Saki Hossein, Nazem Farzad, Khaiyat Omid, Fariba Farnaz
Department of Exercise Physiology, Sports Science Faculty, Bu-Ali Sina University, Hamadan, Iran.
Department of Exercise Physiology, Sports Science Faculty, Bu-Ali Sina University, Hamadan 65174, Iran.
Ther Adv Endocrinol Metab. 2025 Mar 28;16:20420188251325148. doi: 10.1177/20420188251325148. eCollection 2025.
Exercise has been suggested to effectively improve cardiac performance in children with type 1 diabetes (T1D) by enhancing the glycemic control. The purpose of this study was to investigate (1) effects of a 12-week combined interval running and resistance training (CIRRT) and (2) 1 month of detraining on cardiac structure and myocardial performance in adolescent males with T1D.
A total of 72 participants, including 48 adolescent males with T1D (fasting blood glucose (FBG): 274.67 ± 52.99 mg/dL, age: 15.20 ± 1.78 years) and 24 healthy adolescents (FBG: 90.75 ± 5.47 mg/dL, age: 15.08 ± 1.67 years), were recruited to the study. Participants were allocated into diabetes exercise (DE), diabetes control (DC), and healthy controls (HC) groups. The DE group performed 12 weeks of a CIRRT program three times per week. Blood glucose profile, echocardiography (ECHO) indices, and peak oxygen consumption (VO) were measured pre- and post-intervention and following 1-month detraining period. Repeated measures ANOVA was used for pre- and post-intervention comparisons within the DE group and across the three study groups. Significance level was set at < 0.05.
Exercise intervention resulted in decreased hemoglobin A1c (HbA1c% = Pre: 10.44 ± 2.03, Post: 9.38 ± 1.66, < 0.05), FBG, left ventricular (LV) internal diameter, and both tricuspid and mitral deceleration time (DT) in the DE group. VO, ejection fraction (EF% = Pre: 62.38 ± 1.6, Post: 64.08 ± 1.18, < 0.05), fractional shortening, early tricuspid diastolic inflow E velocity, and tricuspid velocity during atrial contraction were also increased following the exercise training. HbA1c (Pre vs Follow-up: 9.83 ± 1.73, < 0.05), EF (Pre vs Follow-up: 62.97 ± 1.56, < 0.05), LV, and DT tricuspid remained significantly improved after detraining period compared to the baseline. In the baseline, the glycemic index and ECHO variable significantly differed in the DE and DC groups with the HC group ( < 0.05). However, after the intervention, the DC and HC groups did not change significantly ( > 0.05).
The CIRRT intervention was associated with improved cardiac structure and performance in male adolescents with T1D potentially due to exercise-induced adaptations. Meanwhile, the results indicate that most cardiac morphological and functional changes are reversible following periods of inactivity in patients with T1D.
有研究表明，运动可通过改善血糖控制，有效提升1型糖尿病（T1D）患儿的心脏功能。本研究旨在探讨：（1）为期12周的间歇跑步与抗阻训练相结合（CIRRT）对T1D青少年男性心脏结构和心肌功能的影响；（2）为期1个月的停训对其的影响。
本研究共纳入72名参与者，其中包括48名T1D青少年男性（空腹血糖（FBG）：274.67±52.99mg/dL，年龄：15.20±1.78岁）和24名健康青少年（FBG：90.75±5.47mg/dL，年龄：15.08±1.67岁）。参与者被分为糖尿病运动（DE）组、糖尿病对照（DC）组和健康对照（HC）组。DE组每周进行3次为期12周的CIRRT方案。在干预前后以及1个月停训期后，测量血糖谱、超声心动图（ECHO）指标和峰值耗氧量（VO）。重复测量方差分析用于DE组内及三个研究组之间干预前后的比较。显著性水平设定为<0.05。
运动干预使DE组的糖化血红蛋白（HbA1c% = 干预前：10.44±2.03，干预后：9.38±1.66，<0.05）、FBG、左心室（LV）内径以及三尖瓣和二尖瓣减速时间（DT）均降低。运动训练后，VO、射血分数（EF% = 干预前：62.38±1.6，干预后：64.08±1.18，<0.05）、缩短分数、三尖瓣舒张早期流入E速度以及心房收缩期三尖瓣速度也有所增加。与基线相比，停训期后HbA1c（干预前与随访：9.83±1.73，<0.05）、EF（干预前与随访：62.97±1.56，<0.05）、LV和三尖瓣DT仍显著改善。在基线时，DE组和DC组的血糖指数和ECHO变量与HC组相比有显著差异（<0.05）。然而，干预后，DC组和HC组无显著变化（>0.05）。
CIRRT干预与T1D男性青少年心脏结构和功能的改善相关，这可能归因于运动诱导的适应性变化。同时，结果表明，T1D患者在一段时间不活动后，大多数心脏形态和功能变化是可逆的。
