University of Chicago, Chicago, IL.
George Washington University Biostatistics Center, Rockville, MD.
Diabetes Care. 2019 Aug;42(8):1521-1529. doi: 10.2337/dc19-0538. Epub 2019 Jun 8.
We examined the relationship between habitual daily physical activity and measures of glucose tolerance, insulin sensitivity, and β-cell responses in adults with impaired glucose tolerance (IGT) or drug-naive, recently diagnosed type 2 diabetes.
Participants included 230 adults (mean ± SD age 54.5 ± 8.5 years, BMI 35 ± 5.5 kg/m; 42.6% women) who underwent a 3-h oral glucose tolerance test (OGTT) and hyperglycemic clamp. Wrist accelerometers worn for 7 consecutive days measured total physical activity counts (TAC) (daily mean 233,460 [∼50th percentile for age]). We evaluated whether TAC was associated with fasting plasma glucose, OGTT 2-h plasma glucose or glucose incremental area under the curve (G-iAUC), hyperglycemic clamp measures of insulin sensitivity (steady-state glucose infusion rate/insulin [M/I]) and β-cell responses (acute C-peptide response to glucose, steady-state C-peptide, and maximal β-cell response), and OGTT C-peptide index (ΔC-peptide/Δglucose).
After adjustments for confounders, there was no association of TAC with fasting plasma glucose, 2-h glucose, or G-iAUC. Higher TAC was associated with higher insulin sensitivity (M/I). After adjusting for M/I, higher TAC was not associated with measures of β-cell response.
In adults with IGT or drug-naive, recently diagnosed type 2 diabetes, higher levels of habitual physical activity are associated with higher insulin sensitivity. Further studies are needed to understand why higher levels of physical activity are not associated with better β-cell response.
我们研究了习惯性日常体力活动与葡萄糖耐量受损(IGT)或初诊 2 型糖尿病患者葡萄糖耐量、胰岛素敏感性和β细胞反应指标之间的关系。
参与者包括 230 名成年人(平均年龄 54.5 ± 8.5 岁,BMI 35 ± 5.5kg/m;女性占 42.6%),他们进行了 3 小时口服葡萄糖耐量试验(OGTT)和高血糖钳夹试验。连续 7 天佩戴手腕加速度计测量总体力活动计数(TAC)(每日平均 233460[接近年龄的 50%分位数])。我们评估了 TAC 是否与空腹血糖、OGTT 2 小时血糖或血糖增量曲线下面积(G-iAUC)、高血糖钳夹试验胰岛素敏感性(稳态血糖输注率/胰岛素[M/I])和β细胞反应(葡萄糖刺激的急性 C 肽反应、稳态 C 肽和最大β细胞反应)以及 OGTT C 肽指数(ΔC 肽/Δ葡萄糖)有关。
在调整混杂因素后,TAC 与空腹血糖、2 小时血糖或 G-iAUC 均无相关性。较高的 TAC 与更高的胰岛素敏感性相关(M/I)。在调整 M/I 后,较高的 TAC 与β细胞反应的指标无关。
在 IGT 或初诊 2 型糖尿病的成年人中,习惯性体力活动水平较高与胰岛素敏感性较高相关。需要进一步的研究来了解为什么较高的体力活动水平与更好的β细胞反应无关。