Departments of Endocrinology and Metabolism, Radiology, and Nephrology, Leiden University Medical Center, C3-R, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Department of Cardiology, Tjongerschans Hospital, Heerenveen, the Netherlands; Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
Radiology. 2013 Nov;269(2):434-42. doi: 10.1148/radiol.13121631. Epub 2013 Jun 25.
To prospectively assess the effects of an exercise intervention on organ-specific fat accumulation and cardiac function in type 2 diabetes mellitus.
Written informed consent was obtained from all participants, and the study protocol was approved by the medical ethics committee. The study followed 12 patients with type 2 diabetes mellitus (seven men; mean age, 46 years ± 2 [standard error]) before and after 6 months of moderate-intensity exercise, followed by a high-altitude trekking expedition with exercise of long duration. Abdominal, epicardial, and paracardial fat volume were measured by using magnetic resonance (MR) imaging. Cardiac function was quantified with cardiac MR, and images were analyzed by a researcher who was supervised by a senior researcher (4 and 21 years of respective experience in cardiac MR). Hepatic, myocardial, and intramyocellular triglyceride (TG) content relative to water were measured with proton MR spectroscopy at 1.5 and 7 T. Two-tailed paired t tests were used for statistical analysis.
Exercise reduced visceral abdominal fat volume from 348 mL ± 57 to 219 mL ± 33 (P < .01), and subcutaneous abdominal fat volume remained unchanged (P = .9). Exercise decreased hepatic TG content from 6.8% ± 2.3 to 4.6% ± 1.6 (P < .01) and paracardial fat volume from 4.6 mL ± 0.9 to 3.7 mL ± 0.8 (P = .02). Exercise did not change epicardial fat volume (P = .9), myocardial TG content (P = .9), intramyocellular lipid content (P = .3), or cardiac function (P = .5).
A 6-month exercise intervention in type 2 diabetes mellitus decreased hepatic TG content and visceral abdominal and paracardial fat volume, which are associated with increased cardiovascular risk, but cardiac function was unaffected. Tissue-specific exercise-induced changes in body fat distribution in type 2 diabetes mellitus were demonstrated in this study.
前瞻性评估运动干预对 2 型糖尿病患者器官特异性脂肪堆积和心脏功能的影响。
所有参与者均签署了书面知情同意书，研究方案获得了医学伦理委员会的批准。该研究对 12 名 2 型糖尿病患者（7 名男性；平均年龄 46 岁±2[标准误差]）进行了 6 个月的中等强度运动前后的随访，并在运动时间较长的高海拔徒步旅行后进行了随访。使用磁共振成像（MR）测量腹部、心外膜和心包脂肪体积。通过心脏磁共振定量心脏功能，并由一名研究人员分析图像，该研究人员由一名具有 4 年和 21 年心脏磁共振经验的高级研究人员监督。在 1.5 和 7 T 下，通过质子磁共振波谱测量肝、心肌和肌内甘油三酯（TG）与水的相对含量。采用双尾配对 t 检验进行统计学分析。
运动使内脏腹部脂肪体积从 348 毫升±57 减少到 219 毫升±33（P <.01），而皮下腹部脂肪体积保持不变（P =.9）。运动使肝 TG 含量从 6.8%±2.3%降至 4.6%±1.6%（P <.01），心包脂肪体积从 4.6 毫升±0.9 降至 3.7 毫升±0.8（P =.02）。运动没有改变心外膜脂肪体积（P =.9）、心肌 TG 含量（P =.9）、肌内脂含量（P =.3）或心脏功能（P =.5）。
2 型糖尿病患者 6 个月的运动干预降低了肝 TG 含量以及内脏腹部和心包脂肪体积，这些与心血管风险增加有关，但心脏功能未受影响。本研究显示，2 型糖尿病患者的身体脂肪分布在组织特异性运动后发生了变化。
