Bruce C R, Kriketos A D, Cooney G J, Hawley J A
Exercise Metabolism Group, School of Medical Sciences, RMIT University, PO Box 71, Bundoora, Victoria 3083, Australia.
Diabetologia. 2004 Jan;47(1):23-30. doi: 10.1007/s00125-003-1265-7. Epub 2003 Dec 12.
AIM/HYPOTHESIS: We determined the effect of exercise training on insulin sensitivity and muscle lipids (triglyceride [TG(m)] and long-chain fatty acyl CoA [LCACoA] concentration) in patients with Type 2 diabetes.
Seven patients with Type 2 diabetes and six healthy control subjects who were matched for age, BMI, % body fat and VO(2)peak participated in a 3 days per week training program for 8 weeks. Insulin sensitivity was determined pre- and post-training during a 120 min euglycaemic-hyperinsulinaemic clamp and muscle biopsies were obtained before and after each clamp. Oxidative enzyme activities [citrate synthase (CS), beta-hydroxy-acyl-CoA (beta-HAD)] and TG(m) were determined from basal muscle samples pre- and post training, while total LCACoA content was measured in samples obtained before and after insulin-stimulation, pre- and post training.
The training-induced increase in VO(2)peak (approximately 20%, p<0.01) was similar in both groups. Compared with control subjects, insulin sensitivity was lower in the diabetic patients before and after training (approximately 60%; p<0.05), but was increased to the same extent in both groups with training (approximately 30%; p<0.01). TG(m) was increased in patients with Type 2 diabetes (170%; p<0.05) before, but was normalized to levels observed in control subjects after training. Basal LCACoA content was similar between groups and was unaltered by training. Insulin-stimulation had no detectable effect on LCACoA content. CS and beta-HAD activity were increased to the same extent in both groups in response to training ( p<0.001).
CONCLUSION/INTERPRETATION: We conclude that the enhanced insulin sensitivity observed after short-term exercise training was associated with a marked decrease in TG(m) content in patients with Type 2 diabetes. However, despite the normalization of TG(m )to levels observed in healthy individuals, insulin resistance was not completely reversed in the diabetic patients.
目的/假设：我们确定了运动训练对2型糖尿病患者胰岛素敏感性和肌肉脂质（甘油三酯[TG(m)]和长链脂肪酰辅酶A[LCACoA]浓度）的影响。
7名2型糖尿病患者和6名年龄、体重指数、体脂百分比和最大摄氧量(VO₂)峰值相匹配的健康对照者参加了每周3天、为期8周的训练计划。在120分钟的正常血糖-高胰岛素钳夹试验期间，于训练前后测定胰岛素敏感性，并在每次钳夹前后获取肌肉活检样本。从训练前后的基础肌肉样本中测定氧化酶活性[柠檬酸合酶(CS)、β-羟酰基辅酶A(β-HAD)]和TG(m)，而在训练前后胰岛素刺激前后获取的样本中测量总LCACoA含量。
两组训练诱导的VO₂峰值增加（约20%，p<0.01）相似。与对照者相比，糖尿病患者训练前后的胰岛素敏感性均较低（约60%；p<0.05），但两组训练后胰岛素敏感性增加程度相同（约30%；p<0.01）。2型糖尿病患者的TG(m)在训练前增加（170%；p<0.05），但训练后恢复到对照者观察到的水平。两组之间基础LCACoA含量相似，且不受训练影响。胰岛素刺激对LCACoA含量无明显影响。两组CS和β-HAD活性因训练而增加程度相同（p<0.001）。
结论/解读：我们得出结论，短期运动训练后观察到的胰岛素敏感性增强与2型糖尿病患者TG(m)含量显著降低有关。然而，尽管TG(m)恢复到健康个体观察到的水平，但糖尿病患者的胰岛素抵抗并未完全逆转。
