Effects of acute exercise on insulin sensitivity, glucose effectiveness and disposition index in type 2 diabetic patients
Effects of acute exercise on insulin sensitivity, glucose effectiveness and disposition index in type 2 diabetic patients
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DOI：
10.1016/j.diabet.2007.12.008
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发表时间：
2008-06-01
影响因子：
7.2
通讯作者：
Brun, J. -F.
中科院分区：
文献类型：
--
作者：
Bordenave, S.;Brandou, F.;Brun, J. -F.
瞄准- 这项工作的目的是量化2型糖尿病（T2 D）患者对急性运动的胰岛素敏感性（S-I）和葡萄糖有效性（S-G）的变化幅度，如先前在非糖尿病受试者中研究的那样。- 7名T2 D患者和7名非糖尿病对照参与了研究。以随机方式进行两次静脉葡萄糖耐量试验（0.5g/kg），在180分钟内频繁采血并进行数学建模，一次在休息时，另一次在以最大理论心率（HRmax）的50%运动15分钟后立即进行，随后以HRmax的85%运动5分钟。采用Bergman最小模型计算S-I和S-G。- 运动后，S-I增加了773%（从0.62 +/- 0.16增加到5.41 +/- 1.59 min（-1）x 10（-4）/（mu U/mL），甚至在休息时达到了对照值的区域（5.52 +/- 2.28），而S-G保持不变。运动后处置指数急性胰岛素反应（AIR（G））× S-I和空腹胰岛素乘积（I-B）× S-I也增加。- 在2型糖尿病患者中进行一次中等强度的运动并没有改善S-G，但显著改善了这些患者中发现的低S-I值，这表明运动对S-I的急性影响在解释训练相关的S-I变化时具有定量重要性，甚至可能是治疗上有用的。替代品，如稳态模型评估（HOMA）和定量胰岛素敏感性检查指数（QUICKI）的敏感性不足以检测这种增加Si，可能应该谨慎使用在糖尿病患者的运动方案的后续行动。(C)2008年，Elsevier Masson SAS。All rights reserved.
Aim. - The aim of this work was to quantify the magnitude of changes in insulin sensitivity (S-I) and glucose effectiveness (S-G) in response to acute exercise in type 2 diabetic (T2D) patients, as previously studied in non-diabetic subjects.Methods. - Seven T2D patients and seven non-diabetic controls participated ill the Study. Two intravenous glucose tolerance tests (0.5g/kg) with frequent blood sampling over 180 minutes and mathematical modelling were carried out in a randomized fashion, one at rest and the other immediately following 15 minutes of exercise at 50% of the maximum theoretical heart rate (HRmax)followed by five minutes at 85% of the HRmax. S-I and S-G were calculated using Bergman's minimal model.Results. - After exercise, S-I was increased by 773% (from 0.62 +/- 0.16 to 5.41 +/- 1.59 min(-1) x 10(-4)/(mu U/mL) and even reached the zone of control values at rest (5.52 +/- 2.28), whereas S-G remained unchanged. The disposition index acute insulin response (AIR(G)) x S-I and the product of fasting insulin (I-B) x S-I also increased after exercise.Conclusion. - A single bout of exercise at moderate intensity in type 2 diabetics did not improve S-G, but markedly improved the low S-I values found in these patients, indicating that the acute effects of exercise on S-I are quantitatively important in the interpretation of training-related S-I changes and may even be therapeutically useful on their own. Surrogates such as homoeostasis model assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI) were not sensitive enough to detect this increase in Si and should probably be used with caution in the follow-up of exercise protocols in diabetic patients. (C) 2008 Elsevier Masson SAS. All rights reserved.