中年2型糖尿病患者有氧运动结合原地深蹲抗阻训练方案及其干预效果研究
|
摘要
目的探讨有氧运动结合原地深蹲抗阻训练的有效方案及其对中年2型糖尿病患者的干预效果。方法 2016年3—9月选取于湖北大学校医院就诊的45~59岁中年2型糖尿病患者56例为研究对象。在均衡性别、年龄、病程、BMI、用药等因素的前提下将其分为对照组(20例,维持原有锻炼习惯)、有氧运动组(18例,采用有氧运动方案)和有氧运动结合原地深蹲组(18例,采用有氧运动结合原地深蹲抗阻训练方案,其中有氧运动方案同有氧运动组,原地深蹲抗阻训练方案通过原地深蹲正交试验确定)。收集患者一般资料,记录不同运动负荷原地深蹲患者深蹲次数、心率、间歇时间、运动时间,不同原地深蹲组合时间-血糖曲线下面积(GAUC),3组患者干预前后血糖、糖化血红蛋白(Hb A1c)、胰岛素、C肽、血脂。结果中等负荷、较大负荷原地深蹲患者深蹲次数、心率大于低负荷,间歇时间、运动时间长于低负荷(P<0.05);较大负荷原地深蹲患者深蹲次数、心率大于中等负荷,间歇时间、运动时间长于中等负荷(P<0.05)。L-5-60"(餐后60 min低负荷5组)、M-5-45"(餐后45 min中等负荷5组)原地深蹲组合GAUC小于对照(餐后保持静坐)及L-3-30"(餐后30 min低负荷3组)、M-3-45"(餐后45 min中等负荷3组)、H-3-60"(餐后60 min较大负荷3组)、L-4-45"(餐后45 min低负荷4组)、M-4-60"(餐后60 min中等负荷4组)、H-4-30"(餐后30 min较大负荷4组)、H-5-30"(餐后30 min较大负荷5组)原地深蹲组合(P<0.05)。综上,确定有氧运动结合原地深蹲组的原地深蹲抗阻训练方案:运动方式为原地深蹲;运动强度为30%或50%最大原地深蹲次数,5组;运动时间为20~30 min,间歇时间为2~3 min;运动频率为2次/周(周二、四);运动起始时间为血糖峰值前30~45 min。干预后,有氧运动组、有氧运动结合原地深蹲组患者血糖低于对照组(P<0.05)。有氧运动组干预后血糖低于干预前(P<0.05);有氧运动结合原地深蹲组患者干预后血糖、C肽低于干预前(P<0.05)。干预后,有氧运动组、有氧运动结合原地深蹲组患者三酰甘油(TG)、胆固醇(CHO)低于对照组(P<0.05);干预后,有氧运动结合原地深蹲组患者高密度脂蛋白胆固醇(HDL-C)高于对照组、有氧运动组(P<0.05)。有氧运动组患者干预后TG、CHO低于干预前(P<0.05);有氧运动结合原地深蹲组患者干预后TG、CHO低于干预前,HDL-C高于干预前(P<0.05)。结论有氧运动结合M-5-45"、L-5-60"原地深蹲可作为中年2型糖尿病患者的有氧运动结合原地深蹲抗阻训练的有效方案,其具有改善患者血糖、血脂及增强胰岛细胞功能的作用,且增加HDL-C的作用优于单纯有氧运动。
Objective To investigate the effective programs and intervention effect of aerobic exercise combined with situ squats in middle-aged patients with type 2 diabetes.Methods A total of 56 middle-aged patients aged 45-59 years with type 2 diabetes were enrolled from the Hospital of Hubei University between March and September 2016.They were divided into the control group(20 cases,maintaining the original exercise habit),the aerobic exercise group(18 cases,aerobic exercise program)and the aerobic exercise combined with situ squats group(18 cases,aerobic exercise combined with situ squats resistance training program,and aerobic exercise plan was the same as the aerobic exercise group,situ squats resistance training scheme was determined by orthogonal tests)on the premise of gender,age,course of disease,BMI,medication andso on.Patients' general information was collected,and situ squat number of different loads,heart rate,intermittent time,sports time,time-glucose area under the curve(GAUC)of different squat combinations were examined.Fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1 c),insulin,C peptide and blood lipid were also determined before and after the intervention.Results The number of squats,heart rate of patients in medium load and higher load groups were significantly higher,and their interval time and exercise time were also significantly longer than those in low load group(P<0.05).The number of squats,heart rate in higher load group were significantly higher,and its interval time and exercise time were significantly longer than those in medium load group(P<0.05).GAUC of M-5-45"(45 min after meal with medium load 5 groups)and L-5-60"(60 min after meal with low load 5 groups)was less than that in the control group(sitting after meal),L-3-30"(30 min after meal with low load 3 groups),M-3-45"(45 min after meal with medium load 3 groups),H-3-60"(60 min after meal with higher load 3 groups),L-4-45"(45 min after meal with low load 4 groups),M-4-60"(60 min after meal with medium load 4 groups),H-4-30"(30 min after meal with higher load 4 groups)and H-5-30"(30 min after meal with higher load 5 groups)(P < 0.05).To sum up,the training program of aerobic exercise with situ squats was determined as the following:the exercise intensity was 30% or 50% of the maximum number of situ squats,5 groups;the exercise time was 20-30 min,and the interval time was 2-3 min;the exercise frequency was twice a week(Tuesday,Thursday);the starting time of exercise was 30 to 45 minutes before