T.F.,2013,Influence of resistance training on glycometabolism and lipid metabolism in elderly patients with type 2 diabetes,Shiyong Linchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),17(23):19-22(程会兰,施加加,翁雅婧,李伟,许腾飞,2013,抗阻训练对老年2型糖尿病患者糖代谢、脂代谢等方面的影响,实用临床医药杂志,17(23):19-22)
Dey S.K.,Ghosh C.,Debray P.,and Chatterjee M.,2002,Coronary artery disease risk factors&their association with physical activity in older athletes,J.Cardiovasc.Risk,9(6):383-392
Earnest C.P.,Blair S.N.,and Church T.S.,2012,Heart rate variability and exercise in aging women,J.Womens Health(Larchmt),21(3):334-339
Elias D.,Prigozin H.,Polak N.,Rapoport M.,Lohse A.W.,and Cohen I.R.,1994,Autoimmune diabetes induced by theβ-cell toxin STZ.Immunity to the 60-k D heat shock protein and to insuli,Diabetes,43(8):992-998
Fogelholm M.,Kaprio J.,and Sarna S.,1994,Healthy lifestyles of former Finnish world class athletes,Med.Sci.Sports Exerc.,26(2):224-229
Galetta F.,Franzoni F.,Tocchini L.,Camici M.,Milanesi D.,Belatti F.,Speziale G.,Rossi M.,Gaudio C.,Carpi A.,and Santoro G.,2013,Effect of physical activity on heart rate variability and carotid intima-media thickness in older people,Intern.Emerg.Med.,8(1):27-29
Gao J.K.,Huang X.D.,and Ke J.C.,2009,influence of gestational impaired glucose tolerance on maternal and neonatal outcomes,Xiandai Yiyuan(Modern Hospital),9(5):65-67(高结坤,黄杏端,柯柬初,2009,妊娠期糖耐量受损对母婴预后的影响,现代医院,9(5):65-67)
Giannopoulou I.,Fernhall B.,Carhart R.,Weinstock R.S.,Baynard T.,Figueroa A.,and Kanaley J.A.,2005,Effects of diet and or exercise on the adipocytokine and inflammatory cytokine levels of postmenopausal women with type 2 diabetes,Metabolism.54(7):866-875
Gordon B.A.,Benson A.C.,Bird S.R.,and Fraser S.F.,2009,Resistance training improves metabolic health in type 2 diabetes:a systematic review,Diabetes Res.Clin.Pract.,83(2):157-175
Group D.P.P.,2002,The diabetes prevention program(DPP):description of lifestyle intervention,Diabetes Care,25(12):2165-2171
Kemp A.H.,and Quintana D.S.,2013,The relationship between mental and physical health:Insights from the study of heart rate variability,Int.J.Psychophysiol.,89(3):288-296
Kitabchi A.E.,Umpierrez G.E.;Miles J.M.,and Fisher J.N.,2009,Hyperglycemic crises in adult patients with diabetes,Diabetes Care,32(7):1335-1343
Malin S.K.,Niemi N.,Solomon T.P.,Haus J.M.,Kelly K.R.,Filion J.,Rocco M.,Kashyap S.R.,Barkoukis H.,and Kirwan J.P.,2012,Exercise training with weight loss and either a high-or low-glycemic index diet reduces metabolic syndrome severity in older adults,Ann.Nutr.Metab.,61(2):135-141
Ni L.F.,Dai Y.T.,Su T.C.,and Hu W.Y.,2013,Substance use,gender,socioeconomic status and metabolic syndrome among adults in Taiwan,Public Health Nurs.,30(1):18-28
Ohlsson C.,Mellstrm D.,Carlzon D.,Orwoll E.,Ljunggren O.,Karlsson M.K.,and Vandenput L.,2011,Older men with low serum IGF-1 have an increased risk of incident fractures:the Mr OS Sweden study,Bone Miner Res.,26(4):865-872
Ozaktay A.C.,Kallakuri S.,Takebayashi T.,Cavanaugh J.M.,Asik I.,De Leo J.A.,and Weinstein J.N.,2006,Effects of interleukin-1 beta,interleukin-6,and tumor necrosis factor on sensitivity of dorsal root ganglion and peripheral receptive fields in rats,Eur.Spine.J.,15(10):1529-1537
Pihl E.,Jrime T.,and Kaasik T.,1998,Coronary heart disease risk factors in middle-aged former top-level athletes,Scand.J.Med.Sci.Sports,8(4):229-235
Roumen C.,Corpeleijn E.,Feskens E.J.,Mensink M.,Saris W.H.,and Blaak E.E.,2008,Impact of 3-year lifestyle intervention on postprandial glucose metabolism:the SLIM study,Diabet.Med.,25(5):597-605
