Yangzhou University, 136 Jiangyang Road, Yangzhou, 225009 PR China.
Shaoyang University, Meizijing Campus, Xueyuan Road, Daxiang District, Shaoyang City, 422000 PR China.
Prim Care Diabetes. 2021 Apr;15(2):340-346. doi: 10.1016/j.pcd.2020.11.003. Epub 2020 Dec 10.
The pathophysiology of each phenotype of prediabetes is unique that promotes different levels of diabetes and cardiovascular disease risks. Exercise guidelines for individuals with prediabetes including both aerobic and resistance training could improve metabolic control, but its effects on different prediabetes subtypes are unclear. The aim of this explorative randomized controlled trial was to evaluate the effects of aerobic training (AT) or resistance training (RT) on glucose metabolism and lipid profile by different prediabetes subtypes with.
A randomized controlled trial in which 128 individuals with isolated impaired fasting glucose (i-IFG; n = 39), isolated impaired glucose tolerance (i-IGT; n = 29), combined glucose tolerance (CGI; n = 27) and isolated elevated HbA (n = 33) were randomly assigned to the control group, AT group and RT group, respectively. Supervised exercise training, including AT and RT were completed at moderate intensity for 60 min per day, three non-consecutive days per week for 12 months. The primary outcome was improvement in glucose metabolism. Secondary outcomes included measure of lipid profile and if these effects were moderated by the prediabetes phenotype.
Of the initial 128 participants, 118 finished the study, but all participants were included in the intention-to-treat analyses. The improvement in 2 h postprandial plasma glucose (2 hPG) between group difference (AT vs. RT) at 12 months was 0.87 (95% CI, -1.59 to-0.16; p < 0.05). Compared with RT group, AT significantly decreased the 2hPG in participants with i-IGT at 12 months (-1.66, 95% CI -3.04 to -0.28; p < 0.05).
AT program conferred benefits in improving 2 h PG and HbA compared with RT for prediabetes. These findings may moderate by prediabetes phenotype, and AT appeared more effective in i-IGT. A future trial with large sample size and long time follow up of prediabetes phenotype groups are needed.
每种糖尿病前期表型的病理生理学都是独特的，会导致不同程度的糖尿病和心血管疾病风险。针对糖尿病前期患者的运动指南包括有氧运动和抗阻训练，可以改善代谢控制，但对于不同的糖尿病前期亚型的效果尚不清楚。本探索性随机对照试验旨在评估有氧运动（AT）或抗阻运动（RT）对不同糖尿病前期亚型患者的葡萄糖代谢和血脂谱的影响。
这是一项随机对照试验，将 128 名单纯空腹血糖受损（i-IFG；n=39）、单纯糖耐量受损（i-IGT；n=29）、混合糖耐量受损（CGI；n=27）和单纯糖化血红蛋白升高（n=33）的个体随机分为对照组、AT 组和 RT 组。监督运动训练，包括 AT 和 RT，以中等强度进行，每天 60 分钟，每周非连续 3 天，持续 12 个月。主要结局是改善葡萄糖代谢。次要结局包括血脂谱的测量，如果这些效果受糖尿病前期表型的调节。
在最初的 128 名参与者中，有 118 名完成了研究，但所有参与者均纳入意向治疗分析。12 个月时，餐后 2 小时血糖（2 hPG）组间差异（AT 与 RT）的改善为 0.87（95%CI，-1.59 至-0.16；p<0.05）。与 RT 组相比，AT 组在 12 个月时明显降低了 i-IGT 患者的 2hPG（-1.66，95%CI，-3.04 至-0.28；p<0.05）。
与 RT 相比，AT 方案在改善 2 hPG 和糖化血红蛋白方面对糖尿病前期患者有益。这些发现可能受到糖尿病前期表型的调节，并且 AT 在 i-IGT 中更有效。需要对糖尿病前期表型组进行更大样本量和更长时间随访的未来试验。