the peak of blood glucose.After the intervention,FPG of the aerobic exercise group and aerobic exercise combined with situ squats group was lower than that of the control group(P<0.05).FPG in the aerobic exercise group was significantly lower after intervention than before intervention(P<0.05).FPG and c-peptide in the aerobic exercise combined with situ squats group after intervention were significantly lower than those before intervention(P<0.05).After intervention,triglyceride(TG)and cholesterol(CHO)in the aerobic exercise group and aerobic exercise combined with situ squats group were much lower than those in the control group(P<0.05).After intervention,high-density lipoprotein cholesterol(HDL-C)in the aerobic exercise combined with situ squats group was higher than that in the control group and the aerobic exercise group(P<0.05).TG and CHO in the aerobic exercise group after intervention were much lower than those before intervention(P<0.05).After intervention,TG and CHO in the aerobic exercise combined with situ squats group were lower than those before intervention,and HDL-C was higher than that before intervention(P<0.05).Conclusion Aerobic exercise combined with M-5-45",L-5-60" situ squats in middle-aged patients with type 2 diabetes can be used as effective therapy when combined with resistance training in terms of improving the patient's FPG,blood lipid and enhancing the effect of islet cell function.Moreover its function in increasing HDL-C effect was much better than simple aerobic exercise.
Objective To investigate the effective programs and intervention effect of aerobic exercise combined with situ squats in middle-aged patients with type 2 diabetes.Methods A total of 56 middle-aged patients aged 45-59 years with type 2 diabetes were enrolled from the Hospital of Hubei University between March and September 2016.They were divided into the control group(20 cases,maintaining the original exercise habit),the aerobic exercise group(18 cases,aerobic exercise program)and the aerobic exercise combined with situ squats group(18 cases,aerobic exercise combined with situ squats resistance training program,and aerobic exercise plan was the same as the aerobic exercise group,situ squats resistance training scheme was determined by orthogonal tests)on the premise of gender,age,course of disease,BMI,medication andso on.Patients' general information was collected,and situ squat number of different loads,heart rate,intermittent time,sports time,time-glucose area under the curve(GAUC)of different squat combinations were examined.Fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1 c),insulin,C peptide and blood lipid were also determined before and after the intervention.Results The number of squats,heart rate of patients in medium load and higher load groups were significantly higher,and their interval time and exercise time were also significantly longer than those in low load group(P<0.05).The number of squats,heart rate in higher load group were significantly higher,and its interval time and exercise time were significantly longer than those in medium load group(P<0.05).GAUC of M-5-45"(45 min after meal with medium load 5 groups)and L-5-60"(60 min after meal with low load 5 groups)was less than that in the control group(sitting after meal),L-3-30"(30 min after meal with low load 3 groups),M-3-45"(45 min after meal with medium load 3 groups),H-3-60"(60 min after meal with higher load 3 groups),L-4-45"(45 min after meal with low load 4 groups),M-4-60"(60 min after meal with medium load 4 groups),H-4-30"(30 min after meal with higher load 4 groups)and H-5-30"(30 min after meal with higher load 5 groups)(P < 0.05).To sum up,the training program of aerobic exercise with situ squats