High intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2 diabetes: a randomised controlled trial.
High intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2 diabetes: a randomised controlled trial.
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DOI：
10.1007/s00125-015-3741-2
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发表时间：
2016-01
期刊：
影响因子：
8.2
通讯作者：
Trenell MI
中科院分区：
文献类型：
--
作者：
Cassidy S;Thoma C;Hallsworth K;Parikh J;Hollingsworth KG;Taylor R;Jakovljevic DG;Trenell MI
心脏疾病仍然是2型糖尿病死亡的主要原因，但很少有针对心功能不全的策略已经开发出来。这项随机对照试验旨在研究高强度间歇性训练（HIIT）作为改善2型糖尿病心脏结构和功能的潜在疗法。还研究了HIIT对肝脏脂肪和代谢控制的影响。使用在线随机分配序列，将28例2型糖尿病患者（二甲双胍和饮食控制）随机分配至12周HIIT（n = 14）或标准治疗（n = 14）。采用3.0T磁共振成像和标记法测量心脏结构和功能。通过1H-磁共振光谱测定肝脏脂肪，通过OGTT控制血糖。MRI分析由对组分配不知情的观察者进行。所有研究程序均在英国泰恩河畔纽卡斯尔进行。5例患者未完成研究，因此从分析中排除：这留下12例HIIT患者和11例对照患者进行意向治疗分析。与对照组相比，HIIT改善了心脏结构（左室壁质量104 ± 17 g至116 ± 20 g vs 107 ± 25 g至105 ± 25 g，p < 0.05）和收缩功能（每搏输出量76 ± 16 ml至87 ± 19 ml vs 79 ± 14 ml至75 ± 15 ml，p < 0.01）。治疗组舒张早期充盈率增加（241 ± 84 ml/s至299 ± 89 ml/s vs 250 ± 44 ml/s至251 ± 47 ml/s，p < 0.05），峰值扭转降低（8.1 ± 1.8°至6.9 ± 1.6° vs 7.1 ± 2.2°至7.6 ± 1.9°，p < 0.05）。HIIT后，肝脏脂肪相对减少39%（p < 0.05），HbA 1c减少（7.1 ± 1.0% [54.5 mmol/mol]至6.8 ± 0.9% [51.3 mmol/mol] vs 7.2 ± 0.5% [54.9 mmol/mol]至7.4 ± 0.7% [57.0 mmol/mol]，p < 0.05）。肝脏脂肪的变化与HbA 1c（r = 0.70，p < 0.000）和2 h葡萄糖（r = 0.57，p < 0.004）的变化相关。未记录不良事件。这是第一项研究证明心脏结构和功能的改善，沿着肝脏脂肪的最大减少，在2型糖尿病的运动干预后记录。临床护理团队应考虑HIIT作为改善2型糖尿病患者心脏代谢风险的治疗方法。www.isrctn.com 78698481医学研究理事会。
Cardiac disease remains the leading cause of mortality in type 2 diabetes, yet few strategies to target cardiac dysfunction have been developed. This randomised controlled trial aimed to investigate high intensity intermittent training (HIIT) as a potential therapy to improve cardiac structure and function in type 2 diabetes. The impact of HIIT on liver fat and metabolic control was also investigated. Using an online random allocation sequence, 28 patients with type 2 diabetes (metformin and diet controlled) were randomised to 12 weeks of HIIT (n = 14) or standard care (n = 14). Cardiac structure and function were measured by 3.0 T MRI and tagging. Liver fat was determined by 1H-magnetic resonance spectroscopy and glucose control by an OGTT. MRI analysis was performed by an observer blinded to group allocation. All study procedures took place in Newcastle upon Tyne, UK. Five patients did not complete the study and were therefore excluded from analysis: this left 12 HIIT and 11 control patients for the intention-to-treat analysis. Compared with controls, HIIT improved cardiac structure (left ventricular wall mass 104 ± 17 g to 116 ± 20 g vs 107 ± 25 g to 105 ± 25 g, p < 0.05) and systolic function (stroke volume 76 ± 16 ml to 87 ± 19 ml vs 79 ± 14 ml to 75 ± 15 ml, p < 0.01). Early diastolic filling rates increased (241 ± 84 ml/s to 299 ± 89 ml/s vs 250 ± 44 ml/s to 251 ± 47 ml/s, p < 0.05) and peak torsion decreased (8.1 ± 1.8° to 6.9 ± 1.6° vs 7.1 ± 2.2° to 7.6 ± 1.9°, p < 0.05) in the treatment group. Following HIIT, there was a 39% relative reduction in liver fat (p < 0.05) and a reduction in HbA1c (7.1 ± 1.0% [54.5 mmol/mol] to 6.8 ± 0.9% [51.3 mmol/mol] vs 7.2 ± 0.5% [54.9 mmol/mol] to 7.4 ± 0.7% [57.0 mmol/mol], p < 0.05). Changes in liver fat correlated with changes in HbA1c (r = 0.70, p < 0.000) and 2 h glucose (r = 0.57, p < 0.004). No adverse events were recorded. This is the first study to demonstrate improvements in cardiac structure and function, along with the greatest reduction in liver fat, to be recorded following an exercise intervention in type 2 diabetes. HIIT should be considered by clinical care teams as a therapy to improve cardiometabolic risk in patients with type 2 diabetes. www.isrctn.com 78698481 Medical Research Council.