运动对 2 型糖尿病男女患者腹部脂肪减少的影响。
Effect of exercise on abdominal fat loss in men and women with and without type 2 diabetes.
机构信息
Department of Kinesiology, Towson University, Towson, Maryland, USA.
出版信息
BMJ Open. 2013 Nov 25;3(11):e003897. doi: 10.1136/bmjopen-2013-003897.
OBJECTIVE
To examine the effect of exercise on abdominal adipose tissue in adults with and without type 2 diabetes mellitus (T2DM).
DESIGN
Post hoc analysis of two randomised controlled trials.
SETTING
Outpatient secondary prevention programme in Baltimore, Maryland, USA.
PARTICIPANTS
97 men and women with prehypertension, stage 1 or medically controlled hypertension. 49% of the sample was also diagnosed with T2DM.
INTERVENTION
All participants completed a 26-week (6.5 months) supervised aerobic and resistance exercise programme following American College of Sports Medicine guidelines.
PRIMARY AND SECONDARY OUTCOME MEASURES
The main outcomes in this post hoc analysis were total abdominal adipose tissue (TAT), subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) measured by MRI. Secondary outcomes were to determine whether the magnitude of abdominal fat change differed by diabetes status in men and women and to identify the predictors of change in abdominal fat distribution with exercise.
RESULTS
Overall, participants (mean age 61±6 years; 45% women) significantly improved peak oxygen uptake by 15% (p<0.01) and reduced weight by 2% (p<0.01). No change in SAT was observed after training. The reduction in VAT following exercise was attenuated in participants with T2DM (-3%) compared with participants who were non-T2DM (-18%, p<0.001 for the difference in change). The magnitude of VAT loss was associated with a decrease in body weight (r=0.50, p<0.001). After adjustment for weight change using regression analysis, diabetes status remained an independent predictor of the change in VAT.
CONCLUSIONS
Although participants with and without T2DM attained an exercise training effect as evidenced by increased fitness, VAT was unchanged in T2DM compared to those without T2DM, suggesting that these individuals may be resistant to this important benefit of exercise. The strategies for reducing cardiovascular disease risk in T2DM may be most effective when they include a weight loss component.
CLINICAL TRIALS REGISTRATION
Clinicaltrials.gov Registry NCT00212303.
目的
研究运动对伴有和不伴有 2 型糖尿病（T2DM）的成年人腹部脂肪组织的影响。
设计
两项随机对照试验的事后分析。
地点
美国马里兰州巴尔的摩的门诊二级预防计划。
参与者
97 名患有高血压前期、1 期或经医学控制的高血压的男性和女性。该样本的 49%还被诊断患有 T2DM。
干预措施
所有参与者均按照美国运动医学学院的指南完成了 26 周（6.5 个月）的监督有氧运动和阻力运动计划。
主要和次要结果测量
本事后分析的主要结果是通过 MRI 测量的总腹部脂肪组织（TAT）、皮下脂肪组织（SAT）和内脏脂肪组织（VAT）。次要结果是确定男性和女性的糖尿病状态对腹部脂肪变化幅度的影响是否不同，并确定运动对腹部脂肪分布变化的预测因素。
结果
总体而言，参与者（平均年龄 61±6 岁；45%为女性）的峰值摄氧量显著提高了 15%（p<0.01），体重减轻了 2%（p<0.01）。训练后 SAT 没有变化。与非 T2DM 参与者（-18%，p<0.001）相比，T2DM 参与者的 VAT 减少量减少（-3%，p<0.001）。VAT 损失的幅度与体重下降相关（r=0.50，p<0.001）。使用回归分析调整体重变化后，糖尿病状态仍然是 VAT 变化的独立预测因子。
结论
尽管伴有和不伴有 T2DM 的参与者均表现出了运动训练的效果，表现为健康状况改善，但与无 T2DM 参与者相比，T2DM 参与者的 VAT 没有变化，这表明这些人可能对运动的这种重要益处具有抵抗力。在 T2DM 中，降低心血管疾病风险的策略可能最有效，当它们包括体重减轻成分时。
临床试验注册
Clinicaltrials.gov 注册号 NCT00212303。
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