运动训练对2型糖尿病患者的抗炎作用。
The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus.
作者信息
Kadoglou Nikolaos P E, Iliadis Fotios, Angelopoulou Nikoleta, Perrea Despina, Ampatzidis George, Liapis Christos D, Alevizos Miltiadis
机构信息
First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Athens, Greece.
出版信息
Eur J Cardiovasc Prev Rehabil. 2007 Dec;14(6):837-43. doi: 10.1097/HJR.0b013e3282efaf50.
BACKGROUND
Diabetes mellitus (DM) and chronic inflammation are strongly related to increased cardiovascular risk. The purpose of this study was to evaluate whether an aerobic training programme would ameliorate inflammatory and anti-inflammatory markers in patients with type 2 DM.
DESIGN
Interventional study.
METHODS
A total of 60 overweight individuals with type 2 DM, but without vascular complications, were randomly assigned to either a 6-month aerobic exercise training programme (four times/week, 45-60 min/session), designated as exercise group, or to the control group. All participants were on an oral antidiabetic regimen and none was receiving lipid-lowering medications. Anthropometric parameters, cardiorespiratory fitness, glycaemic and lipid profiles, high sensitivity C-reactive protein (hs CRP), adiponectin, interleukin (IL)-10, IL-18, tumour necrosis factor (TNF)-alpha, insulin, reciprocal index of homoeostasis model assessment (HOMA-IR), body fat and blood pressure (BP) were measured at baseline and at the end of the study.
RESULTS
In comparison with baseline and control group, exercise-treated patients improved glucose control, lipid profile, exercise capacity (VO2 peak) and exhibited decreased insulin resistance and systolic BP considerably (P<0.05). Plasma adiponectin, TNF-alpha and body weight changed slightly across treatment (P>0.05), whereas diastolic BP and fat mass tended to decrease (P=0.071 and 0.061, respectively). Exercise training reduced hs CRP (from 0.48+/-0.16 to 0.29+/-0.2 mg/dl; P=0.04) and IL-18 (from 315.19+/-122.76 to 203.77+/-96.02 pg/ml; P=0.02). Moreover, exercise provided anti-inflammatory protection through IL-10 increment (P=0.039) and IL-18/IL-10 ratio downregulation (P=0.014). In multiple regression analysis, alteration in IL-18 was independently correlated with hs CRP and VO2 peak changes (P<0.05).
CONCLUSION
Aerobic exercise training without significant weight loss improves metabolic profile and exerts anti-inflammatory effects in patients with type 2 DM.
背景
糖尿病（DM）与慢性炎症与心血管风险增加密切相关。本研究旨在评估有氧运动训练计划是否能改善2型糖尿病患者的炎症和抗炎标志物。
设计
干预性研究。
方法
总共60名超重的2型糖尿病患者，但无血管并发症，被随机分配到6个月的有氧运动训练计划组（每周4次，每次45 - 60分钟），称为运动组，或对照组。所有参与者均采用口服抗糖尿病治疗方案，且均未接受降脂药物治疗。在基线和研究结束时测量人体测量参数、心肺功能、血糖和血脂谱、高敏C反应蛋白（hs CRP）、脂联素、白细胞介素（IL）-10、IL-18、肿瘤坏死因子（TNF）-α、胰岛素、稳态模型评估的倒数指数（HOMA-IR）、体脂和血压（BP）。
结果
与基线和对照组相比，运动治疗的患者改善了血糖控制、血脂谱、运动能力（VO2峰值），并显著降低了胰岛素抵抗和收缩压（P<0.05）。血浆脂联素、TNF-α和体重在治疗过程中略有变化（P>0.05），而舒张压和脂肪量有下降趋势（分别为P = 0.071和0.061）。运动训练降低了hs CRP（从0.48±0.16降至0.29±0.2mg/dl；P = 0.04）和IL-18（从315.19±122.76降至203.77±96.02pg/ml；P = 0.02）。此外，运动通过IL-10增加（P = 0.039）和IL-18/IL-10比值下调（P = 0.014）提供抗炎保护。在多元回归分析中，IL-18的变化与hs CRP和VO2峰值变化独立相关（P<0.05）。
结论
无显著体重减轻的有氧运动训练可改善2型糖尿病患者的代谢状况并发挥抗炎作用。
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