Shi Y.,and Hu F.B.,2014,The global implications of diabetes and cancer,Lancet,383(9933):1947-1948
Trevizani G.A.,Benchimol-Barbosa P.R.,and Nadal J.,2012,Effects of age and aerobic fitness on heart rate recovery in adult men,Arq.Bras.Cardiol.,99(3):802-810
Tuomilehto J.,Lindstrem J.,Eriksson J.G.,Valle T.T.,Hamalainen H.,Ilanne-Parikka P.,Keinanen-Kiukaanniemi S.,Laakso M.,Louheranta A.,Rastas M.,Salminen V.,Uusitupa M.,and Finnish Diabetes Prevention Study Group,2001,Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance,N.Engl.J.Med.,344(18):1343-1350
Unt E.,Zilmer K.,Mgi A.,Kullisaar T.,Kairane C.,and Zilmer M.,2008,Homocysteine status in former top-level male athletes:Possible effect of physical activity and physical fitness,Scand.J.Med.Sci.Sports,18(3):360-366
Verheyden B.,Eijnde B.O.,Beckers F.,Vanhees L.,and Aubert A.E.,2002,Low-dose exercise training does not influence cardiac autonomic control in healthy sedentary men aged55-75 years,J.Sports Sci.,24(11):1137-1147
Wang X.,Hsu F.C.,Isom S.,Walkup M.P.,Kritchevsky S.B.,Goodpaster B.H.,Church T.S.,Pahor M.,Stafford R.S.,and Nicklas B.J.,2012,Effects of a 12-month physical activity intervention on prevalence of metabolic syndrome in elderly men and women,J.Gerontol.A.Biol.Sci.Med.Sci.,67(4):417-424
Wang Y.H.,2011,The effect of gestational impaired glucose tolerance on pregnancy outcome of maternal and child,Linchuang Heli Yongyao Zazhi(Chinese Journal of Clinical Rational Drug Use),4(19):37-38(王咏红,2011,妊娠期糖耐量受损对妊娠结局母婴的影响,临床合理用药杂志,4(19):37-38)
Ying Y.Y.,and Xu G.Z.,2016,The progress of study on pre-diabetes,Shiyong Yufang Yixue(Practical Preventive Medicine),23(2):250-253(应焱燕,许国章,2016,糖尿病前期的研究进展,实用预防医学,23(2):250-253)
Cheng H.L.,Shi J.J.,Weng Y.J.,Li W.,and Xu T.F.,2013,Influence of resistance training on glycometabolism and lipid metabolism in elderly patients with type 2 diabetes,Shiyong Linchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),17(23):19-22(程会兰,施加加,翁雅婧,李伟,许腾飞,2013,抗阻训练对老年2型糖尿病患者糖代谢、脂代谢等方面的影响,实用临床医药杂志,17(23):19-22)
Dey S.K.,Ghosh C.,Debray P.,and Chatterjee M.,2002,Coronary artery disease risk factors&their association with physical activity in older athletes,J.Cardiovasc.Risk,9(6):383-392
Earnest C.P.,Blair S.N.,and Church T.S.,2012,Heart rate variability and exercise in aging women,J.Womens Health(Larchmt),21(3):334-339
Elias D.,Prigozin H.,Polak N.,Rapoport M.,Lohse A.W.,and Cohen I.R.,1994,Autoimmune diabetes induced by theβ-cell toxin STZ.Immunity to the 60-k D heat shock protein and to insuli,Diabetes,43(8):992-998
Fogelholm M.,Kaprio J.,and Sarna S.,1994,Healthy lifestyles of former Finnish world class athletes,Med.Sci.Sports Exerc.,26(2):224-229
Galetta F.,Franzoni F.,Tocchini L.,Camici M.,Milanesi D.,Belatti F.,Speziale G.,Rossi M.,Gaudio C.,Carpi A.,and Santoro G.,2013,Effect of physical activity on heart rate variability and carotid intima-media thickness in older people,Intern.Emerg.Med.,8(1):27-29
Gao J.K.,Huang X.D.,and Ke J.C.,2009,influence of gestational impaired glucose tolerance on maternal and neonatal outcomes,Xiandai Yiyuan(Modern Hospital),9(5):65-67(高结坤,黄杏端,柯柬初,2009,妊娠期糖耐量受损对母婴预后的影响,现代医院,9(5):65-67)
Giannopoulou I.,Fernhall B.,Carhart R.,Weinstock R.S.,Baynard T.,Figueroa A.,and Kanaley J.A.,2005,Effects of diet and or exercise on the adipocytokine and inflammatory cytokine levels of postmenopausal women with type 2 diabetes,Metabolism.54(7):866-875
