有氧运动和抗阻运动对糖调节受损患者空腹血糖及胰岛素抵抗的影响研究  

Effects of Aerobic versus Resistance Exercise on Fasting Plasma Glucose and Insulin Resistance in Patients with Impaired Glucose Regulation

作　　者：麻晓君 戴霞[1] 陆丽荣 罗祖纯 韦春[3] MA Xiao -jun DAI Xia LU Li - rong LUO Za -chun WEI Chun(Department of Internal Medicine, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China Department of Nursing, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530021, China Department of Science Education, Guangxi Medical University Nursing College, Nanning 530021, China)

机构地区：[1]广西医科大学第一附属医院内科,广西南宁市530021 [2]广西中医药大学第一附属医院护理部,广西南宁市530021 [3]广西医科大学护理学院科教科,广西南宁市530021

出　　处：《中国全科医学》2017年第29期3584-3589,共6页Chinese General Practice

基　　金：广西医疗卫生适宜技术研究与开发课题项目(S201413-03);广西研究生教育创新计划项目(YCSZ2015111)

摘　　要：目的探讨有氧运动和抗阻运动对糖调节受损(IGR)患者空腹血糖(FPG)和胰岛素抵抗的干预效果,为有效预防和延缓糖尿病前期进展为糖尿病提供依据。方法于2015年6—8月在桂林市叠彩、南门及秀峰社区卫生服务中心长期管理的居民中筛选IGR患者143例,采用随机数字表法分为对照组(47例)、有氧组(48例)、抗阻组(48例)。对照组每3个月随访1次,但不对其进行行为干预。有氧组进行中等强度的有氧运动,主要为韵律操、有氧健身操等。抗阻组进行中等强度的抗阻运动,采用弹力绳以60%~70%的单次最大负荷完成指定动作,主要选取腰背部及腹部肌群、腿部及臀部肌群、上肢肌群进行训练。有氧组和抗阻组总运动时间均为50 min/次,隔日1次。分别于干预前及干预3、6、12个月时检测FPG、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR)、胰岛素作用指数(IAI)。结果干预结束后,对照组38例、有氧组39例、抗阻组38例完成本研究。时间与运动方式对FPG、FINS、HOMA-IR、IAI的交互作用显著,时间、运动方式对FPG、FINS、HOMA-IR、IAI的主效应显著(P<0.05)。干预3个月时,有氧组、抗阻组FPG低于对照组;干预6个月时,有氧组、抗阻组FPG、FINS、HOMA-IR低于对照组,IAI高于对照组,抗阻组FPG低于有氧组;干预12个月时,有氧组、抗阻组FPG、FINS、HOMA-IR低于对照组,IAI高于对照组(P<0.05)。干预3个月时,有氧组、抗阻组FPG、HOMA-IR低于干预前,IAI高于干预前;干预6个月时,有氧组、抗阻组FPG、FINS、HOMA-IR低于干预前,IAI高于干预前;干预12个月时,有氧组、抗阻组FPG低于干预前,对照组、有氧组、抗阻组FINS、HOMA-IR低于干预前,IAI高于干预前(P<0.05)。结论有氧运动和抗阻运动对IGR患者的FPG、FINS、胰岛素抵抗、胰岛素敏感性均有明显的改善作用,效果相似。Objective To study the effects of aerobic versus resistance exercise on fasting plasma glucose（ FPG） and insulin resistance in patients with impaired glucose regulation（ IGR） in order to provide an evidence for preventing and delaying the progression of diabetes mellitus. Methods From June to August 2015,143 IGR patients who were managed for a long time by Diecai,Nanmen and Xiufeng Community Health Service Center in Guilin were selected and divided into the control group（ n= 47）,aerobic group（ n = 48）,and resistance group（ n = 48） based on the random number table. Patients in the control group,aerobic group and resistance group were respectively treated with one follow-up every 3 months without other intervention measures,50-min moderate intensity aerobic exercise（ rhythmic exercise,fit aerobics and so on）,once every other day,50-min moderate intensity resistance exercise（ mainly training lumbar and abdominal muscles,leg and hip muscles,and upper limb muscles via using elastic rope to complete the assigned actions with 60%-70% of one repetition maximum）,once every other day,respectively. The FPG and fasting insulin（ FINS） of the participants were measured before intervention,at the end of third, sixth and 12 th months of intervention, respectively. The homeostatic model assessment of insulin resistance index（ HOMA-IR） and insulin action index（ IAI） were calculated. Results Thirty-eight patients in the control group,39 in the aerobic group and 38 in the resistance group completed the intervention. Intervention duration and mode exerted significant interaction on the FPG,FINS,HOMA-IR and IAI values（ P〈0. 05）, and they had obvious main effect on FPG, FINS,HOMA-IR and IAI values（ P〈0. 05）. When the third month of intervention ended,FPG values in the aerobic and resistance groups were lower than in the control group（ P〈0. 05）; FPG and HOMA-IR values decreased but IAI increased in both the aerobic and resistance groups compared with those before intervention（

关 键 词：糖尿病前期 有氧运动 抗阻训练 血糖 胰岛素抗药性 

分 类 号：R587.1[医药卫生—内分泌]