不同运动方式对糖尿病前期患者2型糖尿病风险的影响:一项为期2年的前瞻性随机对照研究  

Effects of different types of exercise on type 2 diabetes risk in patients with pre-diabetes:One 2-year prospective randomized controlled study

作　　者：李敏 袁晓丹[2] 戴霞[3] 李凡 季红[5] 楼青青 Li Min;Yuan Xiaodan;Dai Xia;Li Fan;Ji Hong;Lou Qingqing(The College of Nursing,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Healthy Education,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;The First Affiliated Hospital of Guangxi Medicine University,Nanning 530021,China;Nursing College,University of Missouri St.Louis,St.Louis 63121,America;Danyang People′s Hospital,Danyang 212300,China;Department of Endocrinology,Hainan Provincial People′s Hospital,Haikou 570311,China)

机构地区：[1]南京中医药大学护理学院,210023 [2]南京中医药大学附属中西医结合医院健康教育科,210028 [3]广西医科大学第一附属医院,南宁530021 [4]美国密苏里大学圣路易斯分校护理学院,63121 [5]丹阳市人民医院,212300 [6]海南省人民医院内分泌科,海口570311

出　　处：《中华内分泌代谢杂志》2021年第10期895-904,共10页Chinese Journal of Endocrinology and Metabolism

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)。

摘　　要：目的探讨24个月的抗阻运动(RT)和有氧运动(AT)对糖尿病前期患者2型糖尿病发病风险的影响。方法本研究为多中心前瞻性随机对照研究。共纳入248例糖尿病前期患者并分为3组:RT组(82例)、AT组(83例)和对照组(83例)。RT组和AT组的参与者在3个研究中心研究人员的组织和监督下,每周集中进行3次中等强度的RT或AT(150 min/周),为期24个月。RT使用弹力绳,以60%的1RM(肌肉能一次举起的最大重量)进行运动;AT组患者以最大心率的60%~70%进行有氧操运动。在基线以及第6、12和24个月结束时对每个受试者进行评估。主要结局指标为2型糖尿病风险的改变,次要结局包括血糖、血脂、血压的变化。结果完成6、12和24个月随访的研究对象分别为217、206和173例。基线时RT组、AT组和对照组的平均年龄分别为(59.91±5.92)、(60.93±5.71)和(60.73±5.83)岁。与对照组相比,RT组和AT组在第12个月和第24个月末时HbA1C显著降低(P<0.05),稳态模型评估的胰岛β细胞功能指数(HOMA2-β)明显上升(P<0.01)。校正年龄、性别、他汀类药物使用、血脂、血压和体重指数等参数后,COX回归显示24个月的RT和AT分别使2型糖尿病风险降低55.6%(P=0.012)和59.8%(P=0.010)。结论为期24个月的中等强度RT和AT均能降低胰岛素抵抗,改善β细胞功能和糖脂代谢,降低2型糖尿病发病风险。Objective To evaluate the impacts of resistance training(RT)and aerobic training(AT)for 24 months on the risk of type 2 diabetes in patients with pre-diabetes.Methods Two hundred forty-eight pre-diabetic patients were enrolled in this multi-center randomized controlled trial.All patients were randomly divided into 3 groups:RT(n=82),AT(n=83),and control(n=83)groups.The participants in RT and AT groups undertook moderate RT or AT 3 times a week(150 minutes/week)under supervision in 3 research centers for 24 months.Elastic bands were used in each session of RT,with intensity of 60%1RM(maximum weight that muscle can lift at once).Patients in AT group performed aerobic dance at 60%-70%of maximum heart rate.Assessments for each subject were made at baseline and by the end of 6,12 and 24 months.Primary outcomes were changes in the risk of type 2 diabetes.Secondary outcomes included changes in blood glucose,blood lipids,and blood pressure.Results There were 217,206,and 173 subjects who completed the follow-up of 6,12,and 24 months,respectively.The mean ages of RT,AT,and control groups at baseline were(59.91±5.92),(60.93±5.71),and(60.73±5.83)years.Compared to control group,both RT and AT groups revealed a significant reduction in HbA1C(P<0.05),and a significant increase in homeostasis model assessment for β-cell function index(HOMA2-β,P<0.01)by the end of 12 and 24 months.Adjusted for age,gender,statin use,lipid profile,blood pressure,and body mass index,COX regression analysis showed that RT and AT reduced the risk of type 2 diabetes by 55.6%(P=0.012)and 59.8%(P=0.010).Conclusions This study demonstrates that 24-month moderate RT and AT have comparable effects on reducing insulin resistance,improving β-cell function,blood glucose and lipid,and reducing the risk of type 2 diabetes.

关 键 词：糖尿病前期 糖调节受损 抗阻运动 2型糖尿病预防 

分 类 号：R587.1[医药卫生—内分泌]