was determined as the following:the exercise intensity was 30% or 50% of the maximum number of situ squats,5 groups;the exercise time was 20-30 min,and the interval time was 2-3 min;the exercise frequency was twice a week(Tuesday,Thursday);the starting time of exercise was 30 to 45 minutes before the peak of blood glucose.After the intervention,FPG of the aerobic exercise group and aerobic exercise combined with situ squats group was lower than that of the control group(P<0.05).FPG in the aerobic exercise group was significantly lower after intervention than before intervention(P<0.05).FPG and c-peptide in the aerobic exercise combined with situ squats group after intervention were significantly lower than those before intervention(P<0.05).After intervention,triglyceride(TG)and cholesterol(CHO)in the aerobic exercise group and aerobic exercise combined with situ squats group were much lower than those in the control group(P<0.05).After intervention,high-density lipoprotein cholesterol(HDL-C)in the aerobic exercise combined with situ squats group was higher than that in the control group and the aerobic exercise group(P<0.05).TG and CHO in the aerobic exercise group after intervention were much lower than those before intervention(P<0.05).After intervention,TG and CHO in the aerobic exercise combined with situ squats group were lower than those before intervention,and HDL-C was higher than that before intervention(P<0.05).Conclusion Aerobic exercise combined with M-5-45",L-5-60" situ squats in middle-aged patients with type 2 diabetes can be used as effective therapy when combined with resistance training in terms of improving the patient's FPG,blood lipid and enhancing the effect of islet cell function.Moreover its function in increasing HDL-C effect was much better than simple aerobic exercise.
引文
[1]LUC,SUN W.Prevalence of diabetics in Chinese adults[J].JAMA,2014,311(2):199-200.DOI:10.1001/jama.2013.283124.
[2]陆丽荣,戴霞,陈青云,等.联合抗阻-有氧运动对糖尿病前期人群代谢指标的影响[J].广西医科大学学报,2016,33(10):1230-1233.DOI:10.16190/j.cnki.45-1211/r.2016.01.016.LU L R,DAI X,CHEN Q Y,et al.Effect of combined resistance-aerobic exercise on the metabolic index of pre-diabetes population[J].Journal of Guangxi Medical University,2016,33(10):1230-1233.DOI:10.16190/j.cnki.45-1211/r.2016.01.016.
[3]刘晨涛,杨琦.抗阻运动在改善胰岛素抵抗中的机制[J].运动,2016(3):162.DOI:10.3969/j.issn.1674-151x.2016.03.074.LIU C T,YANG Q.Mechanism of resistance exercise in improving insulin resistance[J].Sports,2016(3):162.DOI:10.3969/j.issn.1674-151x.2016.03.074.
[4]王光平,张开发.抗阻训练对老年人肌肉力量影响的元分析[J].体育学刊,2011,18(5):132-138.DOI:10.3969/j.issn.1006-7116.2011.05.030.WANG G P,ZHANG K F.Meta analysis of the effects of resistance training on the muscle strength of the elderly[J].Journal of Physical Education,2011,18(5):132-138.DOI:10.3969/j.issn.1006-7116.2011.05.030.
[5]罗曦娟,王正珍,朱玲,等.有氧和抗阻运动对糖尿病前期人群血糖干预效果的比较研究[J].中国运动医学杂志,2015,34(9):831-837.LUO X J,WANG Z Z,ZHU L,et al.Comparison of the effects of aerobic and resistant exercise on the blood glucose in prediabetic subjects[J].Chinese Journal of Sports Medicine,2015,34(9):831-837.
[6]范玉仙,李彩凤,魏贞.现代糖尿病诊疗进展[M].上海:第二军医大学出版社,2010:16-17.
[7]中国2型糖尿病防治指南(2013年版)[EB/OL].(2014-08-20)[2017-12-05].http://www.360doc.com/conte nt/14/0820/21/565268_403433665.shtml.
[8]王正珍.ACSM运动测试与运动处方指南[M].北京:人民卫生出版社,2010:205-210.
[9]常凤.2型糖尿病运动干预方案与策略研究[D].武汉:武汉体育学院,2015.CHANG F.Study on exercise intervention program and strategy of type2 diabetes mellitus[D].Wuhan:Wuhan Sports University,2015.
[10]元香南,陈璎珞,齐智,等.餐后不同运动因素对健康成人血糖和胰岛素的影响[J].中国运动医学杂志,2009,28(1):14-16.YUAN X N,CHEN Y L,QI Z,et al.The effects of intensity,duration and timing of postprandial exercise on the blood glucose and insulin in healthy adults[J].Chinese Journal of Sports Medicine,2009,28(1):14-16.
