Ortega Juan Fernando, Hamouti Nassim, Fernández-Elías Valentín Emilio, Mora-Rodriguez Ricardo
Exercise Physiology Laboratory at Toledo, University of Castilla-La Mancha, Avda. Carlos III, s/n. 45071 Toledo, Spain.
Appl Physiol Nutr Metab. 2014 Jul;39(7):787-92. doi: 10.1139/apnm-2013-0507. Epub 2014 Apr 11.
The aim of the present study was to determine which of the available glucose tolerance tests (oral (OGTT) vs. intravenous (IVGTT)) could more readily detect the insulin sensitizing effects of a bout of continuous exercise. Ten healthy moderately fit young men (V̇O2peak of 45.4 ± 1.8 mL·kg(-1)·min(-1); age 27.5 ± 2.7 yr) underwent 4 OGTT and 4 IVGTT on different days following a standardized dinner and overnight fast. One test was performed immediately after 55 min of cycle-ergometer exercise at 60% V̇O2peak. Insulin sensitivity index was determined during a 50 min IVGTT according to Tura (CISI) and from a 120 min OGTT using the Matsuda composite index (MISI). After exercise, MISI improved 29 ± 10% without reaching statistical significance (p = 0.182) due to its low reproducibility (coefficient of variation 16 ± 3%; intra-class reliability 0.846). However, CISI significantly improved (50 ± 4%; p < 0.001) after exercise showing better reproducibility (coefficient of variation 13 ± 4%; intra-class reliability 0.955). Power calculation revealed that 6 participants were required for detecting the effects of exercise on insulin sensitivity when using IVGTT, whereas 54 were needed when using OGTT. The superior response of CISI compared with MISI suggests the preferential use of IVGTT to assess the effects of exercise on insulin sensitivity when using a glucose tolerance test.
本研究的目的是确定哪种可用的葡萄糖耐量试验（口服葡萄糖耐量试验（OGTT）与静脉葡萄糖耐量试验（IVGTT））能够更轻松地检测出一次持续运动的胰岛素增敏作用。十名健康、适度健康的年轻男性（峰值摄氧量为45.4±1.8 mL·kg⁻¹·min⁻¹；年龄27.5±2.7岁）在标准化晚餐和过夜禁食后的不同日子接受了4次OGTT和4次IVGTT。其中一次试验在以60%峰值摄氧量进行55分钟的自行车测力计运动后立即进行。根据图拉法在50分钟的IVGTT期间测定胰岛素敏感性指数（CISI），并使用松田综合指数（MISI）从120分钟的OGTT中测定。运动后，由于MISI的低重复性（变异系数16±3%；组内可靠性0.846），其提高了29±10%，但未达到统计学显著性（p = 0.182）。然而，运动后CISI显著提高（50±4%；p < 0.001），显示出更好的重复性（变异系数13±4%；组内可靠性0.955）。功效计算表明，使用IVGTT检测运动对胰岛素敏感性的影响需要6名参与者，而使用OGTT时则需要54名。与MISI相比，CISI的优越反应表明，在使用葡萄糖耐量试验评估运动对胰岛素敏感性的影响时，优先使用IVGTT。
