Richter E A, Turcotte L, Hespel P, Kiens B
August Krogh Institute, University of Copenhagen, Denmark.
Diabetes Care. 1992 Nov;15(11):1767-76. doi: 10.2337/diacare.15.11.1767.
In this study, some important metabolic responses to exercise will be discussed, and aspects of particular interest for patients with diabetes mellitus will be emphasized. Alterations in the metabolic responses to exercise induced by physical endurance training and consequences of training for metabolism of plasma lipids and lipoproteins will be discussed. Glucoregulation during exercise is not perfect in normal subjects and is less so in patients with diabetes mellitus. For instance, during intense exercise, large increases in the plasma glucose concentration occur and a state of insulin resistance exists for a few hours after intense exercise. Even so, increased sensitivity to insulin is found the day after intense exercise and also shortly after more moderate intensity exercise, both in healthy subjects and in patients with diabetes mellitus. Increased sensitivity to insulin is also found after endurance training, whereas insulin sensitivity is decreased after inactivity. Exercise training increases the ability of muscle to take up and oxidize free fatty acids during exercise and also increases the activity of the enzyme lipoprotein lipase in muscle. The activity of lipoprotein lipase in muscle correlates with muscle insulin sensitivity. This might explain why insulin resistance is often associated with hypercholesterolemia, hypertriglyceridemia, and low high-density lipoprotein cholesterol.
在本研究中，将讨论一些对运动的重要代谢反应，并强调糖尿病患者特别感兴趣的方面。将讨论耐力训练引起的运动代谢反应变化以及训练对血浆脂质和脂蛋白代谢的影响。正常受试者运动期间的血糖调节并不完美，糖尿病患者更是如此。例如，在剧烈运动期间，血浆葡萄糖浓度会大幅升高，剧烈运动后数小时会存在胰岛素抵抗状态。即便如此，在剧烈运动后的第二天以及中等强度运动后不久，健康受试者和糖尿病患者对胰岛素的敏感性都会增加。耐力训练后也会发现对胰岛素的敏感性增加，而不运动后胰岛素敏感性会降低。运动训练会增加肌肉在运动期间摄取和氧化游离脂肪酸的能力，还会增加肌肉中脂蛋白脂肪酶的活性。肌肉中脂蛋白脂肪酶的活性与肌肉胰岛素敏感性相关。这可能解释了为什么胰岛素抵抗常与高胆固醇血症、高甘油三酯血症和低高密度脂蛋白胆固醇相关。
