Abate Michele, Salini Vincenzo, Schiavone Cosima
Department of Medicine and Science of Aging, University G. d'Annunzio, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti Scalo, CH, Italy.
Aging Clin Exp Res. 2016 Apr;28(2):355-8. doi: 10.1007/s40520-015-0391-7. Epub 2015 Jun 10.
Exercise is an important therapeutic tool in the management of diabetes in older people. Aim of this study was to assess the relationship among type II diabetes, sport, overweight, and symptomatic Achilles tendinopathy in elderly subjects.
Thirty-eight patients suffering from Achilles tendinopathy and thirty-eight controls were enrolled. The prevalence of diabetes and sport practice as well as BMI and Glycated Hemoglobin (HbA1c) values were registered. An ultrasound evaluation of Achilles tendon was performed.
Patients showed an increased prevalence of diabetes (42 vs. 13.1 %, p = 0.004), and practice of sport (60.5 vs. 28.9 %, p = 0.0001), and higher BMI values (26.8 ± 3 vs. 24.8 ± 2.3, p = 0.001). Sonographic abnormalities, being diagnostic criteria, were present in all the patients with Achilles tendinopathy, but signs of degeneration were also found in 36.8 % of asymptomatic controls. Symptomatic subjects with diabetes, compared to those without, showed a higher prevalence of severe degeneration (75 vs. 36.3 %, p = 0.01). HbA1c values were significantly lower in sport practitioners, both diabetics and non-diabetics. Moreover, patients practicing sport showed a trend towards lower BMI values, compared to the sedentary counterpart.
Sport practice in elderly diabetics provides relevant metabolic advantages, reducing HbA1c and BMI. However, some sport activities (e.g., speed walking, jogging or tennis) can expose to the risk of Achilles tendinopathy. So, sport practice should be encouraged, but practitioners should follow individual training programs and be submitted to periodic sonographic controls.
运动是老年人糖尿病管理中的一项重要治疗手段。本研究旨在评估老年受试者中2型糖尿病、运动、超重与症状性跟腱病之间的关系。
招募了38例跟腱病患者和38例对照。记录糖尿病患病率、运动情况以及体重指数（BMI）和糖化血红蛋白（HbA1c）值。对跟腱进行超声评估。
患者中糖尿病患病率增加（42% 对13.1%，p = 0.004），运动情况更多（60.5% 对28.9%，p = 0.0001），且BMI值更高（26.8 ± 3对24.8 ± 2.3，p = 0.001）。作为诊断标准的超声异常在所有跟腱病患者中均存在，但在36.8%的无症状对照中也发现了退变迹象。有糖尿病的症状性受试者与无糖尿病的相比，严重退变的患病率更高（75% 对36.3%，p = 0.01）。运动者（包括糖尿病患者和非糖尿病患者）的HbA1c值显著更低。此外，与久坐不动者相比，进行运动的患者BMI值有降低趋势。
老年糖尿病患者进行运动可带来相关代谢益处，降低HbA1c和BMI。然而，一些体育活动（如快走、慢跑或网球）可能会增加跟腱病风险。因此，应鼓励运动，但运动者应遵循个性化训练计划并定期接受超声检查。
