Giannopoulou I, Ploutz-Snyder L L, Carhart R, Weinstock R S, Fernhall B, Goulopoulou S, Kanaley J A
Syracuse University, Syracuse, New York 13244, USA.
J Clin Endocrinol Metab. 2005 Mar;90(3):1511-8. doi: 10.1210/jc.2004-1782. Epub 2004 Dec 14.
This study examined the effects of aerobic exercise without weight loss, a hypocaloric high monounsaturated fat diet, and diet plus exercise (D+E) on total abdominal and visceral fat loss in obese postmenopausal women with type 2 diabetes. Thirty-three postmenopausal women (body mass index, 34.6 +/- 1.9 kg/m(2)) were assigned to one of three interventions: a hypocaloric high monounsaturated fat diet alone, exercise alone (EX), and D+E for 14 wk. Aerobic capacity, body composition, abdominal fat distribution (magnetic resonance imaging), glucose tolerance, and insulin sensitivity were measured pre- and postintervention. Body weight ( approximately 4.5 kg) and percent body fat ( approximately 5%) were decreased (P < 0.05) with the D and D+E intervention, whereas only percent body fat ( approximately 2.3%) decreased with EX. Total abdominal fat and sc adipose tissue (SAT) were reduced with the D and D+E interventions (P < 0.05), whereas visceral adipose tissue (VAT) decreased with the D+E and EX intervention, but not with the D intervention. EX resulted in a reduction in total abdominal fat, VAT, and SAT (P < 0.05) despite the lack of weight loss. The reductions in total abdominal fat and SAT explained 32.7% and 9.7%, respectively, of the variability in the changes in fasting glucose levels, whereas the reductions in VAT explained 15.9% of the changes in fasting insulin levels (P < 0.05). In conclusion, modest weight loss, through either D or D+E, resulted in similar improvements in total abdominal fat, SAT, and glycemic status in postmenopausal women with type 2 diabetes; however, the addition of exercise to diet is necessary for VAT loss. These data demonstrate the importance of exercise in the treatment of women with type 2 diabetes.
本研究考察了不伴有体重减轻的有氧运动、低热量高单不饱和脂肪饮食以及饮食加运动（D+E）对患有2型糖尿病的肥胖绝经后女性腹部总脂肪和内脏脂肪减少情况的影响。33名绝经后女性（体重指数，34.6±1.9kg/m²）被分配到三种干预措施之一：单独的低热量高单不饱和脂肪饮食、单独运动（EX）以及饮食加运动（D+E），为期14周。在干预前后测量了有氧运动能力、身体成分、腹部脂肪分布（磁共振成像）、葡萄糖耐量和胰岛素敏感性。采用D和D+E干预措施后体重（约4.5kg）和体脂百分比（约5%）下降（P<0.05），而仅采用EX干预时只有体脂百分比（约2.3%）下降。采用D和D+E干预措施后腹部总脂肪和皮下脂肪组织（SAT）减少（P<0.05），而采用D+E和EX干预措施时内脏脂肪组织（VAT）减少，采用D干预时则未减少。尽管体重未减轻，但EX导致腹部总脂肪、VAT和SAT减少（P<0.05）。腹部总脂肪和SAT的减少分别解释了空腹血糖水平变化中32.7%和9.7%的变异性，而VAT的减少解释了空腹胰岛素水平变化的15.9%（P<0.05）。总之，通过D或D+E实现的适度体重减轻，在患有2型糖尿病的绝经后女性中，对腹部总脂肪、SAT和血糖状态产生了相似的改善；然而，饮食中添加运动对于减少VAT是必要的。这些数据证明了运动在2型糖尿病女性治疗中的重要性。
