Effects of Exercise Modality on Insulin Resistance and Functional Limitation in Older Adults A Randomized Controlled Trial
Effects of Exercise Modality on Insulin Resistance and Functional Limitation in Older Adults A Randomized Controlled Trial
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DOI：
10.1001/archinternmed.2008.558
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发表时间：
2009-01-26
影响因子：
--
通讯作者：
Ross, Robert
中科院分区：
文献类型：
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作者：
Davidson, Lance E.;Hudson, Robert;Ross, Robert
背景资料：当局主张，阻力和有氧运动对于减少老年人慢性疾病和残疾的风险因素至关重要。然而，增量效果相结合的阻力和有氧运动相比，单独的任何一种方式的疾病和disability.Methods的危险因素是普遍未知的：参与者是136久坐，腹部肥胖的老年男性和女性从2002年9月30日，通过2006年11月15日，在皇后大学招募。参与者被随机分为以下4组，为期6个月：阻力运动，有氧运动，阻力和有氧运动（联合运动），或非运动控制。通过意向治疗模型分析主要结果，包括高胰岛素-正葡萄糖钳夹和功能限制的胰岛素抵抗变化，使用4项试验的平均变化（平均z评分）。结果：在控制年龄、性别和基线值后，与对照组相比，有氧运动组和联合运动组的胰岛素抵抗改善，但阻力运动组没有改善。改进（平均值[ SE]），联合运动组大于抗阻运动组（9.2 [1.3] vs 1.8 [1.3] mg/mL/mu IU/kg骨骼肌/分钟x100 [ P < .001]），但有氧运动组中没有（9.2 [1.3] vs 6.5 [1.3] mg/mL/mu IU/kg骨骼肌/分钟x100 [P < .001]）。μ IU/kg骨骼肌/min × 100 [P=. 46]）。与对照组相比，所有组的功能限制均显著改善。综合运动组的改善大于有氧运动组（0.5 [0.1] vs-0.0 [0.1];标准单位，z评分[P= .003]），但阻力运动组没有。改善阻力运动组是没有不同的有氧运动group.Conclusion：阻力和有氧运动的组合是最佳的运动策略，同时减少胰岛素抵抗和功能限制在以前久坐不动，腹部肥胖的老年人。
Background: Authorities advocate that resistance and aerobic exercise are essential for reducing risk factors for chronic disease and disability in older adults. However, the incremental effects of combined resistance and aerobic exercise compared with either modality alone on risk factors for disease and disability is generally unknown.Methods: Participants were 136 sedentary, abdominally obese older men and women recruited from September 30, 2002, through November 15, 2006, at Queen's University. Participants were randomized to 1 of the following 4 groups for 6 months: resistance exercise, aerobic exercise, resistance and aerobic exercise (combined exercise), or nonexercise control. Primary outcomes were analyzed by an intent-to-treat model and included changes in insulin resistance by hyperinsulinemic-euglycemic clamp and functional limitation using the average change in 4 tests combined (average z score).Results: After controlling for age, sex, and baseline value, insulin resistance improved compared with controls in the aerobic exercise and the combined exercise groups but not in the resistance exercise group. Improvement (mean [ SE]) in the combined exercise group was greater than in the resistance exercise group (9.2 [1.3] vs 1.8 [1.3] mg/mL/mu IU per kilogram of skeletal muscle per minute x 100 [ P < .001]) but not in the aerobic exercise group (9.2 [1.3] vs 6.5 [1.3] mg/mL/mu IU per kilogram of skeletal muscle per minute x 100 [P=. 46]). Functional limitation improved significantly in all groups compared with the control group. Improvement in the combined exercise group was greater than in the aerobic exercise group (0.5 [0.1] vs-0.0 [0.1]; standard units, z score [P= .003]) but not in the resistance exercise group. Improvement in the resistance exercise group was not different from the aerobic exercise group.Conclusion: The combination of resistance and aerobic exercise was the optimal exercise strategy for simultaneous reduction in insulin resistance and functional limitation in previously sedentary, abdominally obese older adults.