Gordon B.A.,Benson A.C.,Bird S.R.,and Fraser S.F.,2009,Resistance training improves metabolic health in type 2 diabetes:a systematic review,Diabetes Res.Clin.Pract.,83(2):157-175
Group D.P.P.,2002,The diabetes prevention program(DPP):description of lifestyle intervention,Diabetes Care,25(12):2165-2171
Kemp A.H.,and Quintana D.S.,2013,The relationship between mental and physical health:Insights from the study of heart rate variability,Int.J.Psychophysiol.,89(3):288-296
Kitabchi A.E.,Umpierrez G.E.;Miles J.M.,and Fisher J.N.,2009,Hyperglycemic crises in adult patients with diabetes,Diabetes Care,32(7):1335-1343
Malin S.K.,Niemi N.,Solomon T.P.,Haus J.M.,Kelly K.R.,Filion J.,Rocco M.,Kashyap S.R.,Barkoukis H.,and Kirwan J.P.,2012,Exercise training with weight loss and either a high-or low-glycemic index diet reduces metabolic syndrome severity in older adults,Ann.Nutr.Metab.,61(2):135-141
Ni L.F.,Dai Y.T.,Su T.C.,and Hu W.Y.,2013,Substance use,gender,socioeconomic status and metabolic syndrome among adults in Taiwan,Public Health Nurs.,30(1):18-28
Ohlsson C.,Mellstrm D.,Carlzon D.,Orwoll E.,Ljunggren O.,Karlsson M.K.,and Vandenput L.,2011,Older men with low serum IGF-1 have an increased risk of incident fractures:the Mr OS Sweden study,Bone Miner Res.,26(4):865-872
Ozaktay A.C.,Kallakuri S.,Takebayashi T.,Cavanaugh J.M.,Asik I.,De Leo J.A.,and Weinstein J.N.,2006,Effects of interleukin-1 beta,interleukin-6,and tumor necrosis factor on sensitivity of dorsal root ganglion and peripheral receptive fields in rats,Eur.Spine.J.,15(10):1529-1537
Pihl E.,Jrime T.,and Kaasik T.,1998,Coronary heart disease risk factors in middle-aged former top-level athletes,Scand.J.Med.Sci.Sports,8(4):229-235
Roumen C.,Corpeleijn E.,Feskens E.J.,Mensink M.,Saris W.H.,and Blaak E.E.,2008,Impact of 3-year lifestyle intervention on postprandial glucose metabolism:the SLIM study,Diabet.Med.,25(5):597-605
Shi Y.,and Hu F.B.,2014,The global implications of diabetes and cancer,Lancet,383(9933):1947-1948
Trevizani G.A.,Benchimol-Barbosa P.R.,and Nadal J.,2012,Effects of age and aerobic fitness on heart rate recovery in adult men,Arq.Bras.Cardiol.,99(3):802-810
Tuomilehto J.,Lindstrem J.,Eriksson J.G.,Valle T.T.,Hamalainen H.,Ilanne-Parikka P.,Keinanen-Kiukaanniemi S.,Laakso M.,Louheranta A.,Rastas M.,Salminen V.,Uusitupa M.,and Finnish Diabetes Prevention Study Group,2001,Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance,N.Engl.J.Med.,344(18):1343-1350
Unt E.,Zilmer K.,Mgi A.,Kullisaar T.,Kairane C.,and Zilmer M.,2008,Homocysteine status in former top-level male athletes:Possible effect of physical activity and physical fitness,Scand.J.Med.Sci.Sports,18(3):360-366
Verheyden B.,Eijnde B.O.,Beckers F.,Vanhees L.,and Aubert A.E.,2002,Low-dose exercise training does not influence cardiac autonomic control in healthy sedentary men aged55-75 years,J.Sports Sci.,24(11):1137-1147
Wang X.,Hsu F.C.,Isom S.,Walkup M.P.,Kritchevsky S.B.,Goodpaster B.H.,Church T.S.,Pahor M.,Stafford R.S.,and Nicklas B.J.,2012,Effects of a 12-month physical activity intervention on prevalence of metabolic syndrome in elderly men and women,J.Gerontol.A.Biol.Sci.Med.Sci.,67(4):417-424
Wang Y.H.,2011,The effect of gestational impaired glucose tolerance on pregnancy outcome of maternal and child,Linchuang Heli Yongyao Zazhi(Chinese Journal of Clinical Rational Drug Use),4(19):37-38(王咏红,2011,妊娠期糖耐量受损对妊娠结局母婴的影响,临床合理用药杂志,4(19):37-38)
Ying Y.Y.,and Xu G.Z.,2016,The progress of study on pre-diabetes,Shiyong Yufang Yixue(Practical Preventive Medicine),23(2):250-253(应焱燕,许国章,2016,糖尿病前期的研究进展,实用预防医学,23(2):250-253)