运动依从性与血红蛋白 A1c 变化之间存在显著的剂量反应关系。
Significant Dose-Response between Exercise Adherence and Hemoglobin A1c Change.
机构信息
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, CANADA.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, CANADA.
出版信息
Med Sci Sports Exerc. 2020 Sep;52(9):1960-1965. doi: 10.1249/MSS.0000000000002339.
INTRODUCTION
The Diabetes Aerobic and Resistance Exercise trial found that aerobic training and resistance training alone each reduced hemoglobin A1c (HbA1c) compared with nonexercising controls, and combined aerobic and resistance training caused greater HbA1c reduction than either training type alone. Our objective was to determine whether a dose-response relationship existed between frequency of exercise training and HbA1c change, and whether this varied by exercise modality or participant characteristics.
METHODS
Post hoc analysis of data from 185 Diabetes Aerobic and Resistance Exercise trial participants with type 2 diabetes randomized to aerobic, resistance or combined training thrice weekly. Dose-response relationships between adherence (percent of prescribed training sessions completed) and HbA1c change were assessed with linear regression.
RESULTS
Median overall adherence was 84.9% (interquartile range, 74.4%-93.6%). Higher exercise adherence was associated with greater HbA1c reduction; a 20% increase in adherence (e.g., an additional two sessions per month) was associated with a 0.15% (2 mmol·mol) decrease in HbA1c (β = -0.0076, R = -0.170, P = 0.021). Significant dose-response relationships were identified for aerobic (β = -0.0142, R = -0.313, P = 0.016) and combined training (β = -0.0109, R = -0.259, P = 0.041), but not resistance training (β = 0.0068, R = 0.153, P = 0.233). Dose-response relationships in all training groups combined were significant in subgroups younger than 55 yr (β = -0.0113, R = -0.286, P = 0.005), males (β = -0.0123, R = -0.234, P = 0.010), and baseline HbA1c ≥7.5% (58 mmol·mol) (β = -0.013, R = -0.263, P = 0.011).
CONCLUSIONS
There was a dose-response relationship between adherence to prescribed exercise and HbA1c reduction suggesting that glycemic control is improved more in individuals with type 2 diabetes with a higher training volume. Dose-response relationships existed for aerobic and combined training but not resistance training. These findings support aerobic and combined exercise prescriptions outlined in clinical practice guidelines.
简介
糖尿病有氧运动和抗阻运动试验发现，与不运动的对照组相比，单独的有氧运动和抗阻运动都能降低糖化血红蛋白（HbA1c），而有氧运动和抗阻运动的联合训练比任何一种训练方式都能更大程度地降低 HbA1c。我们的目的是确定运动训练频率与 HbA1c 变化之间是否存在剂量-反应关系，以及这种关系是否因运动方式或参与者特征而异。
方法
对 185 名 2 型糖尿病患者进行了糖尿病有氧运动和抗阻运动试验的事后分析，这些患者被随机分为有氧运动、抗阻运动或每周三次的联合训练组。采用线性回归评估与 HbA1c 变化相关的依从性（完成规定训练次数的百分比）的剂量-反应关系。
结果
总体依从性中位数为 84.9%（四分位间距，74.4%-93.6%）。较高的运动依从性与 HbA1c 降低幅度更大有关；依从性增加 20%（例如，每月增加两次训练）与 HbA1c 降低 0.15%（2 mmol·mol）（β=-0.0076，R=-0.170，P=0.021）有关。在有氧运动（β=-0.0142，R=-0.313，P=0.016）和联合训练（β=-0.0109，R=-0.259，P=0.041）中发现了显著的剂量-反应关系，但在抗阻训练中没有（β=0.0068，R=0.153，P=0.233）。在所有训练组中，年龄小于 55 岁（β=-0.0113，R=-0.286，P=0.005）、男性（β=-0.0123，R=-0.234，P=0.010）和基线 HbA1c≥7.5%（58 mmol·mol）（β=-0.013，R=-0.263，P=0.011）的亚组中，也存在剂量-反应关系。
结论
与规定的运动依从性和 HbA1c 降低之间存在剂量-反应关系，这表明 2 型糖尿病患者的训练量越大，血糖控制效果越好。在有氧运动和联合训练中存在剂量-反应关系，但在抗阻训练中不存在。这些发现支持临床实践指南中概述的有氧运动和联合运动处方。
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