Cauza Edmund, Hanusch-Enserer Ursula, Strasser Barbara, Kostner Karam, Dunky Attila, Haber Paul
Department of Internal Medicine V, Department of Diabetes and Rheumatology, Wilhelminenspital, Vienna, Austria.
Wien Med Wochenschr. 2006 Sep;156(17-18):515-9. doi: 10.1007/s10354-006-0337-y.
The effectiveness of physical exercise in the management of diabetes mellitus type 2 is well established. The purpose of this investigation was to evaluate the effect of long term exercise on glycemic and metabolic control measured after eight months in contrast to patients who had ceased their training after four months.
After an effective 4 months' strength training or endurance training period, ten patients (5 male and 5 female, mean age +/- SE:57.1 +/- 1.6 yr) were randomised to a further 4 months of combined endurance and strength training, while a control group of 10 patients (5 male and 5 female, mean age +/- SE:56.9 +/- 1.6 yr) ceased training.
Long term glycemic control improved and HbA1C values fell from 6.9 +/- 0.4 to 6.2 +/- 0.2 in active patients and increased from 7.5 +/- 0.4 to 8.7 +/- 0.6 in control patients (p = 0.002). Baseline levels of total cholesterol significantly decreased in training group (205.5 mg/dl +/- 14.1 to 177.5 +/- 13.3) and increased in controls (185.9 +/- 14.1 to 220.2 +/- 15.8) [p = 004]. In addition, significant decreases in LDL-cholesterol and triglyceride levels (both p < 05) were observed in the training group compared to controls.
This study showed that in addition to a 4 month training period, continuation of training proved highly beneficial with further reductions in fasting blood glucose, HbA1C, total cholesterol, LDL-cholesterol, triglyceride, and an elevation in HDL-cholesterol concentrations in diabetes mellitus type 2 patients, thus resulting in a reduced atherogenic lipid profile. In contrast, patients who ceased training after 4 months developed an atherogenic lipid profile and a worsened glycemic control. The results of this study indicate that long term exercise plays an important role in the treatment of diabetes mellitus type 2 and may protect against the development of cardiovascular diseases.
体育锻炼对2型糖尿病管理的有效性已得到充分证实。本研究的目的是评估长期运动对血糖和代谢控制的影响，在八个月后进行测量，并与四个月后停止训练的患者进行对比。
在进行了为期4个月的有效力量训练或耐力训练后，10名患者（5名男性和5名女性，平均年龄±标准误：57.1±1.6岁）被随机分配到另外4个月的耐力和力量联合训练中，而10名患者的对照组（5名男性和5名女性，平均年龄±标准误：56.9±1.6岁）停止训练。
长期血糖控制得到改善，活跃患者的糖化血红蛋白（HbA1C）值从6.9±0.4降至6.2±0.2，而对照患者从7.5±0.4升至8.7±0.6（p = 0.002）。训练组的总胆固醇基线水平显著下降（从205.5毫克/分升±14.1降至177.5±13.3），而对照组则上升（从185.9±14.1升至220.2±15.8）[p = 0.04]。此外，与对照组相比，训练组的低密度脂蛋白胆固醇和甘油三酯水平显著下降（均p < 0.05）。
本研究表明，除了4个月的训练期外，继续训练被证明非常有益，2型糖尿病患者的空腹血糖、HbA1C、总胆固醇、低密度脂蛋白胆固醇、甘油三酯进一步降低，高密度脂蛋白胆固醇浓度升高，从而导致致动脉粥样硬化脂质谱降低。相比之下，4个月后停止训练的患者出现了致动脉粥样硬化脂质谱，血糖控制恶化。本研究结果表明，长期运动在2型糖尿病治疗中起重要作用，并可能预防心血管疾病的发生。
