摘要
目的:探讨2年的抗阻运动和有氧运动对糖尿病前期患者心血管疾病风险的影响。方法:选取2014年1—4月在南京中医药大学附属中西医结合医院以及2014年5—12月在丹阳市人民医院和广西医科大学第一附属医院就诊的糖尿病前期患者共248例,随机数字表法将248例患者随机分为3组:抗阻运动组(RT组)82例,有氧运动组(AT组)83例和对照组83例。AT组、RT组干预24个月后,比较各组患者在基线以及第12个月和第24个月时的血糖、血脂等指标。结果:随着干预时间的延长,RT组和AT组患者糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、血压和稳态模型2胰岛素抵抗指数(HOMA2-IR)趋于降低,稳态模型2β细胞功能指数(HOMA2-β)趋于增高。24个月时,RT组和AT组患者HbA1c[5.80(5.43,6.20)%、5.70(5.50,6.00)%比6.20(5.70,6.60)%,P值均≤0.01],LDL-C[3.07(2.69,3.58)mmol/L、2.97(2.62,3.95)mmol/L比3.21(2.54,3.78)mmol/L,P值均<0.05]和HOMA2-IR[0.96(0.82,1.47)、1.20(0.99,1.43)比1.34.(1.09,1.51),P值均<0.05]均明显低于对照组,而HOMA2-β[84.50(60.55,107.33)、93.00(78.60,119.75)比53.40(37.70,80.40),P值均=0.001]则高于对照组,而甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)运动干预组与对照组之间差异无统计学意义(P值均>0.05)。校正年龄、性别、血压后,干预后RT组(P=0.017)和AT组(P=0.018)的糖尿病前期心血管风险显著降低。校正年龄、性别、他汀类药物治疗、体重指数、腰臀围比后,Cox回归显示抗阻运动(HR=0.419,95%CI=0.415~0.942,P=0.037)和有氧运动(HR=0.310,95%CI=0.447~0.866,P=0.026)为糖尿病前期心血管疾病保护因子,分别降低了糖尿病前期患者58.1%和69.0%的心血管疾病风险。结论:24个月有氧和抗阻运动可改善血糖控制和糖尿病前期患者HOMA2-IR。抗阻运动能够降低心血管疾病风险,对于没有明显运动禁忌证的糖尿病前期患者,抗阻运动是值得推荐的运动方式。
Objective To investigate the effect of a 2-year resistance and aerobic training on reducing the risk of cardiovascular disease in patients with prediabetes.Methods A total of 248 patients with prediabetes were enrolled from Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January to April 2014,and Danyang People′s Hospital and The First Affiliated Hospital of Guangxi Medical University from May to December 2014.Based on random number table method,the patients were divided into 3 groups:the resistance training group(RT group,82 cases),the aerobic training group(AT group,83 cases)and control group(83 cases).Participants in the RT group and the AT group underwent a total of 24 months of exercise training.Changes in indicators(blood glucose,blood lipid,etc.)at baseline and the end of 12 and 24 months among the groups were compared.Results After intervention,glycosylated hemoglobin(HbA1c),low density lipoprotein cholesterol(LDL-C),blood pressure and homeostasis model 2 insulin resistance index(HOMA2-IR)in the RT and AT groups tended to decrease,and the steady state model 2βcell function index(HOMA2-β)tended to increase.At the end of 24 months,HbA1c[5.80(5.43,6.20)%,5.70(5.50,6.00)%vs.6.20(5.70,6.60)%,all P≤0.01],LDL-C[3.07(2.69,3.58)mmol/L,2.97(2.62,3.95)mmol/L vs.3.21(2.54,3.78)mmol/L,all P<0.05]and HOMA2-IR[0.96(0.82,1.47),1.20(0.99,1.43)vs.1.34(1.09,1.51),all P<0.05]were significantly decreased in the RT and AT groups than in the control group.In addition,HOMA2-β[84.50(60.55,107.33),93.00(78.60,119.75)vs.53.40(37.70,80.40),all P=0.001]was significantly increased in the AT and RT groups compared with that in the control group.There were no significant differences in triglyceride(TG)and high-density lipoproteincholesterol(HDL-C)levels between the training groups and the control group(all P>0.05).After adjusting for age,sex and blood pressure,the cardiovascular risk of prediabetes was significantly reduced in RT(P=0.017)and AT groups(P=0.018).The Cox regression ana
作者
王潆
袁晓丹
戴霞
李凡
季红
楼青青
Wang Ying;Yuan Xiaodan;Dai Xia;Li Fan;Ji Hong;Lou Qingqing(The College of Nursing,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Health Education,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;Department of Endocrinology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Endocrinology,The People′s Hospital of Danyang,Danyang,Jiangsu 212300,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2021年第1期22-28,共7页
Chinese Journal of Internal Medicine
基金
国家自然科学基金(81370923)
国家中医药管理局国家中医临床研究基地业务建设科研专项(JDZX2015132)
南京中医药大学“江苏高校护理学优势学科建设工程资助项目”(2019YSHL124)。
关键词
糖尿病前期
抗阻运动
有氧运动
心血管疾病风险
Prediabetic state
Resistance training
Aerobic training
Cardiovascular risk