[11]SHAW J E,SICREE R A,ZIMMET P Z.Global estimates of the prevalence of diabetics for 2010 and 2030[J].Diabetics Res Clin Pract,2010,87(1):4-14.DOI:10.1016/j.diabetes.2009.10.007.
[12]李秀钧,董砚虎,程丽霞,等.糖尿病研究进展——第16届国际糖尿病联盟大会纪要[J].中华内分泌代谢杂志,1998,14(2):72-77.DOI:10.3760/j.issn:1000-6699.1998.02.003.
[13]UK Prospective Diabetics Study(UKPDS)GROUP.Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type2 Diabetics(UKPDS 33)[J].Lancet,1998,352:837-853.DOI:10.1016/S0140-6736(98)07019-6.
[14]LOIAALA A,GROUNDSTROEM K,RINNE M,et al.Effect of long-term endurance and streng training on metabolic control and arterial elasticity in patients with type 2 diabetics mellitus[J].J Am Coll Cardiol,2009,103(7):972-977.DOI:10.1016/j.amjcanl.2008.12.026.
[15]TOMAS-CARUS P,ORTEGA-ALONSO A,PIETIL?INEN K H,et al.A randomized controlled trial on the effects of combined aerobic-resistance exercise on muscle strength and fatigue,glycemic control and health-related quality of life of type 2 diabetics patients[J].J Sports Med Phys Fitness,2015.[Epub ahead of print].
[16]SIGAL R J,KENNY G P,BOULéN G,et al.Effects of aerobic training,resistance training,or both on glycemic control in type 2diabetics:a randomized trial[J].Ann Intern Med,2007,147(6):357-369.
[17]王玉霞,袁凤山,都镇先,等.2型糖尿病患者运动及感觉神经传导速度变化与C肽的关系[J].中国临床康复,2004,8(21):4228-4229.DOI:10.3321/j.issn:1673-8225.2004.21.052.
[18]SIMMA A A.C-peptide and diabetic neuropathy[J].Expert Opin Investig Drugs,2003,12(9):1471-1488.DOI:10.1517/13543784.12.9.1471.
[19]CHO K,SONG Y,KWON D.Conjugated linoleic acid supplementation enhances insulin sensitivity and peroxisome proliferator-activated receptor gamma and glucose transporter type4 protein expression in the skeletal muscles of rats during endurance exercise[J].Iran J Basic Med Sci,2016,19(1):20-27.
[20]COEN P M,TANNER C J,HELBLING N L,et al.Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity[J].J Clin Invest,2015,125(1):248-257.DOI:10.1172/JCI78016.
[21]NOJIMA H,WATANABC H,YAMANC K,et al.Effect of aerobic exercise training on oxidative stress in patients with type 2diabetics mellitus[J].Metabolism,2008,57:170-176.DOI:10.1016/j.metabol.2007.08.021.
[22]杨中方,白姣姣,李全磊,等.抗阻力运动对2型糖尿病患者血糖控制效果的Meta分析[J].护理学杂志,2014,29(3):81-84.DOI:10.3870/hlxzz.2014.03.081.YANG Z F,BAI J J,LI Q L,et al.Progressive resistance exercise improves glycemic control in people with type 2 diabetes mellitus:a meta-analysis[J].Journal of Nursing Science,2014,29(3):81-84.DOI:10.3870/hlxzz.2014.03.081.
[23]刘政潭.不同运动方式对2型糖尿病患者血糖相关指标的影响[J].山东体育学院学报,2010,26(7):46-51.DOI:10.3969/j.issn.1006-2076.2010.07.011.LIU Z T.Effect of different modes of exercise training on glycemic indices in patients with type 2 diabetes[J].Journal of Shandong Institute of Physical Education and Sports,2010,26(7):46-51.DOI:10.3969/j.issn.1006-2076.2010.07.011.
[24]刘学荣,胡耀敏,刘伟.脂蛋白脂肪酶与胰岛素抵抗[J].国际内分泌代谢杂志,2008,28(s1):8-10.DOI:10.3760/cma.j.issn.1673-4157.2008.z1.003.LIU X R,HU Y M,LIU W.Lipoprotein lipase and insulin resistance[J].International Journal of Endocrinology and Metabolism,2008,28(s1):8-10.DOI:10.3760/cma.j.issn.1673-4157.2008.z1.003.
