结合划船和骑行的高强度间歇训练可改善但不能恢复2型糖尿病患者的β细胞功能。
High-intensity interval training combining rowing and cycling improves but does not restore beta-cell function in type 2 diabetes.
作者信息
Houborg Petersen Maria, Stidsen Jacob Volmer, Eisemann de Almeida Martin, Kleis Wentorf Emil, Jensen Kurt, Ørtenblad Niels, Højlund Kurt
机构信息
Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
出版信息
Endocr Connect. 2024 Apr 12;13(5). doi: 10.1530/EC-23-0558. Print 2024 May 1.
AIM
We investigated whether a high-intensity interval training (HIIT) protocol could restore beta-cell function in type 2 diabetes compared with sedentary obese and lean individuals.
MATERIALS AND METHODS
In patients with type 2 diabetes, and age-matched, glucose-tolerant obese and lean controls, we examined the effect of 8 weeks of supervised HIIT combining rowing and cycling on the acute (first-phase) and second-phase insulin responses, beta-cell function adjusted for insulin sensitivity (disposition index), and serum free fatty acid (FFA) levels using the Botnia clamp (1-h IVGTT followed by 3-h hyperinsulinemic-euglycemic clamp).
RESULTS
At baseline, patients with type 2 diabetes had reduced insulin sensitivity (40%), acute insulin secretion (13-fold), and disposition index (>35-fold), whereas insulin-suppressed serum FFA was higher (⁓2.5-fold) compared with controls (all P < 0.05). The HIIT protocol increased insulin sensitivity in all groups (all P < 0.01). In patients with type 2 diabetes, this was accompanied by a large (>200%) but variable improvement in the disposition index (P < 0.05). Whereas insulin sensitivity improved to the degree seen in controls at baseline, the disposition index remained markedly lower in patients with type 2 diabetes after HIIT (all P < 0.001). In controls, HIIT increased the disposition index by ~20-30% (all P < 0.05). In all groups, the second-phase insulin responses and insulin-suppressed FFA levels were reduced in response to HIIT (all P < 0.05). No group differences were seen in these HIIT-induced responses.
CONCLUSION
HIIT combining rowing and cycling induced a large but variable increase in beta-cell function adjusted for insulin sensitivity in type 2 diabetes, but the disposition index remained severely impaired compared to controls, suggesting that this defect is less reversible in response to exercise training than insulin resistance.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT03500016).
目的
我们研究了与久坐的肥胖和瘦人相比，高强度间歇训练（HIIT）方案是否能恢复2型糖尿病患者的β细胞功能。
材料与方法
在2型糖尿病患者以及年龄匹配的糖耐量正常的肥胖和瘦人对照中，我们使用博特尼亚钳夹法（1小时静脉葡萄糖耐量试验，随后3小时高胰岛素-正常血糖钳夹），研究了为期8周的结合划船和骑行的有监督的HIIT对急性（第一相）和第二相胰岛素反应、经胰岛素敏感性调整的β细胞功能（处置指数）以及血清游离脂肪酸（FFA）水平的影响。
结果
在基线时，2型糖尿病患者的胰岛素敏感性降低了约40%，急性胰岛素分泌降低了约13倍，处置指数降低了超过35倍，而与对照组相比，胰岛素抑制的血清FFA更高（约2.5倍）（所有P<0.05）。HIIT方案提高了所有组的胰岛素敏感性（所有P<0.01）。在2型糖尿病患者中，这伴随着处置指数大幅提高（>200%）但存在个体差异（P<0.05）。虽然胰岛素敏感性提高到了基线时对照组的水平，但HIIT后2型糖尿病患者的处置指数仍显著低于对照组（所有P<0.001）。在对照组中，HIIT使处置指数提高了约20%-30%（所有P<0.05）。在所有组中，HIIT导致第二相胰岛素反应和胰岛素抑制的FFA水平降低（所有P<0.05）。在这些HIIT诱导的反应中未观察到组间差异。
结论
结合划船和骑行的HIIT在2型糖尿病患者中使经胰岛素敏感性调整的β细胞功能大幅提高但存在个体差异，不过与对照组相比，处置指数仍严重受损，这表明该缺陷对运动训练的反应不如胰岛素抵抗可逆。
试验注册
ClinicalTrials.gov（NCT03500016）。
Zotero 插件