Balducci Stefano, Haxhi Jonida, Vitale Martina, Mattia Lorenza, Bollanti Lucilla, Conti Francesco, Cardelli Patrizia, Sacchetti Massimo, Orlando Giorgio, Zanuso Silvano, Nicolucci Antonio, Pugliese Giuseppe
Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy; Diabetes Unit, Sant'Andrea University Hospital, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy.
Department of Clinical and Molecular Medicine, University of Rome La Sapienza, Rome, Italy; Diabetes Unit, Sant'Andrea University Hospital, Rome, Italy.
Diabetes Res Clin Pract. 2022 Nov;193:110140. doi: 10.1016/j.diabres.2022.110140. Epub 2022 Nov 1.
In the Italian Diabetes and Exercise Study_2, a counselling intervention produced modest but sustained increments in moderate-to vigorous-intensity physical activity (MVPA), with reallocation of sedentary-time (SED-time) to light-intensity physical activity (LPA). This post hoc analysis evaluated the impact of intervention on estimated β-cell function and insulin sensitivity.
Patients with type 2 diabetes were randomized to one-month counselling once-a-year or standard care for 3 years. The HOmeostatic Model Assessment-2 (HOMA-2) method was used for estimating indices of β-cell function (HOMA-B%), insulin sensitivity (HOMA-S%), and insulin resistance (HOMA-IR); the disposition index (DI) was estimated as HOMA-β%/HOMA-IR; MVPA, LPA, and SED-time were objectively measured by accelerometer.
HOMA-B% and DI decreased in control group, whereas HOMA-B% remained stable and DI increased in intervention group. Between-group differences were significant for almost all insulin secretion and sensitivity indices. Changes in HOMA-B% and DI correlated with SED-time, MVPA and LPA. Changes in HOMA-B%, DI, and all indices were independently predicted by changes in SED-time (or LPA), MVPA, and BMI (or waist circumference), respectively.
In individuals with type 2 diabetes, increasing MVPA, even without achieving the recommended target, is effective in maintaining estimated β-cell function if sufficient amounts of SED-time are reallocated to LPA.
在意大利糖尿病与运动研究2中，一项咨询干预使中等到高强度身体活动（MVPA）出现适度但持续的增加，同时将久坐时间（SED时间）重新分配至低强度身体活动（LPA）。这项事后分析评估了干预对估计的β细胞功能和胰岛素敏感性的影响。
2型糖尿病患者被随机分为每年接受一次为期1个月的咨询或接受3年的标准护理。采用稳态模型评估-2（HOMA-2）方法来估计β细胞功能指标（HOMA-B%）、胰岛素敏感性指标（HOMA-S%）和胰岛素抵抗指标（HOMA-IR）；将处置指数（DI）估计为HOMA-β%/HOMA-IR；通过加速度计客观测量MVPA、LPA和SED时间。
对照组中HOMA-B%和DI下降，而干预组中HOMA-B%保持稳定且DI增加。几乎所有胰岛素分泌和敏感性指标的组间差异均具有显著性。HOMA-B%和DI的变化与SED时间、MVPA和LPA相关。HOMA-B%、DI和所有指标的变化分别由SED时间（或LPA）、MVPA和BMI（或腰围）的变化独立预测。
在2型糖尿病患者中，如果将足够量的SED时间重新分配至LPA，即使未达到推荐目标，增加MVPA也可有效维持估计的β细胞功能。