[25]张培珍,田野.耐力性运动防治血脂异常的机制[J].西安体育学院学报,2007,24(2):66-69.DOI:10.3969/j.issn.1001-747X.2007.02.016.ZHANG P Z,TIAN Y.Mechanism of dyslipidemia's treatment and prevention by endurance exercise[J].Journal of Xian Physical Education University,2007,24(2):66-69.DOI:10.3969/j.issn.1001-747X.2007.02.016.
[26]梁丽娟,赵金利,曾静.饮食及运动干预对高脂血症患者血脂水平的影响[J].现代临床护理,2014,13(5):54-56.DOI:10.3969/j.issn.1671-8283.2014.05.17.LIANG L J,ZHAO J L,ZENG J.Effects of dieting and exercise intervention on lipid level in patients with hyperlipidemia[J].Modern Clinical Nursing,2014,13(5):54-56.DOI:10.3969/j.issn.1671-8283.2014.05.17.
[27]孙莉敏,胡永善,吴毅.运动锻炼对Ⅱ型糖尿病患者血脂与体质指标的影响[J].中国运动医学杂志,2002,21(1):51-53.DOI:10.3969/j.issn.1000-6710.2002.01.014.
[28]AUGUSTO LIBARDI C,BONGANHA V,SOARES CONCEI??O M,et al.The pefiodized resistance training promotes similar changes in lipid profile in middle-aged men and women[J].J Sports Med Phys Fitness,2012,52(3):286-292.
[29]VARADY K A,JONES P J.Combination diet and exercise interventions for the treatment of dyslipidemia:an effective preliminary strategy to lower cholesterol levels?[J].J Nutr,2005,135(8):1829-1835.DOI:10.1093/jn/135.8.1829.
[30]TOKMAKIDIS S P,VOIAKLIS K A.Training and detraining effects of a combined-strength and aerobic exercise program on blood lipids in patients with coronary artery disease[J].J Cardiopulm Rehabil,2003,23(3):193-200.
[31]FAHLMAN M M,BOARDLEY D,LAMBERT C P,et al.Effects of endurance training and resistance training on plasma lipoprotein profiles in elderly women[J].J Gerontol A Biol Sci Med Sci,2002,57(2):B54-60.
[32]程会兰,施加加,翁雅婧,等.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[J].实用临床医药杂志,2013,17(23):19-22.DOI:10.7619/jcmp.201323006.
[33]王军,陈彩珍,卢健.耐力和抗阻运动对血脂代谢的影响[J].福建体育科技,2008,27(6):40-43.DOI:10.3969/j.issn.1004-8790.2008.06.014.WANG J,CHEN C Z,LU J.The effect of endurance exercise and resistance exercise on the metabolism of blood lipoprotein[J].Fujian Sports Science and Technology,2008,27(6):40-43.DOI:10.3969/j.issn.1004-8790.2008.06.014.
[2]陆丽荣,戴霞,陈青云,等.联合抗阻-有氧运动对糖尿病前期人群代谢指标的影响[J].广西医科大学学报,2016,33(10):1230-1233.DOI:10.16190/j.cnki.45-1211/r.2016.01.016.LU L R,DAI X,CHEN Q Y,et al.Effect of combined resistance-aerobic exercise on the metabolic index of pre-diabetes population[J].Journal of Guangxi Medical University,2016,33(10):1230-1233.DOI:10.16190/j.cnki.45-1211/r.2016.01.016.
[3]刘晨涛,杨琦.抗阻运动在改善胰岛素抵抗中的机制[J].运动,2016(3):162.DOI:10.3969/j.issn.1674-151x.2016.03.074.LIU C T,YANG Q.Mechanism of resistance exercise in improving insulin resistance[J].Sports,2016(3):162.DOI:10.3969/j.issn.1674-151x.2016.03.074.
[4]王光平,张开发.抗阻训练对老年人肌肉力量影响的元分析[J].体育学刊,2011,18(5):132-138.DOI:10.3969/j.issn.1006-7116.2011.05.030.WANG G P,ZHANG K F.Meta analysis of the effects of resistance training on the muscle strength of the elderly[J].Journal of Physical Education,2011,18(5):132-138.DOI:10.3969/j.issn.1006-7116.2011.05.030.
