Center for Human Nutrition, Washington University School of Medicine, St Louis, MO, USA.
Center for Human Nutrition, Washington University School of Medicine, St Louis, MO, USA; Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Cell Metab. 2022 Oct 4;34(10):1431-1441.e5. doi: 10.1016/j.cmet.2022.08.012. Epub 2022 Sep 8.
Lifestyle therapy (energy restriction and exercise) is the cornerstone of therapy for people with type 2 diabetes (T2D) but is difficult to implement. We conducted an 8-month randomized controlled trial in persons with obesity and T2D (17 women and 1 man) to determine the therapeutic effects and potential mechanisms of intensive lifestyle therapy on cardiometabolic function. Intensive lifestyle therapy was conducted at the worksite to enhance compliance and resulted in marked (17%) weight loss and beneficial changes in body fat mass, intrahepatic triglyceride content, cardiorespiratory fitness, muscle strength, glycemic control, β cell function, and multi-organ insulin sensitivity, which were associated with changes in muscle NAD biosynthesis, sirtuin signaling, and mitochondrial function and in adipose tissue remodeling. These findings demonstrate that intensive lifestyle therapy provided at the worksite has profound therapeutic clinical and physiological effects in people with T2D, which are likely mediated by specific alterations in skeletal muscle and adipose tissue biology.
生活方式疗法（能量限制和运动）是 2 型糖尿病（T2D）患者治疗的基石，但实施起来很困难。我们对肥胖和 T2D 患者（17 名女性和 1 名男性）进行了为期 8 个月的随机对照试验，以确定强化生活方式疗法对心脏代谢功能的治疗效果和潜在机制。强化生活方式疗法在工作场所进行，以提高依从性，导致体重显著减轻（17%），体脂质量、肝内甘油三酯含量、心肺适应性、肌肉力量、血糖控制、β 细胞功能和多器官胰岛素敏感性都得到了有益的改善，这与肌肉 NAD 生物合成、沉默信息调节因子信号和线粒体功能以及脂肪组织重塑的变化有关。这些发现表明，在工作场所提供的强化生活方式疗法对 T2D 患者具有深远的治疗临床和生理影响，这可能是通过特定的骨骼肌和脂肪组织生物学改变介导的。
