体育锻炼干预对久坐老年糖尿病患者生理和认知功能影响的研究  

Effects of Physical Activity Intervention on Physical and Cognitive Function in Sedentary Adults With and Without Diabetes

作　　者：张克菲 张丽金[1] 杨文爽 徐彪 牛敬荣[1] ZHANG Kefei;ZHANG Lijin;YANG Wenshuang;XU biao;NIU Jingrong(Department of Vascular Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院血管外科,北京100020

出　　处：《转化医学杂志》2021年第3期163-169,共7页Translational Medicine Journal

摘　　要：目的探讨体育锻炼的干预方式是否影响久坐成年糖尿病患者的生理和认知功能。方法采用生活方式干预与老年人独立试验结合,进行体育锻炼干预(步行,耐力训练以及柔韧性锻炼)的随机对照临床试验。纳入70~89岁的久坐非痴呆且功能受限的老年人,经随机化分组后收集平均2年的身体和认知功能标准化检测指标。将干预组415名糖尿病患者与对照组1,061名非糖尿病患者之间的差异采用协方差分析进行比较分析。结果通过24个月的运动干预后,患有糖尿病的患者与非糖尿病老年人的平均400 m步态速度(整体干预×糖尿病交互作用,P=0.99)增快0.019 m/s(总体P=0.007)。而锻炼持续时间的相关得分未见明显收益。糖尿病患者组与对照组比较,参加体育锻炼者的认知测试改善程度显著优于对照组,尤其在整体认知功能(P=0.02)和记忆延迟(P=0.005)方面。此外这些患者受益于体育锻炼干预的95%CI和平均标准偏差分别为0.114[0.007,0.111]和0.208[0.030,0.387]。结论体育锻炼可以改善久坐老年人的步态速度。患有糖尿病的久坐老年患者其认知功能明显受益,所发生的显著改善并未发生于非糖尿病老年患者中。Objective Type 2 diabetes mellitus may alter the effect of physical activity on physical and cognitive function.Methods The Lifestyle Interventions and Independence for Elders(LIFE)trial randomized controlled clinical trial of physical activity intervention(walking,resistance training,and flexibility exercises)enrolled adults aged 70-89 years who were sedentary and non-demented,meanwhile had functional limitations.Standardized measures of physical and cognitive function were collected an average of 2 years post-randomization.Differences between the intervention and control groups from 415 individuals with diabetes and 1,061 individuals without diabetes were contrasted with analyses of covariance.Results At 24 months,assignment to the physical activity intervention resulted in 0.019 m/s relatively faster average 400-meter gait speeds(P=0.007 overall)both for individuals with and without diabetes(intervention×diabetes interaction P=0.99).No benefits were seen on scores from a physical performance battery.Performance on cognitive tests was better among participants assigned to the physical activity intervention compared with control only for those with diabetes,particularly for global cognitive function(P=0.02)and delayed memory(P=0.005),with mean[95%confidence intervals]for benefit from physical activity intervention of 0.114[0.007,0.111]and 0.208[0.030,0.387]standard deviations,respectively.Conclusions Physical activity intervention improved the gait speed of older,sedentary individuals with and without diabetes.The cognitive function benefits occurred among participants with,but not without,diabetes.The mechanisms through which physical activity affects physical and cognitive function in older adults may differ for individuals by diabetes status.

关 键 词：行为干预 2型糖尿病 临床试验 

分 类 号：R587.1[医药卫生—内分泌]