[5]罗曦娟,王正珍,朱玲,等.有氧和抗阻运动对糖尿病前期人群血糖干预效果的比较研究[J].中国运动医学杂志,2015,34(9):831-837.LUO X J,WANG Z Z,ZHU L,et al.Comparison of the effects of aerobic and resistant exercise on the blood glucose in prediabetic subjects[J].Chinese Journal of Sports Medicine,2015,34(9):831-837.
[6]范玉仙,李彩凤,魏贞.现代糖尿病诊疗进展[M].上海:第二军医大学出版社,2010:16-17.
[7]中国2型糖尿病防治指南(2013年版)[EB/OL].(2014-08-20)[2017-12-05].http://www.360doc.com/conte nt/14/0820/21/565268_403433665.shtml.
[8]王正珍.ACSM运动测试与运动处方指南[M].北京:人民卫生出版社,2010:205-210.
[9]常凤.2型糖尿病运动干预方案与策略研究[D].武汉:武汉体育学院,2015.CHANG F.Study on exercise intervention program and strategy of type2 diabetes mellitus[D].Wuhan:Wuhan Sports University,2015.
[10]元香南,陈璎珞,齐智,等.餐后不同运动因素对健康成人血糖和胰岛素的影响[J].中国运动医学杂志,2009,28(1):14-16.YUAN X N,CHEN Y L,QI Z,et al.The effects of intensity,duration and timing of postprandial exercise on the blood glucose and insulin in healthy adults[J].Chinese Journal of Sports Medicine,2009,28(1):14-16.
[11]SHAW J E,SICREE R A,ZIMMET P Z.Global estimates of the prevalence of diabetics for 2010 and 2030[J].Diabetics Res Clin Pract,2010,87(1):4-14.DOI:10.1016/j.diabetes.2009.10.007.
[12]李秀钧,董砚虎,程丽霞,等.糖尿病研究进展——第16届国际糖尿病联盟大会纪要[J].中华内分泌代谢杂志,1998,14(2):72-77.DOI:10.3760/j.issn:1000-6699.1998.02.003.
[13]UK Prospective Diabetics Study(UKPDS)GROUP.Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type2 Diabetics(UKPDS 33)[J].Lancet,1998,352:837-853.DOI:10.1016/S0140-6736(98)07019-6.
[14]LOIAALA A,GROUNDSTROEM K,RINNE M,et al.Effect of long-term endurance and streng training on metabolic control and arterial elasticity in patients with type 2 diabetics mellitus[J].J Am Coll Cardiol,2009,103(7):972-977.DOI:10.1016/j.amjcanl.2008.12.026.
[15]TOMAS-CARUS P,ORTEGA-ALONSO A,PIETIL?INEN K H,et al.A randomized controlled trial on the effects of combined aerobic-resistance exercise on muscle strength and fatigue,glycemic control and health-related quality of life of type 2 diabetics patients[J].J Sports Med Phys Fitness,2015.[Epub ahead of print].
[16]SIGAL R J,KENNY G P,BOULéN G,et al.Effects of aerobic training,resistance training,or both on glycemic control in type 2diabetics:a randomized trial[J].Ann Intern Med,2007,147(6):357-369.
[17]王玉霞,袁凤山,都镇先,等.2型糖尿病患者运动及感觉神经传导速度变化与C肽的关系[J].中国临床康复,2004,8(21):4228-4229.DOI:10.3321/j.issn:1673-8225.2004.21.052.
[18]SIMMA A A.C-peptide and diabetic neuropathy[J].Expert Opin Investig Drugs,2003,12(9):1471-1488.DOI:10.1517/13543784.12.9.1471.
[19]CHO K,SONG Y,KWON D.Conjugated linoleic acid supplementation enhances insulin sensitivity and peroxisome proliferator-activated receptor gamma and glucose transporter type4 protein expression in the skeletal muscles of rats during endurance exercise[J].Iran J Basic Med Sci,2016,19(1):20-27.
[20]COEN P M,TANNER C J,HELBLING N L,et al.Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity[J].J Clin Invest,2015,125(1):248-257.DOI:10.1172/JCI78016.
[21]NOJIMA H,WATANABC H,YAMANC K,et al.Effect of aerobic exercise training on oxidative stress in patients with type 2diabetics mellitus[J].Metabolism,2008,57:170-176.DOI:10.1016/j.metabol.2007.08.021.
