Department of Internal Medicine, Seoul National University College of Medicine, Seouk, Korea.
Diabet Med. 2010 Sep;27(9):1088-92. doi: 10.1111/j.1464-5491.2010.03045.x.
We examined the effects of physical activity with or without dietary restriction for 3 months on regional fat and insulin sensitivity and compared the effect of total energy expenditure from all levels of physical activity with that of physical activity energy expenditure from moderate-to-vigorous exercise in obese women with Type 2 diabetes.
In this randomized, controlled trial, we assessed change of body weight, abdominal visceral fat area, subcutaneous fat area and insulin sensitivity, expressed as K(ITT), and monitored total energy expenditure and physical activity energy expenditure using an accelerometer during a 12-week intervention in four groups: control, diet, exercise and diet plus exercise.
The mean body mass index was 28.0 +/- 2.7 kg/m(2) and the mean duration of diabetes was 8 +/- 6 years. Both the diet and diet plus exercise groups showed significant body weight loss compared with the control group (P < 0.05). However, the visceral fat area was reduced only in the diet and exercise group (P = 0.017) and the subcutaneous fat area was reduced only in the diet group (P = 0.009). Mean energy intake was an independent determinant of the change in subcutaneous fat area (P = 0.020) and mean total anergy expenditure was an independent determinant of visceral fat area (P = 0.002). Insulin sensitivity K(ITT) was associated with physical activity energy expenditure (P = 0.006), energy intake (P = 0.047) and the change in fructosamine level (P = 0.016) but not with changes in body weight, subcutaneous fat area, visceral fat area or adipokine level.
Exercise had an additive effect to dietary restriction on visceral fat reduction. Visceral fat area was associated with total energy expenditure, but insulin sensitivity was associated with physical activity energy expenditure.
我们研究了 3 个月的运动结合或不结合饮食限制对局部脂肪和胰岛素敏感性的影响，并比较了肥胖 2 型糖尿病女性中所有运动水平的总能量消耗与中高强度运动的能量消耗对胰岛素敏感性的影响。
在这项随机对照试验中，我们评估了体重、腹部内脏脂肪面积、皮下脂肪面积和胰岛素敏感性（ITT 表示）的变化，并在 12 周的干预期间使用加速度计监测总能量消耗和运动能量消耗，分为 4 组：对照组、饮食组、运动组和饮食加运动组。
平均 BMI 为 28.0 ± 2.7 kg/m²，糖尿病平均病程为 8 ± 6 年。与对照组相比，饮食组和饮食加运动组的体重均显著下降（P < 0.05）。然而，只有饮食组和运动组的内脏脂肪面积减少（P = 0.017），只有饮食组的皮下脂肪面积减少（P = 0.009）。平均能量摄入是皮下脂肪面积变化的独立决定因素（P = 0.020），平均总能量消耗是内脏脂肪面积的独立决定因素（P = 0.002）。胰岛素敏感性 K（ITT）与运动能量消耗相关（P = 0.006），与能量摄入相关（P = 0.047），与果糖胺水平的变化相关（P = 0.016），但与体重、皮下脂肪面积、内脏脂肪面积或脂肪因子水平的变化无关。
运动对饮食限制减少内脏脂肪有额外的作用。内脏脂肪面积与总能量消耗相关，而胰岛素敏感性与运动能量消耗相关。
