University of Ottawa, Montpetit Hall, ON, Canada.
Diabetologia. 2011 Jan;54(1):93-102. doi: 10.1007/s00125-010-1941-3. Epub 2010 Oct 16.
AIM/HYPOTHESIS: In people with type 2 diabetes, exercise improves glucose control (as reflected in HbA₁(c)) and physical fitness, but it is not clear to what extent these exercise-induced improvements are correlated with one another. We hypothesised that reductions in HbA₁(c) would be related: (1) to increases in aerobic fitness and strength respectively in patients performing aerobic training or resistance training; and (2) to changes in strength and aerobic fitness in patients performing aerobic and resistance training.
We randomly allocated 251 type 2 diabetes patients to aerobic, resistance, or aerobic plus resistance training, or to a sedentary control group. Peak oxygen consumption VO₂(peak), workload, treadmill time and ventilatory threshold measurements from maximal treadmill exercise testing were measured at baseline and 6 months. Muscular strength was measured as the maximum weight that could be lifted eight times on the leg press, bench press and seated row exercises.
With aerobic training, significant associations were found between changes in both VO₂(peak) (p = 0.040) and workload (p = 0.022), and changes in HbA₁(c.) With combined training, improvements in VO₂(peak) (p = 0.008), workload (p = 0.034) and ventilatory threshold (p = 0.003) were significantly associated with changes in HbA₁(c.) Increases in strength on the seated row (p = 0.006) and in mid-thigh muscle cross-sectional area (p = 0.030) were significantly associated with changes in HbA₁(c) after resistance exercise, whereas the association between increases in muscle cross-sectional area and HbA₁(c) in participants doing aerobic plus resistance exercise (p = 0.059) was of borderline significance.
CONCLUSIONS/INTERPRETATION: There appears to be a link between changes in fitness and HbA₁(c). The improvements in cardiorespiratory fitness with aerobic training may be a better predictor of changes in HbA₁(c) than improvements in strength.
目的/假设：在 2 型糖尿病患者中，运动可以改善血糖控制（表现在 HbA₁(c) 上）和身体适应性，但运动引起的这些改善之间在多大程度上相互关联尚不清楚。我们假设，HbA₁(c) 的降低将与以下因素相关：（1）在进行有氧训练或阻力训练的患者中，分别与有氧适应性和力量的增加相关；（2）在进行有氧和阻力训练的患者中，与力量和有氧适应性的变化相关。
我们将 251 名 2 型糖尿病患者随机分配到有氧、阻力或有氧加阻力训练组，或静坐对照组。在基线和 6 个月时，进行最大跑步机运动测试，测量峰值摄氧量 VO₂(peak)、工作量、跑步机时间和通气阈值测量。肌肉力量通过腿部按压、卧推和坐姿划船练习中可以举起 8 次的最大重量来测量。
有氧训练时，发现 VO₂(peak)（p=0.040）和工作量（p=0.022）的变化与 HbA₁(c) 的变化之间存在显著相关性。综合训练时，VO₂(peak)（p=0.008）、工作量（p=0.034）和通气阈值（p=0.003）的改善与 HbA₁(c) 的变化显著相关。在阻力训练后，坐姿划船（p=0.006）和大腿中段肌肉横截面积（p=0.030）的力量增加与 HbA₁(c) 的变化显著相关，而在进行有氧加阻力训练的参与者中，肌肉横截面积与 HbA₁(c) 之间的相关性（p=0.059）接近显著。
结论/解释：似乎有一个适应性和 HbA₁(c) 之间的联系。有氧训练时心肺适应性的改善可能比力量的改善更能预测 HbA₁(c) 的变化。