[22]杨中方,白姣姣,李全磊,等.抗阻力运动对2型糖尿病患者血糖控制效果的Meta分析[J].护理学杂志,2014,29(3):81-84.DOI:10.3870/hlxzz.2014.03.081.YANG Z F,BAI J J,LI Q L,et al.Progressive resistance exercise improves glycemic control in people with type 2 diabetes mellitus:a meta-analysis[J].Journal of Nursing Science,2014,29(3):81-84.DOI:10.3870/hlxzz.2014.03.081.
[23]刘政潭.不同运动方式对2型糖尿病患者血糖相关指标的影响[J].山东体育学院学报,2010,26(7):46-51.DOI:10.3969/j.issn.1006-2076.2010.07.011.LIU Z T.Effect of different modes of exercise training on glycemic indices in patients with type 2 diabetes[J].Journal of Shandong Institute of Physical Education and Sports,2010,26(7):46-51.DOI:10.3969/j.issn.1006-2076.2010.07.011.
[24]刘学荣,胡耀敏,刘伟.脂蛋白脂肪酶与胰岛素抵抗[J].国际内分泌代谢杂志,2008,28(s1):8-10.DOI:10.3760/cma.j.issn.1673-4157.2008.z1.003.LIU X R,HU Y M,LIU W.Lipoprotein lipase and insulin resistance[J].International Journal of Endocrinology and Metabolism,2008,28(s1):8-10.DOI:10.3760/cma.j.issn.1673-4157.2008.z1.003.
[25]张培珍,田野.耐力性运动防治血脂异常的机制[J].西安体育学院学报,2007,24(2):66-69.DOI:10.3969/j.issn.1001-747X.2007.02.016.ZHANG P Z,TIAN Y.Mechanism of dyslipidemia's treatment and prevention by endurance exercise[J].Journal of Xian Physical Education University,2007,24(2):66-69.DOI:10.3969/j.issn.1001-747X.2007.02.016.
[26]梁丽娟,赵金利,曾静.饮食及运动干预对高脂血症患者血脂水平的影响[J].现代临床护理,2014,13(5):54-56.DOI:10.3969/j.issn.1671-8283.2014.05.17.LIANG L J,ZHAO J L,ZENG J.Effects of dieting and exercise intervention on lipid level in patients with hyperlipidemia[J].Modern Clinical Nursing,2014,13(5):54-56.DOI:10.3969/j.issn.1671-8283.2014.05.17.
[27]孙莉敏,胡永善,吴毅.运动锻炼对Ⅱ型糖尿病患者血脂与体质指标的影响[J].中国运动医学杂志,2002,21(1):51-53.DOI:10.3969/j.issn.1000-6710.2002.01.014.
[28]AUGUSTO LIBARDI C,BONGANHA V,SOARES CONCEI??O M,et al.The pefiodized resistance training promotes similar changes in lipid profile in middle-aged men and women[J].J Sports Med Phys Fitness,2012,52(3):286-292.
[29]VARADY K A,JONES P J.Combination diet and exercise interventions for the treatment of dyslipidemia:an effective preliminary strategy to lower cholesterol levels?[J].J Nutr,2005,135(8):1829-1835.DOI:10.1093/jn/135.8.1829.
[30]TOKMAKIDIS S P,VOIAKLIS K A.Training and detraining effects of a combined-strength and aerobic exercise program on blood lipids in patients with coronary artery disease[J].J Cardiopulm Rehabil,2003,23(3):193-200.
[31]FAHLMAN M M,BOARDLEY D,LAMBERT C P,et al.Effects of endurance training and resistance training on plasma lipoprotein profiles in elderly women[J].J Gerontol A Biol Sci Med Sci,2002,57(2):B54-60.
[32]程会兰,施加加,翁雅婧,等.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[J].实用临床医药杂志,2013,17(23):19-22.DOI:10.7619/jcmp.201323006.
[33]王军,陈彩珍,卢健.耐力和抗阻运动对血脂代谢的影响[J].福建体育科技,2008,27(6):40-43.DOI:10.3969/j.issn.1004-8790.2008.06.014.WANG J,CHEN C Z,LU J.The effect of endurance exercise and resistance exercise on the metabolism of blood lipoprotein[J].Fujian Sports Science and Technology,2008,27(6):40-43.DOI:10.3969/j.issn.1004-8790.2008.06.014.