Petrofsky Jerrold, Prowse Michelle, Remigio Wilton, Raju Chinna, Salcedo Samuel, Sirichotiratana Melissa, Madani Piyush, Chamala Raja Ram, Puckett Eryn, Wong May, Fajita Matthew, Kaur Ramneek, Moore Staci, Pereira Andrea, Katikaneni Swapna, Regula Krishna, Elavarthy Prasanth, Kumar Ujjwal, Raju Linga, Gadagoju Ashita
Department of Physical Therapy, Loma Linda University, Loma Linda, California 92350, USA.
Diabetes Technol Ther. 2009 Jun;11(6):361-8. doi: 10.1089/dia.2008.0094.
Vascular endothelial and autonomic damage are hallmarks of type 1 and type 2 diabetes. However, while much has been published on impairment of the autonomic nervous system, much less has been published on the interrelationship between autonomic damage and exercise.
The present investigation examined the change in heart rate, blood pressure, skin and limb blood flow, and sweat during non-fatiguing (10% and 25% maximum strength [maximal voluntary contraction (MVC)]) and a fatiguing isometric contraction (40% MVC) in people with type 2 diabetes compared to younger and older controls to see if a simple handgrip test could show the extent of autonomic damage in people with diabetes. Fifteen younger subjects (30.6 +/- 8.6 years), 15 older subjects (65.8 +/- 8.8 years), and 15 subjects with diabetes (63.4 +/- 14.4 years) whose average percentage body fat was 40.1 +/- 12.9%, 36.1 +/- 9.3%, and 39.6 +/- 15.5%, respectively, participated in these studies. Whole forearm blood flow, skin blood flow, and sweat on the forearm, chest, and forehead were measured at rest and during and after a contraction at 10% MVC, 25% MVC, and 40% MVC.
Blood flows and sweat rates were greatest in younger subjects, significantly less in older subjects, and even significantly less in subjects with diabetes (P < 0.05). The heart rate response was unaltered during contractions at 10% and 25% MVC and less in diabetes than in the other two groups with 40% MVC. Strength was about half in the diabetes group than with the other two groups, but endurance was similar.
Diabetes is associated with a reduction in handgrip strength and significantly impaired autonomic function during and after isometric exercise.
血管内皮和自主神经损伤是1型和2型糖尿病的特征。然而，虽然关于自主神经系统损伤的研究已发表了很多，但关于自主神经损伤与运动之间的相互关系的研究却少得多。
本研究调查了2型糖尿病患者在进行非疲劳性（最大力量的10%和25%[最大自主收缩（MVC）]）和疲劳性等长收缩（40%MVC）时心率、血压、皮肤和肢体血流以及出汗情况的变化，并与年轻和老年对照组进行比较，以确定简单的握力测试是否能显示糖尿病患者自主神经损伤的程度。15名年轻受试者（30.6±8.6岁）、15名老年受试者（65.8±8.8岁）和15名糖尿病受试者（63.4±14.4岁）参与了这些研究，他们的平均体脂百分比分别为40.1±12.9%、36.1±9.3%和39.6±15.5%。在静息状态下以及在10%MVC、25%MVC和40%MVC收缩期间及之后，测量全前臂血流、皮肤血流以及前臂、胸部和前额的出汗情况。
年轻受试者的血流和出汗率最高，老年受试者显著降低，糖尿病受试者更低（P<0.05）。在10%和25%MVC收缩期间，心率反应未改变，而在40%MVC收缩时，糖尿病患者的心率反应低于其他两组。糖尿病组的力量约为其他两组患者的一半，但耐力相似。
糖尿病与握力降低以及等长运动期间和之后自主神经功能显著受损有关。
