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Effect of exercise training on metabolism and atherosclerosis in patients with diabettus mellitus and coronary artery diseases.

运动训练对糖尿病和冠状动脉疾病患者代谢和动脉粥样硬化的影响。

基本信息

批准号：
15590726
负责人：
MATSUMOTO Akihiro
金额：
$ 1.92万
依托单位：
The University of Tokyo
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2004
项目状态：
已结题

项目摘要

Adiponectin plays an important role in the metabolic syndrome and insulin sensitivity. To investigate its clinical roles, the relationships of plasma adiponectin levels with blood sugar and exercise capacity were studied in patients with coronary artery diseases, who have diabetes mellitus, hypertension, and/or obesity. The effects of cardiac rehabilitation on plasma adiponectin, exercise capacity, and exhaled nitric oxide output were also evaluated. The plasma adiponectin level was low (8.1±5.9 [mean±SD] μg/ml) in these patients. Their body mass index was 25.4±3.1. They had higher levels of fasting blood sugar (126±39 mg/dl) and HbAlc (5.9±1.2 %). Peak oxygen uptake was moderately decreased (68±12 % of predicted normal values). Cardiac rehabilitation increased plasma adiponectin level from 14.3±2.0 to 16.1±2.1 μg/ml (p<0.05) in the training group, but not in the non-training group. Cardiac rehabilitation increased peak oxygen uptake and anaerobic threshold in the training group, but not in the non-training group. Cardiac rehabilitation also increased exhaled nitric oxide output at peak exercise in the training group, but not in the non-training group. Plasma adiponectin level was decreased in patients with coronary artery diseases, and this was due to the high existence of obesity and diabetes mellitus in these patients. Exercise capacity such as peak oxygen uptake and anaerobic threshold was decreased in these subjects, and mall amount of exercise in daily activities plays an important role in the lower level of plasma adiponectin. Cardiac rehabilitation increased plasma adiponectin level with the simultaneous increase in exercise capacity. Cardiac rehabilitation also increased exhaled nitric oxide output during exercise, suggesting that it improved endothelium function. The beneficial effect of exercise training on plasma adiponectin level may play important role in the improvement of insulin resistance in these patients.

脂联素在代谢综合征和胰岛素敏感性中起重要作用。为探讨脂联素的临床意义，对合并糖尿病、高血压和/或肥胖的冠心病患者血浆脂联素水平与血糖和运动耐量的关系进行了研究。心脏康复对血浆脂联素、运动能力和呼出的一氧化氮输出的影响也被评估。这些患者的血浆脂联素水平较低(8.1±5.9[Mean±SD]μg/ml)。体重指数为25.4±3.1。他们的空腹血糖(126±39 mg/dl)和糖化血红蛋白(5.9±1.2%)水平较高。最大摄氧量中度降低(为正常值的68±12%)。心脏康复训练组血浆脂联素水平由14.3±2.0μg/ml升高至16.1±2.1 mgg/ml(P<0.0 5)，而非训练组则无明显变化。心脏康复训练提高了训练组的峰值摄氧量和无氧阈值，而非训练组则没有。心脏康复训练组运动高峰时呼出的一氧化氮输出量也有所增加，而非训练组则没有。冠心病患者血浆脂联素水平降低，这是由于肥胖和糖尿病在这些患者中的高度存在所致。这些受试者的峰值摄氧量、无氧阈值等运动能力降低，日常活动中少量的运动量是导致血浆脂联素水平降低的重要原因。心脏康复使血浆脂联素水平升高，同时运动能力增加。心脏康复还增加了运动时呼出的一氧化氮输出，表明它改善了内皮功能。运动训练对血浆脂联素水平的有益影响可能在改善这些患者的胰岛素抵抗中起重要作用。