高强度间歇训练在 2 型糖尿病患者代谢需求增加时保护心脏：一项随机对照试验。
High intensity interval training protects the heart during increased metabolic demand in patients with type 2 diabetes: a randomised controlled trial.
机构信息
Faculty of Medical Sciences, Cardiovascular Research Centre, Institutes of Cellular and Genetic Medicine, Newcastle University, 4th Floor William Leech Building M4.074, Newcastle upon Tyne, NE2 4HH, UK.
Department of Cardiology, Specialist Hospital for Diabetes Merkur, Vrnjacka Banja, Serbia.
出版信息
Acta Diabetol. 2019 Mar;56(3):321-329. doi: 10.1007/s00592-018-1245-5. Epub 2018 Nov 1.
AIM
The present study assessed the effect of high intensity interval training on cardiac function during prolonged submaximal exercise in patients with type 2 diabetes.
METHODS
Twenty-six patients with type 2 diabetes were randomized to a 12 week of high intensity interval training (3 sessions/week) or standard care control group. All patients underwent prolonged (i.e. 60 min) submaximal cardiopulmonary exercise testing (at 50% of previously assess maximal functional capacity) with non-invasive gas-exchange and haemodynamic measurements including cardiac output and stroke volume before and after the intervention.
RESULTS
At baseline (prior to intervention) there was no significant difference between the intervention and control group in peak exercise oxygen consumption (20.3 ± 6.1 vs. 21.7 ± 5.5 ml/kg/min, p = 0.21), and peak exercise heart rate (156.3 ± 15.0 vs. 153.8 ± 12.5 beats/min, p = 0.28). During follow-up assessment both groups utilized similar amount of oxygen during prolonged submaximal exercise (15.0 ± 2.4 vs. 15.2 ± 2.2 ml/min/kg, p = 0.71). However, cardiac function i.e. cardiac output during submaximal exercise decreased significantly by 21% in exercise group (16.2 ± 2.7-12.8 ± 3.6 L/min, p = 0.03), but not in the control group (15.7 ± 4.9-16.3 ± 4.1 L/min, p = 0.12). Reduction in exercise cardiac output observed in the exercise group was due to a significant decrease in stroke volume by 13% (p = 0.03) and heart rate by 9% (p = 0.04).
CONCLUSION
Following high intensity interval training patients with type 2 diabetes demonstrate reduced cardiac output during prolonged submaximal cardiopulmonary exercise testing. Ability of patients to maintain prolonged increased metabolic demand but with reduced cardiac output suggests cardiac protective role of high intensity interval training in type 2 diabetes.
TRIAL REGISTRATION
ISRCTN78698481. Registered 23 January 2013, retrospectively registered.
目的
本研究旨在评估高强度间歇训练对 2 型糖尿病患者在长时间亚极量运动中心脏功能的影响。
方法
26 例 2 型糖尿病患者被随机分为高强度间歇训练组（每周 3 次）或标准护理对照组。所有患者均进行长时间（即 60 分钟）亚极量心肺运动测试（以之前评估的最大功能能力的 50%），进行无创气体交换和血流动力学测量，包括干预前后的心输出量和每搏量。
结果
在基线（干预前）时，干预组和对照组在峰值运动耗氧量（20.3±6.1 与 21.7±5.5 ml/kg/min，p=0.21）和峰值运动心率（156.3±15.0 与 153.8±12.5 次/分钟，p=0.28）方面均无显著差异。在随访评估期间，两组在长时间亚极量运动中使用的氧气量相似（15.0±2.4 与 15.2±2.2 ml/min/kg，p=0.71）。然而，在亚极量运动中心脏功能，即心输出量，在运动组中显著下降了 21%（16.2±2.7-12.8±3.6 L/min，p=0.03），而在对照组中没有下降（15.7±4.9-16.3±4.1 L/min，p=0.12）。运动组心输出量的下降归因于每搏量显著下降 13%（p=0.03）和心率下降 9%（p=0.04）。
结论
在高强度间歇训练后，2 型糖尿病患者在长时间亚极量心肺运动测试中表现出心输出量降低。患者在维持长时间增加的代谢需求的同时，心输出量降低，提示高强度间歇训练对 2 型糖尿病具有心脏保护作用。
试验注册
ISRCTN78698481。2013 年 1 月 23 日注册，回顾性注册。
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