Wang Lijun, Zhou Baihua, Li Xinying, Wang Yang, Yang Xiu Mei, Wang Hongwei, Yan Jun, Dong Jiakun
Department of Cardiology, Affiliated Zhongshan Hospital, Dalian University, Dalian 116001, China.
Department of Respiratory and Critical Care Medicine, Yueyang Second People's Hospital, Yueyang, Hunan, China.
Biosci Microbiota Food Health. 2022;41(3):112-120. doi: 10.12938/bmfh.2021-024. Epub 2022 Feb 21.
Recent research has confirmed that moderate-intensity exercise affects the gut microbiome composition and improves cardiac function in an animal model after myocardial infarction (MI). However, few studies have investigated the effects of exercise on glucose and lipid metabolism in patients with coronary heart disease (CHD) receiving a statin treatment and successful percutaneous coronary intervention (PCI). Meanwhile, since statin therapy may lead to the risk of an increase in blood glucose level in CHD patients, we hypothesized that moderate-intensity exercise may be helpful for regulating glucose-lipid metabolism and stabilizing the blood glucose level in CHD patients. Therefore, to confirm our conjecture, we conducted a clinical retrospective study and animal experiment, respectively. The clinical study involved a total of 501 statin-treated patients with CHD after PCI. According to the study protocol, patients were divided into the following three groups: a non-exercise group, exercise at the recommended standard group, and exercise not at the recommended standard group. We found that qualified moderate-intensity exercise decreased blood glucose and lipid levels at follow-up at a mean of 2.2 years, and the incidence of new-onset diabetes showed a downward trend compared with the non-exercise and exercise not at the recommended standard groups. Furthermore, we used a high-fat rat model to explore an additional mechanism of the beneficial effects of exercise-based management on glucose-lipid metabolism apart from the known mechanism. We used 16S rRNA high-throughput sequencing technology to analyze the changes induced by exercise in the composition of intestinal flora in experimental rats. We found that rats that exercised with or without statin administration had lower plasma glucose and lipid levels and that these parameters were higher in the control and statin-treated rats that did not exercise. These results were consistent with the human study. The results from high-throughput sequencing of the intestinal flora of rats showed, to the best of our knowledge, that exercise leads to an increased relative abundance of which contributes to improved glucose and lipid metabolism. Based on our current results, we suggest that moderate-intensity exercise can improve glucose and lipid metabolism and prevent statin treatment-related side effects, such as hyperglycemia, in patients after PCI. Exercise could facilitate the applicability of statins for lower lipid levels. Exercise training also provides additional benefits, such as alteration of the gut microbiota, which contributes to improved glucose and lipid metabolism.
近期研究证实，在心肌梗死（MI）动物模型中，中等强度运动可影响肠道微生物群组成并改善心脏功能。然而，很少有研究调查运动对接受他汀类药物治疗且成功进行经皮冠状动脉介入治疗（PCI）的冠心病（CHD）患者糖脂代谢的影响。同时，由于他汀类药物治疗可能会增加CHD患者血糖水平升高的风险，我们推测中等强度运动可能有助于调节CHD患者的糖脂代谢并稳定血糖水平。因此，为证实我们的猜想，我们分别进行了一项临床回顾性研究和动物实验。临床研究共纳入501例PCI术后接受他汀类药物治疗的CHD患者。根据研究方案，患者被分为以下三组：非运动组、达到推荐标准运动组和未达到推荐标准运动组。我们发现，合格的中等强度运动在平均2.2年的随访期内降低了血糖和血脂水平，与非运动组和未达到推荐标准运动组相比，新发糖尿病的发生率呈下降趋势。此外，我们使用高脂大鼠模型来探索运动管理对糖脂代谢有益作用的另一种机制，这一机制不同于已知机制。我们使用16S rRNA高通量测序技术分析运动对实验大鼠肠道菌群组成的影响。我们发现，无论是否给予他汀类药物，运动的大鼠血浆葡萄糖和脂质水平较低，而未运动的对照大鼠和接受他汀类药物治疗的大鼠这些参数较高。这些结果与人体研究一致。据我们所知，大鼠肠道菌群的高通量测序结果表明，运动导致 的相对丰度增加，这有助于改善糖脂代谢。基于我们目前的结果，我们建议中等强度运动可以改善PCI术后患者的糖脂代谢，并预防他汀类药物治疗相关的副作用，如高血糖。运动可以促进他汀类药物在降低血脂水平方面的适用性。运动训练还具有其他益处，如改变肠道微生物群，这有助于改善糖脂代谢。
