BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan building C, 3590, Diepenbeek, Belgium.
REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan building A, 3590, Diepenbeek, Belgium.
Sports Med. 2019 Feb;49(2):255-268. doi: 10.1007/s40279-018-1003-4.
The effect of exercise on cardiac function/structure in type 2 diabetes mellitus (T2DM) with or without diabetic cardiomyopathy (DCM) is not yet completely understood. To date, results of studies have been controversial with variable outcomes due to the variety of exercise modalities.
The aim of the present review was to examine the impact of exercise intervention, and different types of exercise, on cardiac function and structure in T2DM through a systematic literature review, combining both pre-clinical and clinical studies.
A systematic literature search was performed on PubMed, Web of Science, and PEDro to identify studies up to 2 April 2018. Articles were included when well-defined exercise protocols were provided, and cardiac function in T2DM patients or validated animal models was examined.
In diabetic animals, improvements in both diastolic and systolic function through exercise therapy were mainly attributed to reduced collagen deposition. In T2DM patients, improvements were observed in diastolic function, but not consistently in systolic function, after endurance (and combined resistance) exercise training. Different exercise intervention modalities and exercise types seemed equally effective in improving cardiac structure and function.
Exercise training elicits significant improvements in diastolic function and beneficial remodeling in T2DM and DCM animal models, but not necessarily improvements in systolic function and left ventricular structure, regardless of exercise type. Therefore, exercise intervention should be a cornerstone in the treatment of T2DM patients not only to improve glycemic control but also to specifically enhance cardiac function.
运动对 2 型糖尿病（T2DM）伴或不伴糖尿病心肌病（DCM）患者心功能/结构的影响尚不完全清楚。迄今为止，由于运动方式的多样性，研究结果存在争议，且结果各不相同。
本综述旨在通过系统文献回顾，结合临床前和临床研究，检查运动干预及其不同类型对 T2DM 患者心功能和结构的影响。
在 PubMed、Web of Science 和 PEDro 上进行了系统的文献检索，以确定截至 2018 年 4 月 2 日的研究。当提供了明确的运动方案，并且检查了 T2DM 患者或经过验证的动物模型中心功能时，文章被纳入。
在糖尿病动物中，运动疗法主要通过减少胶原蛋白沉积来改善舒张和收缩功能。在 T2DM 患者中，耐力（和联合阻力）运动训练后，舒张功能得到改善，但收缩功能没有得到一致改善。不同的运动干预方式和运动类型似乎同样有效地改善心脏结构和功能。
运动训练可显著改善 T2DM 和 DCM 动物模型的舒张功能和有益重塑，但不一定改善收缩功能和左心室结构，无论运动类型如何。因此，运动干预应该成为 T2DM 患者治疗的基石，不仅可以改善血糖控制，还可以专门增强心功能。
