Gallo-Villegas Jaime, Aristizabal Juan Carlos, Estrada Mauricio, Valbuena Luis H, Narvaez-Sanchez Raul, Osorio Jorge, Aguirre-Acevedo Daniel C, Calderón Juan C
GRINMADE Group, University of Antioquia, Medellín, Colombia.
Epidemiology Group, University of Antioquia, Medellín, Colombia.
Trials. 2018 Feb 27;19(1):144. doi: 10.1186/s13063-018-2541-7.
Evidence of the efficacy of high-intensity, low-volume interval training (HIIT-low volume) in treating insulin resistance (IR) in patients with metabolic disorders is contradictory. In addition, it is unknown whether this effect is mediated through muscle endocrine function, which in turn depends on muscle mass and fiber type composition. Our aims were to assess the efficacy of HIIT-low volume compared to continuous aerobic exercise (CAE) in treating IR in adults with metabolic syndrome (MS) and to establish whether musclin, apelin, muscle mass and muscle composition are mediators of the effect.
This is a controlled, randomized, clinical trial using the minimization method, with blinding of those who will evaluate the outcomes and two parallel groups for the purpose of showing superiority. Sixty patients with MS and IR with ages between 40 and 60 years will be included. A clinical evaluation will be carried out, along with laboratory tests to evaluate IR (homeostatic model assessment (HOMA)), muscle endocrine function (serum levels of musclin and apelin), thigh muscle mass (by dual energy x-ray absorptiometry (DXA) and thigh muscle composition (by carnosine measurement with proton magnetic resonance spectroscopy (H-MRS)), before and after 12 weeks of a treadmill exercise program three times a week. Participants assigned to the intervention (n = 30) will receive HIIT-low volume in 22-min sessions that will include six intervals at a load of 90% of maximum oxygen consumption (VO max) for 1 min followed by 2 min at 50% of VO max. The control group (n = 30) will receive CAE at an intensity of 60% of VO max for 36 min. A theoretical model based on structural equations will be proposed to estimate the total, direct and indirect effects of training on IR and the proportion explained by the mediators.
Compared with CAE, HIIT-low volume can be effective and efficient at improving physical capacity and decreasing cardiovascular risk factors, such as IR, in patients with metabolic disorders. Studies that evaluate mediating variables of the effect of HIIT-low volume on IR, such as endocrine function and skeletal muscle structure, are necessary to understand the role of skeletal muscle in the pathophysiology of MS and their regulation by exercise.
NCT03087721 . High-intensity Interval, Low Volume Training in Metabolic Syndrome (Intraining-MET). Registered on 22 March 2017, retrospectively registered.
高强度、低容量间歇训练（HIIT - 低容量）治疗代谢紊乱患者胰岛素抵抗（IR）疗效的证据相互矛盾。此外，尚不清楚这种效应是否通过肌肉内分泌功能介导，而肌肉内分泌功能又取决于肌肉质量和纤维类型组成。我们的目的是评估HIIT - 低容量与持续有氧运动（CAE）相比治疗成人代谢综合征（MS）患者IR的疗效，并确定肌肉素、Apelin、肌肉质量和肌肉组成是否为该效应的介导因素。
这是一项采用最小化法的对照、随机临床试验，对评估结果的人员进行盲法处理，并设两个平行组以显示优越性。将纳入60例年龄在40至60岁之间的MS和IR患者。在每周三次的跑步机运动计划进行12周前后，将进行临床评估以及实验室检测，以评估IR（稳态模型评估（HOMA））、肌肉内分泌功能（肌肉素和Apelin的血清水平）、大腿肌肉质量（通过双能X线吸收法（DXA））和大腿肌肉组成（通过质子磁共振波谱法（H - MRS）测量肌肽）。分配到干预组（n = 30）的参与者将接受22分钟的HIIT - 低容量训练，包括六个间歇，每个间歇在最大耗氧量（VO₂max）的90%负荷下进行1分钟，然后在VO₂max的50%负荷下进行2分钟。对照组（n = 30）将接受以VO₂max的60%强度进行36分钟的CAE训练。将提出一个基于结构方程的理论模型，以估计训练对IR的总效应、直接效应和间接效应以及介导因素所解释的比例。
与CAE相比，HIIT - 低容量在改善代谢紊乱患者的体能和降低心血管危险因素（如IR）方面可能既有效又高效。有必要开展研究评估HIIT - 低容量对IR影响的介导变量，如内分泌功能和骨骼肌结构，以了解骨骼肌在MS病理生理学中的作用及其受运动调节的情况。
NCT03087721。代谢综合征中的高强度间歇、低容量训练（Intraining - MET）。于2017年3月22日注册，追溯注册。
