Department of Radiation, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Pediatrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Ann Palliat Med. 2021 May;10(5):5366-5372. doi: 10.21037/apm-21-773. Epub 2021 May 12.
Peripheral artery disease (PAD) is a common chronic complication of type 2 diabetes (T2DM). This study sought to evaluate the effect of supervised exercise therapy (SET) on patients with PAD complicated with T2DM, and to assess the effect of changes in sedentary time on the results of SET treatment.
A total of 100 PAD patients who were treated in our hospital from January 2019 to October 2020 were included, and the age, gender, body mass index (BMI), hypertension, smoking, and ankle brachial index (ABI) were collected. The patients were required to complete SET treatment 2-3 times a week for 12 weeks. Subsequently, the objective 6-minute walk test (6MWT) and Short Physical Performance Battery (SPPB) were used to assess body function. After adjusting for other key confounding variables such as age, gender, and smoking status, linear regression analysis was used to evaluate the effects of changes in sedentary time on the total distance of the 6MWT.
After 12 weeks of treatment, the total SPPB score of the patients increased from a baseline of 9.3±2.7 to 10.1±2.3 (P=0.025), the normal walking distance in the 6MWT increased from 108.9±26.8 to 148.9±29.5 m (P<0.001), the total walking distance increased from 322.5±93.4 to 348.5±86.1 m (P=0.042), and at the same time, the metabolic equivalent on the treadmill increased from 2.6±0.7 to 3.9±1.4 (P<0.001). Compared with the baseline data, the proportion of time that patients spent engaged in mild physical activity at 6 weeks increased by 20%±10% (P=0.003), and the average daily sedentary time decreased by 6.5±2.8 minutes (P=0.008), or by 3.1%±2.1% (P=0.04). Furthermore, compared with the baseline, the proportion of time that patients spent engaged in light and moderate physical activity at 12 weeks increased by 10%±3% (P=0.007) and 20%±10% (P=0.006), respectively, while the average sedentary time per day reduced by 6.8±3.1 minutes (P=0.03), or by 3.6%±1.8% (P=0.005).
The reduction of sedentary time can significantly improve the effectiveness of exercise therapy in patients with PAD complicated by T2DM, and compared with patients with PAD alone, the improvement in patients complicated with T2DM is more significant.
外周动脉疾病（PAD）是 2 型糖尿病（T2DM）的常见慢性并发症。本研究旨在评估监督运动疗法（SET）对 PAD 合并 T2DM 患者的影响，并评估久坐时间变化对 SET 治疗结果的影响。
纳入我院 2019 年 1 月至 2020 年 10 月期间治疗的 100 名 PAD 患者，收集年龄、性别、体重指数（BMI）、高血压、吸烟和踝肱指数（ABI）等信息。患者需要每周完成 2-3 次 SET 治疗，共 12 周。随后，使用客观的 6 分钟步行测试（6MWT）和短体功表现电池（SPPB）评估身体功能。在调整年龄、性别和吸烟状况等其他关键混杂变量后，使用线性回归分析评估久坐时间变化对 6MWT 总距离的影响。
治疗 12 周后，患者的总 SPPB 评分从基线的 9.3±2.7 增加到 10.1±2.3（P=0.025），6MWT 中正常步行距离从 108.9±26.8 增加到 148.9±29.5m（P<0.001），总步行距离从 322.5±93.4 增加到 348.5±86.1m（P=0.042），同时跑步机上的代谢当量从 2.6±0.7 增加到 3.9±1.4（P<0.001）。与基线数据相比，患者在 6 周时轻度体力活动的时间比例增加了 20%±10%（P=0.003），平均每日久坐时间减少了 6.5±2.8 分钟（P=0.008），或减少了 3.1%±2.1%（P=0.04）。此外，与基线相比，患者在 12 周时轻、中度体力活动的时间比例分别增加了 10%±3%（P=0.007）和 20%±10%（P=0.006），而每天的平均久坐时间减少了 6.8±3.1 分钟（P=0.03），或减少了 3.6%±1.8%（P=0.005）。
减少久坐时间可以显著提高运动疗法对 PAD 合并 T2DM 患者的疗效，与单纯 PAD 患者相比，T2DM 合并患者的改善更为显著。
