Jin Heung Yong, Lee Kyung Ae, Park Tae Sun
Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University, Medical School, 634-18, Keum-Am Dong, Jeonju, 561-712, South Korea.
Endocrine. 2015 Apr;48(3):826-33. doi: 10.1007/s12020-014-0422-8. Epub 2014 Sep 25.
The exact effectiveness of supportive care activities, such as exercise, in diabetes patients has yet to be elucidated in the diabetic peripheral neuropathy (DPN) field. Therefore, this study was designed to investigate the effect of regular exercise on the peripheral nerves of streptozotocin-induced diabetic rats. The animals were divided as follows into six groups according to exercise combination and glucose control: Normal group, normal group with exercise (EXE), diabetic group (DM), DM group with EXE, DM+glucose control with insulin (INS), and DM+INS+EXE. Animals in the exercise groups were made to walk on a treadmill machine everyday for 30 min at a setting of 8 m/min without inclination. After 8 weeks, sensory parameters were evaluated, and after 16 weeks, biochemicals and peripheral nerves were quantified by immunohistochemistry and compared among experimental groups. The resulting data showed that fasting blood glucose levels and HbA1c levels were not influenced significantly by exercise in normal and DM groups. However, the current perception threshold and the von Frey stimulation test revealed higher thresholds in the DM+INS+EXE group than in the DM+INS group (P<0.05). Significantly lower thresholds were observed in untreated DM groups (DM or DM+EXE) compared to the normal and insulin-treated DM groups (P<0.05). Intra-epidermal nerve fiber density was reduced in a lesser degree in the DM+INS+EXE group than in the DM+INS group (9.8±0.4 vs. 9.1±0.5, P<0.05). Exercise alone was not associated with a significant protective effect on the peripheral nerve in the normal or DM groups; however, a beneficial effect from exercise was observed when hyperglycemia was controlled with insulin in the DM group. These findings suggest that exercise has a potential protective effect against DPN based on the preferential effort for glucose control, although exercise alone cannot prevent peripheral nerve damage from hyperglycemia.
在糖尿病周围神经病变（DPN）领域，诸如运动等支持性护理活动对糖尿病患者的确切疗效尚未阐明。因此，本研究旨在调查规律运动对链脲佐菌素诱导的糖尿病大鼠周围神经的影响。根据运动组合和血糖控制情况，将动物分为以下六组：正常组、运动正常组（EXE）、糖尿病组（DM）、运动糖尿病组（DM+EXE）、糖尿病+胰岛素血糖控制组（INS）以及糖尿病+胰岛素+运动组（DM+INS+EXE）。运动组的动物每天在跑步机上以8米/分钟的速度无倾斜地行走30分钟。8周后，评估感觉参数，16周后，通过免疫组织化学对生化指标和周围神经进行定量，并在各实验组之间进行比较。结果数据显示，正常组和糖尿病组的空腹血糖水平和糖化血红蛋白水平不受运动的显著影响。然而，电流感觉阈值和von Frey刺激试验显示，糖尿病+胰岛素+运动组的阈值高于糖尿病+胰岛素组（P<0.05）。与正常组和胰岛素治疗的糖尿病组相比，未治疗的糖尿病组（DM或DM+EXE）的阈值显著更低（P<0.05）。糖尿病+胰岛素+运动组的表皮内神经纤维密度降低程度低于糖尿病+胰岛素组（9.8±0.4对9.1±0.5，P<0.05）。单独运动对正常组或糖尿病组的周围神经无显著保护作用；然而，当糖尿病组用胰岛素控制高血糖时，观察到运动有有益效果。这些发现表明，尽管单独运动不能预防高血糖引起的周围神经损伤，但基于对血糖控制的优先作用，运动对糖尿病周围神经病变具有潜在的保护作用。
