O'Connor Eamonn, Kiely Catherine, Gildea Norita, O'Shea Donal, Green Simon, Egaña Mikel
School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland.
Endocrinology, St Columcille's and St Vincent's Hospitals, Dublin, Ireland.
Diabetes Obes Metab. 2025 Oct;27(10):5910-5920. doi: 10.1111/dom.16648. Epub 2025 Jul 30.
Exercise tolerance is often impaired in type 2 diabetes (T2D), and barriers to regular exercise are common. This study evaluated whether 12 weeks of pioglitazone (PIO) therapy could enhance peak oxygen uptake (V̇O) and the time constant of the primary phase of oxygen uptake (τV̇O) during submaximal exercise, compared with exercise training, and whether combining PIO with exercise would provide additional benefits in T2D.
Male participants with T2D were assigned to one of the following groups: (1) non-exercising control (CON, n = 12), (2) PIO (15 mg/day) alone (PIO, n = 6), (3) exercise training alone (EXC, n = 13), or (4) PIO combined with exercise (PIO + EXC, n = 7). Exercise involved aerobic and resistance training three times per week for 12 weeks. V̇O (incremental cycling) and τV̇O, mean arterial pressure, and cardiac output (inert gas re-breathing) during cycling were assessed pre- and post-intervention.
PIO and PIO + EXC groups showed reductions (p < 0.01) in glycated haemoglobin (HbA). V̇O increased (p < 0.05) and τV̇O decreased (p < 0.01) in both the EXC (V̇O: 2.44 ± 0.38 to 2.73 ± 0.42 L·min; τV̇O: 42.7 ± 6.2 to 34.3 ± 7.2 s) and PIO + EXC (V̇O: 2.66 ± 0.43 to 2.88 ± 0.42 L·min; τV̇O: 40.3 ± 10.6 to 32.7 ± 8.3 s) groups. The magnitude of these effects was not different between the exercising groups. PIO alone did not induce changes in V̇O or τV̇O. Neither exercise nor PIO altered systemic cardiovascular dynamics.
Although PO improved glycaemic control, it did not enhance aerobic exercise capacity or V̇O kinetics. Moreover, in combination with exercise training, PIO did not provide additional benefits beyond those achieved through exercise alone.
2型糖尿病（T2D）患者的运动耐力常受损，且经常存在阻碍规律运动的因素。本研究评估与运动训练相比，12周的吡格列酮（PIO）治疗是否能提高次极量运动时的峰值摄氧量（V̇O）和摄氧第一阶段的时间常数（τV̇O），以及PIO与运动相结合是否能为T2D患者带来额外益处。
将患有T2D的男性参与者分为以下几组：（1）不运动对照组（CON，n = 12），（2）单独使用PIO（15毫克/天）组（PIO，n = 6），（3）单独进行运动训练组（EXC，n = 13），或（4）PIO与运动联合组（PIO + EXC，n = 7）。运动包括每周进行三次有氧运动和抗阻训练，共12周。在干预前后评估V̇O（递增式骑行）和τV̇O、平均动脉压以及骑行时的心输出量（惰性气体再呼吸法）。
PIO组和PIO + EXC组糖化血红蛋白（HbA）降低（p < 0.01）。EXC组（V̇O：从2.44 ± 0.38升至2.73 ± 0.42升·分钟；τV̇O：从42.7 ± 6.2秒降至34.3 ± 7.2秒）和PIO + EXC组（V̇O：从2.66 ± 0.43升至2.88 ± 0.42升·分钟；τV̇O：从40.3 ± 10.6秒降至32.7 ± 8.3秒）的V̇O均增加（p < 0.05），τV̇O均降低（p < 0.01）。运动组之间这些效应的幅度没有差异。单独使用PIO未引起V̇O或τV̇O的变化。运动和PIO均未改变全身心血管动力学。
尽管PIO改善了血糖控制，但它并未提高有氧运动能力或V̇O动力学。此外，与运动训练相结合时，PIO并未带来超出单独运动所取得的额外益处。
