Collins Katherine A, Ross Leanna M, Slentz Cris A, Huffman Kim M, Kraus William E
Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
Sports Med Open. 2022 Jul 14;8(1):90. doi: 10.1186/s40798-022-00480-5.
As type 2 diabetes remains a leading cause of morbidity and mortality, identifying the most appropriate preventive treatment early in the development of disease is an important public health matter. In general, lifestyle interventions incorporating exercise and weight loss via caloric restriction improve cardiometabolic risk by impacting several key markers of insulin sensitivity and glucose homeostasis. However, variations in the effects of specific types of exercise interventions on these markers have led to conflicting results surrounding the optimal amount, intensity, and mode of exercise for optimal effects. Moreover, the addition of weight loss via caloric restriction to exercise interventions appears to differentially impact changes in body composition, metabolism, and insulin sensitivity compared to exercise alone. Determining the optimal amount, intensity, and mode of exercise having the most beneficial impact on glycemic status is both: (1) clinically important to provide guidelines for appropriate exercise prescription; and (2) physiologically important to understand the pathways by which exercise-with and without weight loss-impacts glycemic status to enhance precision lifestyle medicine. Thus, the purposes of this narrative review are to: (1) summarize findings from the three Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) randomized trials regarding the differential effects of exercise amount, intensity, and mode on insulin action and glucose homeostasis markers; and (2) compare the STRRIDE findings to other published dose-response exercise trials in order to piece together the various physiologic pathways by which specific exercise interventions-with or without weight loss-impact glycemic status.
由于2型糖尿病仍然是发病和死亡的主要原因，在疾病发展早期确定最适当的预防治疗方法是一项重要的公共卫生事务。一般来说，通过热量限制进行运动和减肥的生活方式干预，通过影响胰岛素敏感性和葡萄糖稳态的几个关键指标，改善心脏代谢风险。然而，特定类型的运动干预对这些指标的影响存在差异，导致围绕最佳运动量、强度和运动方式以获得最佳效果的结果相互矛盾。此外，与单纯运动相比，在运动干预中加入热量限制导致的体重减轻似乎对身体成分、代谢和胰岛素敏感性的变化有不同的影响。确定对血糖状态产生最有益影响的最佳运动量、强度和运动方式，在以下两方面都很重要：（1）在临床上很重要，可为适当的运动处方提供指导；（2）在生理上很重要，有助于理解运动（无论有无体重减轻）影响血糖状态的途径，以加强精准生活方式医学。因此，本叙述性综述的目的是：（1）总结三项通过明确运动降低目标风险干预研究（STRRIDE）随机试验中关于运动量、强度和运动方式对胰岛素作用和葡萄糖稳态指标的不同影响的研究结果；（2）将STRRIDE的研究结果与其他已发表的剂量反应运动试验进行比较，以便拼凑出特定运动干预（无论有无体重减轻）影响血糖状态的各种生理途径。
