让糖尿病患者动起来：不同运动量对2型糖尿病的长期影响

Make your diabetic patients walk: long-term impact of different amounts of physical activity on type 2 diabetes.

作者信息

Di Loreto Chiara, Fanelli Carmine, Lucidi Paola, Murdolo Giuseppe, De Cicco Arianna, Parlanti Natascia, Ranchelli Anna, Fatone Cristina, Taglioni Chiara, Santeusanio Fausto, De Feo Pierpaolo

机构信息

Department of Internal Medicine, Section of Internal Medicine, Endocrine and Metabolic Sciences, University of Perugia, Via E. Dal Pozzo, 06126 Perugia, Italy.

出版信息

Diabetes Care. 2005 Jun;28(6):1295-302. doi: 10.2337/diacare.28.6.1295.

DOI:10.2337/diacare.28.6.1295

PMID:15920042

Abstract

OBJECTIVE

To establish the impact of different amounts of increased energy expenditure on type 2 diabetes care.

RESEARCH DESIGN AND METHODS

Post hoc analysis of long-term effects of different amounts of increased energy expenditure (metabolic equivalents [METS] per hour per week) through voluntary aerobic physical activity was performed in 179 type 2 diabetic subjects (age 62 +/- 1 years [mean +/- SE]) randomized to a physical activity counseling intervention. Subjects were followed for 2 years and divided into six groups based on their increments in METs per hour per week: group 0 (no activity, n = 28), group 1-10 (6.8 +/- 0.3, n = 27), group 11-20 (17.1 +/- 0.4, n = 31), group 21-30 (27.0 +/- 0.5, n = 27), group 31-40 (37.5 +/- 0.5, n = 32), and group >40 (58.3 +/- 1.8, n = 34).

RESULTS

At baseline, the six groups did not differ for energy expenditure, age, sex, diabetes duration, and all parameters measured. After 2 years, in group 0 and in group 1-10, no parameter changed; in groups 11-20, 21-30, 31-40, and >40, HbA(1c), blood pressure, total serum cholesterol, triglycerides, and estimated percent of 10-year coronary heart disease risk improved (P < 0.05). In group 21-30, 31-40, and >40, body weight, waist circumference, heart rate, fasting plasma glucose, serum LDL and HDL cholesterol also improved (P < 0.05). METs per hour per week correlated positively with changes of HDL cholesterol and negatively with those of other parameters (P < 0.001). After 2 years, per capita yearly costs of medications increased (P = 0.008) by USD393 in group 0, did not significantly change in group 1-10 (USD 206, P = 0.09), and decreased in group 11-20 (USD -196, P = 0.01), group 21-30 (USD -593, P = 0.009), group 31-40 (USD -660, P = 0.003), and group >40 (USD -579, P = 0.001).

CONCLUSIONS

Energy expenditure >10 METs . h(-1) . week(-1) obtained through aerobic leisure time physical activity is sufficient to achieve health and financial advantages, but full benefits are achieved with energy expenditure >20 METs . h(-1) . week(-1).

摘要

目的

确定不同程度增加的能量消耗对2型糖尿病护理的影响。

研究设计与方法

对179名2型糖尿病患者（年龄62±1岁[均值±标准误]）进行了一项事后分析，这些患者通过自愿的有氧体育活动实现了不同程度增加的能量消耗（每周每小时代谢当量[METS]），他们被随机分配到一项体育活动咨询干预中。对受试者进行了2年的随访，并根据他们每周每小时METS的增加量分为六组：0组（无活动，n = 28），1 - 10组（6.8±0.3，n = 27），11 - 20组（17.1±0.4，n = 31），21 - 30组（27.0±0.5，n = 27），31 - 40组（37.5±0.5，n = 32），以及>40组（58.3±1.8，n = 34）。

结果

在基线时，六组在能量消耗、年龄、性别、糖尿病病程以及所有测量参数方面均无差异。2年后，0组和1 - 10组的任何参数均未改变；在11 - 20组、21 - 30组、31 - 40组和>40组中，糖化血红蛋白（HbA1c）、血压、总血清胆固醇、甘油三酯以及估计的10年冠心病风险百分比均有所改善（P < 0.05）。在21 - 30组、31 - 40组和>40组中，体重、腰围、心率、空腹血糖、血清低密度脂蛋白（LDL）和高密度脂蛋白（HDL）胆固醇也有所改善（P < 0.05）。每周每小时的METS与HDL胆固醇的变化呈正相关，与其他参数的变化呈负相关（P < 0.001）。2年后，0组的人均年度药物费用增加了393美元（P = 0.008），1 - 10组无显著变化（206美元，P = 0.09），而11 - 20组（-196美元，P = 0.01）、21 - 30组（-593美元，P = 0.009）、31 - 40组（-660美元，P = 0.003）和>40组（-579美元，P = 0.001）的费用则有所下降。