Exercise training improves baroreflex sensitivity in type 2 diabetes
Exercise training improves baroreflex sensitivity in type 2 diabetes
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DOI：
10.2337/diabetes.52.7.1837
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发表时间：
2003-07-01
期刊：
影响因子：
7.7
通讯作者：
Vuori, I
中科院分区：
文献类型：
--
作者：
Loimaala, A;Huikuri, HV;Vuori, I
2型糖尿病是冠心病和心脏性猝死的重要危险因素。它与压力反射敏感性(BRS)和心率变异性(HRV)降低有关，这是不同患者群体死亡率和发病率增加的指标。本研究旨在评估运动训练对2型糖尿病患者BRS、HRV和血流动力学的影响。受试者(50名男性，平均年龄53.3+/-5.1岁)被随机分为对照组和运动组，前者仅接受常规治疗，后者接受常规治疗，同时接受每周两次心率控制耐力训练，并监督每周两次肌肉力量训练，为期12个月。基线和随访测量包括24小时记录期间的标准心率变异性的Vo(2max)时频域测量和苯肾上腺素方法的BRS。用全身阻抗心动图测量心脏指数、全身血管阻力指数、每搏指数和脉搏波速度。Vo(2max)显著改善(运动组：+2.3ml。Kg(-1)。运动组观察血糖控制(HbA(1c)-0.9%；P<；0.001 vs对照组)、肌力(Min(-1)；P<；0.005 vs Control)。BRS：运动组由6.8增至8.6ms/mm Hg，对照组由7.5增至6.4ms/mm Hg(0.05与4.36ms/mm Hg差值的95%可信区间；P<；0.05)。未观察到HRV的时间或频域测量或全身血流动力学的显著变化。我们的结论是，运动训练除了增加运动能力和肌肉力量以及改善血糖控制外，还可以改善2型糖尿病患者的BRS敏感性。运动在反射性自主神经调节和血糖控制方面的这些有益效果可能与改善2型糖尿病患者的预后有关。
Type 2 diabetes is a strong risk factor for coronary heart disease and sudden cardiac death. It is associated with reduced baroreflex sensitivity (BRS) and heart rate variability (HRV), which are indicators of increased risk for mortality and morbidity in various patient populations. This study was designed to assess the effects of exercise training on BRS, HRV, and hemodynamics in patients with type 2 diabetes. Subjects (50 men, mean age 53.3 +/- 5.1 years) with type 2 diabetes were randomized into either a control group, in which they received conventional treatment only, or an exercise group, in which they received conventional treatment together with heart rate-controlled endurance training twice a week and supervised muscle strength training twice a week for 12 months. Measurements taken at baseline and follow-up included Vo(2max) standard time and frequency domain measures of HRV during 24-h recording, and BRS by the phenylephrine method. Cardiac index, systemic vascular resistance index, stroke index, and pulse wave velocity were measured by whole-body impedance cardiography. Significant improvements in Vo(2max) (exercise group: +2.3 ml . kg(-1) . min(-1); P < 0.005 vs. control group), muscle strength, and glycemic control (exercise group: HbA(1c) -0.9%; P < 0.001 vs. control group) were observed in the exercise group. BRS increased in the exercise group, from 6.8 to 8.6 ms/mmHg, and decreased in the control group, from 7.5 to 6.4 ms/mmHg (95% CI for the difference between 0.05 and 4.36 ms/mmHg; P < 0.05). No significant changes in the time or frequency domain measures of HRV or in systemic hemodynamics were observed. We concluded that exercise training improves BRS sensitivity in type 2 diabetes subjects in addition to increasing the exercise capacity and muscle strength and improving glucose control. These beneficial effects in reflectory autonomic regulation and glucose control caused by exercise may be associated with improved prognosis of type 2 diabetes patients.