Stevens An L M, Hansen Dominique, Herbots Lieven, Wens Inez, Creemers An, Dendale Paul, Eijnde Bert O
Reval - Rehabilitation Research Center, Biomed - Biomedical Research Institute, Faculty of Medicine and Life Sciences (Ms Stevens and Drs Hansen, Dendale, Wens, and Eijnde) and I-BioStat (Dr Creemers), Hasselt University, Hasselt, Belgium; and Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium (Drs Hansen, Herbots, and Dendale).
J Cardiopulm Rehabil Prev. 2015 Jan-Feb;35(1):37-46. doi: 10.1097/HCR.0000000000000092.
Chronic heart failure (CHF) patients often present with (pre)diabetes, which negatively influences prognosis. Unlike the proven effect of exercise on glucose regulation in the general population, its effect in CHF is unclear. Therefore, this study aimed at investigating the effect of exercise training on glucose regulation in stable CHF patients.
Twenty-two CHF patients were randomized into training (EX, n = 15) and control (CON, n = 7) groups. Before and after a 12-week training intervention involving endurance and resistance training, glucose tolerance (2-hour oral glucose tolerance test), exercise tolerance (cardiopulmonary exercise test), muscle strength (isokinetic dynamometer), heart function (echocardiography), glycated hemoglobin, body composition (dual-energy x-ray absorptiometry), and quality of life (EQ5D) were assessed.
At baseline, glucose levels 2 hours after glucose intake were elevated in both groups. Whereas area under the glucose curve did not change, area under the insulin curve decreased following training (EX, -13 ± 23% vs CON, +22 ± 33%; P < .05). Changes in the ratio of mitral peak velocity of early filling/early diastolic mitral annular velocity and waist-to-hip fat mass ratio were related to changes in the insulin curve. Exercise training resulted in improved oxygen uptake at the second ventilatory threshold (EX, +10 ± 5% vs CON, -8 ± 5%; P < .05) and isokinetic strength endurance of the upper leg (EX, +25 ± 9% vs CON, -6 ± 5%; P < 0.05). Lean body tissue was increased by 2.2 ± 0.5% in EX versus 0.2 ± 0.6% in CON (P < .05).
Our data suggest that exercise training attenuates worsening of glucose regulation typically seen in a stable CHF population.
慢性心力衰竭（CHF）患者常伴有（预）糖尿病，这对预后产生负面影响。与运动对普通人群血糖调节的已证实效果不同，其在CHF患者中的作用尚不清楚。因此，本研究旨在调查运动训练对稳定型CHF患者血糖调节的影响。
22例CHF患者被随机分为训练组（EX，n = 15）和对照组（CON，n = 7）。在进行为期12周的耐力和阻力训练干预前后，评估葡萄糖耐量（2小时口服葡萄糖耐量试验）、运动耐量（心肺运动试验）、肌肉力量（等速测力计）、心功能（超声心动图）、糖化血红蛋白、身体成分（双能X线吸收法）和生活质量（EQ5D）。
基线时，两组患者摄入葡萄糖2小时后的血糖水平均升高。虽然葡萄糖曲线下面积未改变，但训练后胰岛素曲线下面积减少（EX组，-13±23% vs CON组，+22±33%；P <.05）。二尖瓣早期充盈峰值速度/二尖瓣环早期舒张速度比值和腰臀脂肪质量比的变化与胰岛素曲线的变化相关。运动训练导致第二通气阈值时摄氧量改善（EX组，+10±5% vs CON组，-8±5%；P <.05）以及大腿等速力量耐力提高（EX组，+25±9% vs CON组，-6±5%；P < 0.05）。EX组瘦体组织增加2.2±0.5%，而CON组增加0.2±0.（此处原文有误，应为0.2±0.6%）0.6%（P <.05）。
我们的数据表明，运动训练可减轻稳定型CHF患者中常见的血糖调节恶化情况。
