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12周联合力量与耐力循环训练计划对胰岛素抵抗及超重或轻度肥胖女性胰岛素敏感性和视黄醇结合蛋白4的影响:一项随机对照试验

Effects of 12-Week Combined Strength and Endurance Circuit Training Program on Insulin Sensitivity and Retinol-Binding Protein 4 in Women with Insulin-Resistance and Overweight or Mild Obesity: A Randomized Controlled Trial.

作者信息

Ratajczak Marzena, Krzywicka Monika, Szulińska Monika, Musiałowska Dominika, Kusy Krzysztof, Karolkiewicz Joanna

机构信息

Department of Medical Biology, Poznan University of Physical Education, Poznan, 61-871, Poland.

Department of Cardiological and Rheumatological Rehabilitation, Poznan University of Physical Education, Poznan, 61-871, Poland.

出版信息

Diabetes Metab Syndr Obes. 2024 Jan 6;17:93-106. doi: 10.2147/DMSO.S432954. eCollection 2024.

Abstract

BACKGROUND

Circuit training is an exercise mode, that may include both endurance and resistance components. There are premises that a combination of these two modalities brings additional benefits, particularly in improving insulin sensitivity. The retinol-binding protein 4 (RBP4) may inhibit signaling from insulin metabolic pathways in skeletal muscles, thus developing insulin resistance. This study aimed to evaluate whether moderate intensity circuit training combining strength and endurance exercise induces changes in tissue insulin sensitivity, carbohydrate and lipid metabolism, and serum RBP4 levels in insulin-resistant women.

METHODS

In this clinical controlled trial women diagnosed with insulin-resistance were randomly divided into two groups. The training group (T) performed circuit training combining strength (50%-80%1RM) and endurance (50%-75%HRR) exercise on five weight and two cardio machines, for 33 minutes, three times per week, for 3 months. Women from the control non-training group (NT) did not change their previous physical activity. At the beginning of the study and after the intervention period, a one-repetition maximum, body mass, and composition, resting heart rate (HR), blood pressure, glucose, insulin, blood lipids, thyroid-stimulating hormone (TSH), insulin-like growth factor-1 (IGF-1), RBP4, and insulin resistance (HOMA-IR) were measured. The results of 27 patients were analyzed using a two-way repeated measures ANOVA.

RESULTS

Significant differences in the pattern of change over time between the groups for resting HR (p < 0.010) and total lean mass (p < 0.039) were found. No differences in HOMA-IR, and RBP4 were observed post-study compared to pre-study in the T group. A significant correlation between RBP4 and TSH concentration was found.

CONCLUSION

Twelve-week circuit training combining strength and endurance exercise has minor effects on HOMA-IR, glucose and lipid metabolism, IGF-1, TSH, and RBP4. Although moderate-intensity circuit training is considered safe, its effectiveness in patients with overweight and mild obesity may be insufficient to reduce insulin resistance.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT04528693, registered August 23, 2020.

摘要

背景

循环训练是一种运动模式,可能包括耐力和阻力成分。有前提认为,这两种运动方式的结合会带来额外的益处,尤其是在改善胰岛素敏感性方面。视黄醇结合蛋白4(RBP4)可能会抑制骨骼肌中胰岛素代谢途径的信号传导,从而导致胰岛素抵抗。本研究旨在评估结合力量和耐力运动的中等强度循环训练是否会引起胰岛素抵抗女性的组织胰岛素敏感性、碳水化合物和脂质代谢以及血清RBP4水平发生变化。

方法

在这项临床对照试验中,被诊断为胰岛素抵抗的女性被随机分为两组。训练组(T组)在五台力量训练器械和两台有氧训练器械上进行结合力量(50%-80%1RM)和耐力(50%-75%HRR)运动的循环训练,每次33分钟,每周三次,共3个月。非训练对照组(NT组)女性保持之前的身体活动量不变。在研究开始时和干预期结束后,测量一次最大重复次数、体重和身体成分、静息心率(HR)、血压、血糖、胰岛素、血脂、促甲状腺激素(TSH)、胰岛素样生长因子-1(IGF-1)、RBP4和胰岛素抵抗(HOMA-IR)。使用双向重复测量方差分析对27名患者的结果进行分析。

结果

发现两组之间静息HR(p<0.010)和总瘦体重(p<0.039)随时间变化的模式存在显著差异。与研究前相比,T组在研究后未观察到HOMA-IR和RBP4的差异。发现RBP4与TSH浓度之间存在显著相关性。

结论

结合力量和耐力运动的为期12周的循环训练对HOMA-IR、葡萄糖和脂质代谢、IGF-1、TSH和RBP4的影响较小。尽管中等强度循环训练被认为是安全的,但其对超重和轻度肥胖患者降低胰岛素抵抗可能效果不足。

试验注册

ClinicalTrials.gov:NCT04528693,于2020年8月23日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fb1/10778163/3fa911188b03/DMSO-17-93-g0001.jpg

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