Philippe Marc, Gatterer Hannes, Eder Erika Maria, Dzien Alexander, Somavilla Matthias, Melmer Andreas, Ebenbichler Christoph, Müller Tom, Burtscher Martin
Department of Sports Medicine, Institute of Sports Sciences, Justus-Liebig-University, Giessen, Germany; Department of Sport Science, Medical Section, University of Innsbruck, Innsbruck, Austria.
Department of Sport Science, Medical Section, University of Innsbruck , Innsbruck, Austria.
J Sports Sci Med. 2017 Mar 1;16(1):35-43. eCollection 2017 Mar.
The prevention of type 2 diabetes in persons at risk for diabetes is of utmost importance. Physical activity in general and even exercises at moderate intensities such as walking significantly reduce the risk of the development of type 2 diabetes. However, it is still a matter of debate whether lipids and glucose metabolism are differently affected by regular concentric (e.g., uphill walking) and eccentric (e.g., downhill walking) endurance exercise. The aim of this study was to investigate the effects of short-term (3 weeks) uphill and downhill walking on glucose metabolism and blood lipids in pre-diabetic middle-aged men in a real world setting. The study was designed as an investigator-initiated 2 group random selection pre-test post-test trial. Sixteen pre-diabetic men (age: 56.9 ± 5.1 years; BMI: 28.1 ± 2.3 kg·m) performed 9 uphill (n = 8) or 9 downhill (n = 8) walking sessions within 3 weeks. The primary outcomes were the markers of glucose metabolism and blood lipids measured before and after the training period. After uphill walking glucose tolerance (area under the curve of the oral glucose tolerance test: -43.25 ± 53.12 mg·dl; p = 0.05; effect size: 0.81), triglycerides (-48.75 ± 54.49 mg·dl; p = 0.036; effect size: 0.89), HDL-C (+7.86 ± 9.54 mg·dl; p = 0.05; effect size: 0.82) and total cholesterol/HDL-C ratio (-0.58 ± 0.41; p = 0.012; effect size: 1.39) had significantly improved. No significant metabolic adaptations were found after downhill walking. However, when adjusted for estimated energy expenditure, uphill and downhill walking had equal effects on almost all metabolic parameters. Moreover, the magnitude of the baseline impairments of glucose tolerance was significantly related to the extent of change in both groups. Depending on the fitness level and individual preferences both types of exercise may be useful for the prevention of type 2 diabetes and disorders in lipid metabolism.
预防糖尿病高危人群患2型糖尿病至关重要。一般的体育活动，甚至如步行这种中等强度的运动，都能显著降低患2型糖尿病的风险。然而，规律的向心运动（如爬坡行走）和离心运动（如下坡行走）耐力训练对脂质和葡萄糖代谢的影响是否存在差异仍存在争议。本研究的目的是在现实环境中，调查短期（3周）爬坡和下坡行走对糖尿病前期中年男性葡萄糖代谢和血脂的影响。该研究设计为一项由研究者发起的两组随机选择的前测后测试验。16名糖尿病前期男性（年龄：56.9±5.1岁；体重指数：28.1±2.3kg·m）在3周内进行了9次爬坡（n = 8）或9次下坡（n = 8）行走训练。主要结局指标是训练期前后测量的葡萄糖代谢和血脂指标。爬坡行走后，葡萄糖耐量（口服葡萄糖耐量试验曲线下面积：-43.25±53.12mg·dl；p = 0.05；效应量：0.81）、甘油三酯（-48.75±54.49mg·dl；p = 0.036；效应量：0.89）、高密度脂蛋白胆固醇（HDL-C）（+7.86±9.54mg·dl；p = 0.05；效应量：0.82）和总胆固醇/HDL-C比值（-0.58±0.41；p = 0.012；效应量：1.39）均有显著改善。下坡行走后未发现明显的代谢适应性变化。然而，在根据估计的能量消耗进行调整后，爬坡和下坡行走对几乎所有代谢参数的影响相同。此外，葡萄糖耐量的基线损害程度与两组的变化程度显著相关。根据健康水平和个人偏好，这两种运动类型可能都有助于预防2型糖尿病和脂质代谢紊乱。
