Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy.
Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy; Laboratory of Clinical Chemistry, Sant'Andrea Hospital, Rome, Italy.
Diabetes Res Clin Pract. 2015 Aug;109(2):355-63. doi: 10.1016/j.diabres.2015.05.033. Epub 2015 May 18.
This study evaluated the effect of supervised exercise training on liver enzymes and two surrogate measures of non-alcoholic fatty liver disease (NAFLD) in subjects with type 2 diabetes.
Sedentary patients from 22 outpatient diabetes clinics were randomized by center, age and treatment to twice-a-week supervised aerobic and resistance training plus structured exercise counseling (exercise group, EXE; n=303) versus counseling alone (control group, CON; n=303) for 12 months. EXE participants were further randomized to low-to-moderate (n=142) or moderate-to-high (n=161) intensity training of equal energy cost. Baseline and end-of-study levels of liver enzymes, fatty liver index (FLI) and visceral adiposity index (VAI) were obtained.
Enzyme levels did not change, whereas FLI and VAI decreased significantly in EXE, but not CON participants. Physical activity (PA) volume was an independent predictor of both FLI and VAI reductions, the extent of which increased from the 1st to the 4th quintile of PA volume and baseline to end-of-study changes in fitness parameters. Differences in the effect of LI versus HI training were negligible.
Data from this large cohort of subjects with type 2 diabetes indicate that FLI and VAI decrease with supervised training in a volume-dependent manner.
本研究评估了监督运动训练对 2 型糖尿病患者肝酶和两种非酒精性脂肪肝（NAFLD）替代指标的影响。
22 个门诊糖尿病诊所的久坐患者按中心、年龄和治疗方案随机分为每周两次监督有氧运动和抗阻训练加结构化运动咨询（运动组，EXE；n=303）与单独咨询（对照组，CON；n=303），持续 12 个月。EXE 参与者进一步随机分为低-中（n=142）或中-高（n=161）强度训练，能量消耗相等。获得基线和研究结束时的肝酶、脂肪肝指数（FLI）和内脏脂肪指数（VAI）水平。
酶水平没有变化，而 FLI 和 VAI 在 EXE 中显著降低，但在 CON 参与者中没有。体力活动（PA）量是 FLI 和 VAI 降低的独立预测因素，从 PA 量的第 1 到第 4 五分位数以及从基线到研究结束时的体能参数变化，这种降低的程度都在增加。LI 与 HI 训练效果的差异可以忽略不计。
本研究中 2 型糖尿病患者的大量数据表明，FLI 和 VAI 随监督训练呈体积依赖性降低。
