有氧运动和抗阻运动对降低糖尿病前期患者心血管疾病风险的效果：一项多中心随机对照试验。
Effects of aerobic training and resistance training in reducing cardiovascular disease risk for patients with prediabetes: A multi-center randomized controlled trial.
机构信息
Hainan General Hospital, Haikou, Hainan, China; Jiangsu College of Nursing, Huai'an, Jiangsu, China.
Huai'an Hospital Affiliated to Nanjing Medical University, China.
出版信息
Prim Care Diabetes. 2021 Dec;15(6):1063-1070. doi: 10.1016/j.pcd.2021.08.013. Epub 2021 Oct 11.
AIMS
Aerobic training (AT) and resistance training (RT) can reduce blood glucose and type 2 diabetes risk, and increase muscle mass for prediabetes patients. However, the impact of long-term AT and RT on cardiovascular disease (CVD) risk remains unclear. The purpose of this study was to investigate the impact of AT and RT on CVD risk reduction in prediabetes patients.
MATERIALS AND METHODS
248 prediabetes patients were enrolled in this multi-center randomized controlled trial (RCT). Patients were randomly divided into 3 groups: RT (n = 82), aerobic training (AT (n = 83)), and control group (n = 83). Participants in RT and AT groups had moderate RT or AT 3 times a week (150 min/week) under supervision in 3 research centers for 24 months. Primary outcome was CVD risk measured by Framingham Risk Score (FRS) and The Chinese 10-year ischemic cardiovascular disease (ICVD) risk assessment tool. Secondary outcomes included in HOMA2-IR, HbA1c, blood pressure and serum lipid profile.
RESULTS
Both RT and AT groups experienced a significant reduction in HOMA2-IR, HbA1c, LDL-C, TC, SBP, and DBP at the end of 12 and 24 months. Compared to the control group, Both RT and AT groups had significant reduction of the Chinese 10-year ICVD risk (P < 0.05), but FRS CVD risk declined significantly only in the AT group (all P < 0.05). Although FRS CVD risk decreased more in the RT group than in the control group, the difference was not statistically significant. After adjusting for age, gender, statin use, BMI, and WHR, in COX's proportional hazard model, RT (HR = 0.419, P = 0.037) and AT (HR = 0.310, P = 0.026) were protective factors for CVD risk in prediabetes patients. 24-month RT and AT decreased respectively 58.1% and 69.0% of CVD risk (10-year ICVD risk assessment) in prediabetes patients.
CONCLUSIONS
This study demonstrated that 24-month moderate AT reduces the Chinese 10-year ICVD risk and FRS CVD risk in prediabetes patients. RT groups had significant reduction of CVD risk (10-year ICVD risk assessment) in prediabetes patients.
TRIAL REGISTRATION
Clinical trial registration number: NCT02561377.
DATE OF REGISTRATION
24/09/2015.
目的
有氧运动训练（AT）和抗阻运动训练（RT）可降低血糖和 2 型糖尿病风险，并增加糖尿病前期患者的肌肉量。然而，长期 AT 和 RT 对心血管疾病（CVD）风险的影响仍不清楚。本研究旨在探讨 AT 和 RT 对糖尿病前期患者 CVD 风险降低的影响。
材料和方法
本研究纳入了 248 例糖尿病前期患者，采用多中心随机对照试验（RCT）方法。患者被随机分为 3 组：RT 组（n=82）、有氧运动组（AT 组，n=83）和对照组（n=83）。RT 和 AT 组的参与者在 3 个研究中心接受监督，每周进行 3 次中等强度的 RT 或 AT（150 分钟/周），持续 24 个月。主要结局指标为Framingham 风险评分（FRS）和中国 10 年缺血性心血管疾病（ICVD）风险评估工具评估的 CVD 风险。次要结局指标包括 HOMA2-IR、HbA1c、血压和血清脂质谱。
结果
RT 和 AT 组在 12 个月和 24 个月时 HOMA2-IR、HbA1c、LDL-C、TC、SBP 和 DBP 均显著降低。与对照组相比，RT 和 AT 组的中国 10 年 ICVD 风险均显著降低（P<0.05），但仅 AT 组的 FRS CVD 风险显著降低（均 P<0.05）。尽管 RT 组的 FRS CVD 风险降低幅度大于对照组，但差异无统计学意义。在调整年龄、性别、他汀类药物使用、BMI 和 WHR 后，在 COX 比例风险模型中，RT（HR=0.419，P=0.037）和 AT（HR=0.310，P=0.026）是糖尿病前期患者 CVD 风险的保护因素。24 个月的 RT 和 AT 分别降低了糖尿病前期患者 CVD 风险（中国 10 年 ICVD 风险评估）的 58.1%和 69.0%。
结论
本研究表明，24 个月的中等强度 AT 可降低糖尿病前期患者的中国 10 年 ICVD 风险和 FRS CVD 风险。RT 组糖尿病前期患者的 CVD 风险（中国 10 年 ICVD 风险评估）显著降低。
试验注册
临床试验注册号：NCT02561377。
注册日期
2015 年 9 月 24 日。
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