Baptista Liliana C, Machado-Rodrigues Aristides M, Martins Raul A
Universidade de Coimbra- Faculdade de Ciências do Desporto e Educação Física.
Biol Sport. 2018 Dec;35(4):363-372. doi: 10.5114/biolsport.2018.78057. Epub 2018 Aug 31.
To establish the effect of three types of treatment - multicomponent exercise (MEX); the oral hypoglycaemic drug metformin (MET); combined therapy comprising exercise plus metformin (MEXMET) - on cardiovascular risk in older adults with type 2 diabetes (T2D) and with comorbidities in an early stage of the disease (HbA1c < 7.5%). A sample of 284 participants was evaluated for multifactorial cardiovascular risk at baseline and at 24-month intervention according to anthropometric and hemodynamic components, lipid profile, glycaemia and cardiorespiratory fitness (CRF). Participants underwent one of three conditions: MEX (n = 59), training in three sessions per week; MET (n = 30), using metformin 850 mg twice daily; MEXMET (n = 195), combining exercise and metformin. After the 24-month intervention MEX and MEXMET showed more positive results than MET therapy. MEX decreased body mass (BM; 4%), waist circumference (WC; 4%), body mass index (BMI; 3%), systolic blood pressure (SBP; 11%), diastolic blood pressure (DBP; 11%), triglycerides (21%), and glycaemia (12%), and increased cardiorespiratory fitness (CRF; 18%). Conversely, the MET group showed increased WC (2%), waist-to-hip ratio (WHR) (3%), and SBP (5%). Differences between MEX and MET groups presented large effect sizes for BM, WC, WHR, SBP, DBP and CRF, and moderate effect sizes for BMI and glycaemia. MEX was the most effective therapy in decreasing cardiovascular risk in the early stage of T2D in older adults with multimorbidity and attenuated the adverse effects of pharmacological therapy in MEXMET treatment.
为确定三种治疗方式——多组分运动（MEX）；口服降糖药二甲双胍（MET）；运动加二甲双胍联合治疗（MEXMET）——对患有2型糖尿病（T2D）且处于疾病早期（糖化血红蛋白<7.5%）并伴有合并症的老年人心血管风险的影响。根据人体测量和血液动力学指标、血脂谱、血糖和心肺适能（CRF），对284名参与者在基线和24个月干预时进行多因素心血管风险评估。参与者接受以下三种情况之一：MEX（n = 59），每周训练三次；MET（n = 30），每天两次服用850毫克二甲双胍；MEXMET（n = 195），运动与二甲双胍联合使用。24个月干预后，MEX和MEXMET组比MET治疗显示出更积极的结果。MEX降低了体重（BM；4%）、腰围（WC；4%）、体重指数（BMI；3%）、收缩压（SBP；11%）、舒张压（DBP；11%）、甘油三酯（21%）和血糖（12%），并提高了心肺适能（CRF；18%）。相反，MET组的WC增加了（2%）、腰臀比（WHR）增加了（3%）、SBP增加了（5%）。MEX组和MET组之间在BM、WC、WHR、SBP、DBP和CRF方面差异呈现出大效应量，在BMI和血糖方面呈现出中等效应量。MEX是降低患有多种合并症的老年人T2D早期心血管风险的最有效治疗方法，并减轻了MEXMET治疗中药理治疗的不良反应。
