Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia.
Diabetes Care. 2013 Aug;36(8):2372-9. doi: 10.2337/dc12-2196. Epub 2013 Mar 8.
To investigate changes in body composition after 12 months of high-intensity progressive resistance training (PRT) in relation to changes in insulin resistance (IR) or glucose homeostasis in older adults with type 2 diabetes.
One-hundred three participants were randomized to receive either PRT or sham exercise 3 days per week for 12 months. Homeostasis model assessment 2 of insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c) were used as indices of IR and glucose homeostasis. Skeletal muscle mass (SkMM) and total fat mass were assessed using bioelectrical impedance. Visceral adipose tissue, mid-thigh cross-sectional area, and mid-thigh muscle attenuation were quantified using computed tomography.
Within the PRT group, changes in HOMA2-IR were associated with changes in SkMM (r = -0.38; P = 0.04) and fat mass (r = 0.42; P = 0.02). Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR (r = 0.35; P = 0.07). Changes in HbA1c were related to changes in mid-thigh muscle attenuation (r = 0.52; P = 0.001). None of these relationships were present in the sham group (P > 0.05). Using ANCOVA models, participants in the PRT group who had increased SkMM had decreased HOMA2-IR (P = 0.05) and HbA1c (P = 0.09) compared with those in the PRT group who lost SkMM. Increases in SkMM in the PRT group decreased HOMA2-IR (P = 0.07) and HbA1c (P < 0.05) compared with those who had increased SkMM in the sham group.
Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT.
研究 12 个月高强度渐进式抗阻训练（PRT）对 2 型糖尿病老年患者胰岛素抵抗（IR）或葡萄糖稳态变化的影响。
103 名参与者被随机分配接受 PRT 或假运动，每周 3 天，持续 12 个月。稳态模型评估 2 的胰岛素抵抗（HOMA2-IR）和糖化血红蛋白（HbA1c）用于评估 IR 和葡萄糖稳态。使用生物电阻抗法评估骨骼肌质量（SkMM）和总脂肪量。使用计算机断层扫描量化内脏脂肪组织、大腿中段横截面积和大腿中段肌肉衰减。
在 PRT 组中，HOMA2-IR 的变化与 SkMM（r = -0.38；P = 0.04）和脂肪量（r = 0.42；P = 0.02）的变化相关。内脏脂肪组织的变化与 HOMA2-IR 的变化呈趋势相关（r = 0.35；P = 0.07）。HbA1c 的变化与大腿中段肌肉衰减的变化相关（r = 0.52；P = 0.001）。这些关系在假运动组中均不明显（P > 0.05）。使用 ANCOVA 模型，PRT 组中 SkMM 增加的患者与 PRT 组中 SkMM 减少的患者相比，HOMA2-IR（P = 0.05）和 HbA1c（P = 0.09）降低。PRT 组中 SkMM 的增加降低了 HOMA2-IR（P = 0.07）和 HbA1c（P < 0.05），与假运动组中 SkMM 增加的患者相比。
只有通过高强度 PRT 实现的身体成分改善，才能介导 2 型糖尿病老年患者代谢健康的改善。
