Nieuwoudt Stephan, Fealy Ciarán E, Foucher Julie A, Scelsi Amanda R, Malin Steven K, Pagadala Mangesh, Rocco Michael, Burguera Bartolome, Kirwan John P
Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio.
Am J Physiol Endocrinol Metab. 2017 Sep 1;313(3):E314-E320. doi: 10.1152/ajpendo.00407.2016. Epub 2017 May 16.
Type 2 diabetes (T2D) is characterized by reductions in β-cell function and insulin secretion on the background of elevated insulin resistance. Aerobic exercise has been shown to improve β-cell function, despite a subset of T2D patients displaying "exercise resistance." Further investigations into the effectiveness of alternate forms of exercise on β-cell function in the T2D patient population are needed. We examined the effect of a novel, 6-wk CrossFit functional high-intensity training (F-HIT) intervention on β-cell function in 12 sedentary adults with clinically diagnosed T2D (54 ± 2 yr, 166 ± 16 mg/dl fasting glucose). Supervised training was completed 3 days/wk, comprising functional movements performed at a high intensity in a variety of 10- to 20-min sessions. All subjects completed an oral glucose tolerance test and anthropometric measures at baseline and following the intervention. The mean disposition index, a validated measure of β-cell function, was significantly increased (PRE: 8.4 ± 3.1, POST: 11.5 ± 3.5, = 0.02) after the intervention. Insulin processing inefficiency in the β-cell, expressed as the fasting proinsulin-to-insulin ratio, was also reduced (PRE: 2.40 ± 0.37, POST: 1.78 ± 0.30, = 0.04). Increased β-cell function during the early-phase response to glucose correlated significantly with reductions in abdominal body fat ( = 0.56, = 0.005) and fasting plasma alkaline phosphatase ( = 0.55, = 0.006). Mean total body-fat percentage decreased significantly (Δ: -1.17 0.30%, = 0.003), whereas lean body mass was preserved (Δ: +0.05 ± 0.68 kg, = 0.94). We conclude that F-HIT is an effective exercise strategy for improving β-cell function in adults with T2D.
2型糖尿病（T2D）的特征是在胰岛素抵抗升高的背景下β细胞功能和胰岛素分泌减少。尽管一部分T2D患者表现出“运动抵抗”，但有氧运动已被证明可改善β细胞功能。需要进一步研究其他形式的运动对T2D患者群体β细胞功能的有效性。我们研究了一种新颖的、为期6周的CrossFit功能性高强度训练（F-HIT）干预对12名临床诊断为T2D的久坐不动成年人（54±2岁，空腹血糖166±16mg/dl）β细胞功能的影响。监督训练每周进行3天，包括在各种10至20分钟的训练中进行高强度的功能性动作。所有受试者在基线和干预后均完成了口服葡萄糖耐量试验和人体测量。干预后，经验证的β细胞功能指标平均处置指数显著增加（干预前：8.4±3.1，干预后：11.5±3.5，P=0.02）。以空腹胰岛素原与胰岛素比值表示的β细胞胰岛素加工效率低下也有所降低（干预前：2.40±0.37，干预后：1.78±0.30，P=0.04）。葡萄糖早期反应期间β细胞功能的增加与腹部体脂减少（r=0.56，P=0.005）和空腹血浆碱性磷酸酶降低（r=0.55，P=0.006）显著相关。平均全身脂肪百分比显著下降（Δ：-1.17±0.30%，P=0.003），而瘦体重保持不变（Δ：+0.05±0.68kg，P=0.94）。我们得出结论，F-HIT是改善T2D成年人β细胞功能的有效运动策略。
