Tamaki Toru, Muramatsu Ken, Ikutomo Masako
Department of Physical Therapy, Nagoya Aoi University, Nagoya, JPN.
Department of Physical Therapy, Kyorin University, Mitaka, JPN.
Cureus. 2025 Jul 12;17(7):e87793. doi: 10.7759/cureus.87793. eCollection 2025 Jul.
Background Diabetes mellitus negatively affects the peripheral nervous system, often leading to diabetic neuropathy (DN), which impairs nerve regeneration. Although exercise therapy promotes peripheral nerve regeneration, its effects under diabetic conditions remain unclear. The aim of this study was to investigate the effects of aerobic exercise and interval training on nerve regeneration following tibial nerve crush injury in male and female type 1 diabetic and control rats. Methods Type 1 diabetes mellitus was induced in Wistar rats via intraperitoneal injection of streptozotocin (50 mg/kg), and diabetes was confirmed after two weeks (blood glucose >400 mg/dL). Diabetic (DM) and age-matched control (CO) rats underwent tibial nerve crush injury and were randomly assigned to sedentary (SED), aerobic training (AT), or interval training (IT) groups. The AT group swam for 10 minutes, five times per week, while the IT group performed eight sets of 20-second swimming with 40-second rest intervals while carrying a weight equivalent to 18% of body weight, five times per week. Nerve recovery was assessed using compound muscle action potential (CMAP), nerve conduction velocity (NCV), and retrograde labeling of motor neurons. Results CMAP recovery rate and NCV were significantly lower in diabetic rats than in controls. In male rats, only aerobic training improved CMAP recovery rate and NCV, whereas interval training had no beneficial effects. Conversely, in female rats, both AT and IT significantly enhanced functional recovery, indicating a sex-dependent response. Motor neuron counts were lower in diabetic rats. In males, AT increased the number of motor neurons, whereas no significant changes were observed in females. Conclusion The effects of exercise on diabetic nerve regeneration are sex-dependent. In male rats, only aerobic exercise was beneficial, whereas interval training impaired recovery. In female rats, both aerobic and interval training promoted functional recovery. These findings highlight the potential of sex-specific exercise interventions for the management of DN.
背景 糖尿病会对周围神经系统产生负面影响，常导致糖尿病性神经病变（DN），损害神经再生。尽管运动疗法可促进周围神经再生，但其在糖尿病条件下的效果仍不明确。本研究的目的是调查有氧运动和间歇训练对1型糖尿病雄性和雌性大鼠及对照大鼠胫神经挤压伤后神经再生的影响。方法 通过腹腔注射链脲佐菌素（50 mg/kg）诱导Wistar大鼠患1型糖尿病，两周后确认糖尿病（血糖>400 mg/dL）。糖尿病（DM）大鼠和年龄匹配的对照（CO）大鼠接受胫神经挤压伤，然后随机分为久坐不动组（SED）、有氧训练组（AT）或间歇训练组（IT）。AT组每周游泳5次，每次10分钟，而IT组每周进行8组20秒游泳，每组间休息40秒，同时携带相当于体重18%的重物。使用复合肌肉动作电位（CMAP）、神经传导速度（NCV）和运动神经元逆行标记评估神经恢复情况。结果 糖尿病大鼠的CMAP恢复率和NCV显著低于对照组。在雄性大鼠中，只有有氧运动提高了CMAP恢复率和NCV，而间歇训练没有有益效果。相反，在雌性大鼠中，AT和IT均显著增强了功能恢复，表明存在性别依赖性反应。糖尿病大鼠的运动神经元计数较低。在雄性大鼠中，AT增加了运动神经元的数量，而在雌性大鼠中未观察到显著变化。结论 运动对糖尿病神经再生的影响具有性别依赖性。在雄性大鼠中，只有有氧运动有益，而间歇训练会损害恢复。在雌性大鼠中，有氧运动和间歇训练均促进了功能恢复。这些发现凸显了针对性别特异性运动干预管理DN的潜力。
