Autonomic Function and Exercise in Type 2 Diabetics

2 型糖尿病患者的自主功能和运动

• 批准号: 6820523
• 负责人: JILL A KANALEY
• 金额: $ 14.52万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6820523
• 关键词: aerobic exercise; autonomic disorder; clinical research; diabetes mellitus therapy; diabetic neuropathy; gender difference; glucose metabolism; human middle age (35-64); human subject; human therapy evaluation; insulin sensitivity /resistance; myocardial ischemia /hypoxia; noninsulin dependent diabetes mellitus; obesity; patient oriented research

DESCRIPTION (provided by applicant): Diabetic autonomic neuropathy is found with a high incidence in individuals with type 2 diabetes. More specifically, cardiac autonomic neuropathy (CAN) is the most common neuropathy found and is associated with an increase in ischemic heart disease and a higher incidence of arrhythmias and sudden death in obese and type 2 diabetic individuals. Nearly half of diabetic patients have CAN and if they do then the 5-yr mortality is substantially increased. Obesity alone compromises autonomic function, but in type 2 diabetics the hyperinsulinemic milieu is also speculated to further alter autonomic function potentially leading to the higher incidence of arrhythmias and sudden death in this population. Exercise and weight loss has been shown to improve CAN in obese individuals, but the reversibility of CAN in the type 2 diabetic individual is unclear. The purpose of this study is to determine if differences exist in CAN between obese non-diabetics and obese type 2 diabetic individuals, and if this response can be altered by 16 wk of aerobic exercise training. In addition we will also establish if gender differences occur with this response to training. We will recruit 40 men and women (40-60 yr) (20 obese/non-diabetics and 20 obese/ type 2 diabetics). Subjects will exercise train 4 days/wk at 65% V02 max. This study will train subjects in a supervised setting for the first month and then subjects will train in a supervised home-based program. Subjects will be monitored at home via phone, email and a website to track their progress. At the initiation and completion of the study, subjects will have their metabolic status (glucose and insulin levels (OGTT), blood lipids, HbA 1c) and autonomic function (heart rate variability-HRV) measured. This project is one of the first to determine if autonomic function can be improved in type 2 diabetics after participating in an exercise program, which is part of the current therapy. Because of the increased mortality in this population, this project will provide insight into whether autonomic dysfunction can be reversed and if gender differences occur in this response.

描述（由申请人提供）： 糖尿病自主神经病变在 2 型糖尿病患者中发病率较高。更具体地说，心脏自主神经病（CAN）是最常见的神经病，与肥胖和 2 型糖尿病个体缺血性心脏病的增加以及心律失常和猝死的发生率较高有关。近一半的糖尿病患者患有 CAN，如果患有 CAN，则 5 年死亡率会大幅增加。肥胖本身就会损害自主神经功能，但在 2 型糖尿病患者中，高胰岛素环境也被推测会进一步改变自主神经功能，可能导致该人群心律失常和猝死的发生率更高。运动和减肥已被证明可以改善肥胖个体的 CAN，但 2 型糖尿病个体 CAN 的可逆性尚不清楚。本研究的目的是确定肥胖的非糖尿病患者和肥胖的 2 型糖尿病患者之间 CAN 是否存在差异，以及这种反应是否可以通过 16 周的有氧运动训练来改变。此外，我们还将确定对培训的这种反应是否会出现性别差异。我们将招募 40 名男性和女性（40-60 岁）（20 名肥胖/非糖尿病患者和 20 名肥胖/2 型糖尿病患者）。受试者每周将进行 4 天、最大摄氧量 65% 的训练。这项研究将在第一个月的监督环境中对受试者进行训练，然后受试者将在监督的家庭计划中进行训练。受试者将在家中通过电话、电子邮件和网站进行监控，以跟踪他们的进度。在研究开始和完成时，将测量受试者的代谢状态（葡萄糖和胰岛素水平 (OGTT)、血脂、HbA 1c）和自主功能（心率变异性 - HRV）。该项目是第一个确定 2 型糖尿病患者在参加锻炼计划后是否可以改善自主神经功能的项目之一，锻炼计划是当前治疗的一部分。由于该人群的死亡率增加，该项目将深入了解自主神经功能障碍是否可以逆转，以及这种反应是否存在性别差异。