Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Atherosclerosis. 2012 Oct;224(2):446-53. doi: 10.1016/j.atherosclerosis.2012.07.035. Epub 2012 Aug 2.
To investigate the effect of an exercise intervention on flow-mediated dilation (FMD) and circulating endothelial biomarkers in adults with type 2 diabetes (T2DM).
Sedentary adults (n = 140), aged 40-65, with T2DM and untreated pre or Stage I hypertension or treated hypertension were randomized to a 6-month, supervised, exercise program (3× week) or a sedentary control. Assessments included BMI, body and visceral fat, blood pressure, lipids, HbA1c, insulin sensitivity (QUICKI), fitness, FMD, E-selectin, P-selectin, intracellular and vascular cellular adhesion molecules (ICAM, VCAM), and tissue plasminogen activator (tPA). Intervention effects were compared by t-tests. Pearson's correlations were calculated between changes in cardiovascular risk factors and endothelial outcomes.
Exercisers significantly improved BMI (-0.6 kg/m(2)), body fat % (-1.4%), HbA1c (-0.5%), and fitness (2.9 mL/kg min) vs. controls (p < 0.05). However, there were no differences between groups in changes in FMD, E-selectin, P-selectin, ICAM, VCAM, or tPA. Among exercisers, changes in cardiovascular risk factors correlated with several biomarkers. Decreased P-selectin correlated with decreased BMI (r = 0.29, p = 0.04) and increased HDL cholesterol (r = -0.36, p = 0.01). Decreased ICAM correlated with decreased triglycerides and HbA1c (r = 0.30, p = 0.04; r = 0.31, p = 0.03) and increased QUICKI (r = - 0.28, p = 0.05). Decreased tPA correlated with decreased total body and visceral fat (r = 0.28, p = 0.05; r = 0.38, p = 0.008) and increased QUICKI (r = -0.38, p = 0.007).
While exercise resulted in improved fitness, body composition, and glycemic control, there were no changes in FMD or circulating endothelial biomarkers. The associations of changes in cardiovascular risk factors and endothelial biomarkers suggest that improvement in risk factors could mediate the exercise-induced improvements in endothelial function seen in prior studies.
研究运动干预对 2 型糖尿病（T2DM）成人血流介导的舒张功能（FMD）和循环内皮生物标志物的影响。
久坐的成年人（n=140），年龄 40-65 岁，患有 T2DM 且未治疗的前期或 I 期高血压或治疗后的高血压，随机分为 6 个月的监督性运动计划（每周 3 次）或久坐对照组。评估包括 BMI、身体和内脏脂肪、血压、血脂、HbA1c、胰岛素敏感性（QUICKI）、体能、FMD、E-选择素、P-选择素、细胞内和血管细胞黏附分子（ICAM、VCAM）以及组织型纤溶酶原激活物（tPA）。通过 t 检验比较干预效果。计算心血管危险因素变化与内皮结果之间的 Pearson 相关性。
与对照组相比，运动者的 BMI（-0.6kg/m2）、体脂百分比（-1.4%）、HbA1c（-0.5%）和体能（2.9mL/kg·min）均显著改善（p<0.05）。然而，两组间 FMD、E-选择素、P-选择素、ICAM、VCAM 或 tPA 无差异。在运动者中，心血管危险因素的变化与几种生物标志物相关。P-选择素降低与 BMI 降低（r=0.29，p=0.04）和 HDL 胆固醇升高（r=-0.36，p=0.01）相关。ICAM 降低与甘油三酯和 HbA1c 降低相关（r=0.30，p=0.04；r=0.31，p=0.03）和 QUICKI 升高相关（r=-0.28，p=0.05）。tPA 降低与全身和内脏脂肪减少相关（r=0.28，p=0.05；r=0.38，p=0.008）和 QUICKI 升高相关（r=-0.38，p=0.007）。
虽然运动可改善体能、身体成分和血糖控制，但 FMD 或循环内皮生物标志物无变化。心血管危险因素和内皮生物标志物变化的相关性表明，风险因素的改善可能介导了先前研究中观察到的运动引起的内皮功能改善。
