Mastrototaro Lucia, Apostolopoulou Maria, Hartwig Sonja, Strassburger Klaus, Lipaeva Polina, Trinks Nina, Karusheva Yanislava, Gancheva Sofiya, Trenkamp Sandra, Lehr Stefan, Al-Hasani Hadi, Szendroedi Julia, Roden Michael
Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany.
Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich-Heine-University, Düsseldorf, Germany.
EBioMedicine. 2024 Dec;110:105471. doi: 10.1016/j.ebiom.2024.105471. Epub 2024 Dec 2.
High-intensity interval training (HIIT) has been shown to improve cardiorespiratory fitness (V˙O max) but may ameliorate insulin sensitivity only in insulin-resistant humans. It is yet unclear whether these benefits persist after detraining and to which extent duration and effectiveness of metabolic improvements differ between individuals without and with prediabetes or type 2 diabetes (T2D). Understanding these differences is relevant for developing targeted exercise training modes for individuals with different stages of dysglycemia.
Men with (20 T2D) and without T2D (12 insulin-sensitive, IS-NDM; 10 insulin-resistant, IR-NDM) underwent hyperinsulinemic-euglycemic clamps, spiroergometry, ectopic lipid quantification and muscle biopsies at baseline, after 12-week HIIT and after 4-week detraining.
After detraining, the HIIT-stimulated V˙O max declined in T2D and IR-NDM, but remained higher compared to baseline in all groups. The HIIT-induced changes in hepatic insulin sensitivity and ectopic lipid content were sustained after detraining in T2D and IR-NDM, whereas improvements of whole-body insulin sensitivity were abolished in T2D. T2D and IR-NDM showed persistent increases in the number of small extracellular vesicles, which carry among others antioxidant proteins. The ratio of reduced-to-oxidized glutathione further decreased after detraining in all groups, whereas changes in proteins involved in mitochondrial turnover were dependent on insulin sensitivity, with some evidence for upregulation of fusion and mitophagy in T2D and IR-NDM and upregulation of fission in IS-NDM. Levels of different lipolytic proteins were reduced in all participants after detraining.
HIIT offers sustained improvement of energy metabolism and hepatic insulin sensitivity in insulin-resistant humans, but long-term adherence is required to maintain these benefits.
Funding bodies that contributed to this study are listed in the Acknowledgements section.
高强度间歇训练（HIIT）已被证明可改善心肺功能（最大摄氧量），但可能仅在胰岛素抵抗人群中改善胰岛素敏感性。目前尚不清楚这些益处停训后是否依然存在，以及在无糖尿病前期或2型糖尿病（T2D）的个体与有糖尿病前期或T2D的个体之间，代谢改善的持续时间和效果在多大程度上存在差异。了解这些差异对于为不同血糖异常阶段的个体制定有针对性的运动训练模式具有重要意义。
患有T2D的男性（20例）和无T2D的男性（12例胰岛素敏感，IS-NDM；10例胰岛素抵抗，IR-NDM）在基线、12周HIIT后和4周停训后接受高胰岛素-正葡萄糖钳夹试验、运动心肺功能测试、异位脂质定量和肌肉活检。
停训后，HIIT刺激的最大摄氧量在T2D和IR-NDM中下降，但与所有组的基线相比仍更高。在T2D和IR-NDM中，停训后HIIT诱导的肝脏胰岛素敏感性和异位脂质含量变化得以维持，而T2D中全身胰岛素敏感性的改善消失。T2D和IR-NDM中小细胞外囊泡数量持续增加，这些囊泡携带抗氧化蛋白等物质。所有组停训后还原型谷胱甘肽与氧化型谷胱甘肽的比例进一步降低，而参与线粒体更新的蛋白质变化取决于胰岛素敏感性，有证据表明T2D和IR-NDM中融合和线粒体自噬上调，IS-NDM中裂变上调。所有参与者停训后不同脂解蛋白水平均降低。
HIIT可使胰岛素抵抗人群的能量代谢和肝脏胰岛素敏感性持续改善，但需要长期坚持以维持这些益处。
对本研究有贡献的资助机构列于致谢部分。
