Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight toss

Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight toss
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DOI:
10.1016/j.numecd.2009.04.015
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发表时间:
2010-10-01
影响因子:
3.9
通讯作者:
Pugliese, G.
Pugliese, G.
中科院分区:
医学3区
文献类型:
--
作者:
Balducci, S.;Zanuso, S.;Pugliese, G.

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背景和目的:我们研究了不同运动方式对2型糖尿病和代谢综合征患者高敏c反应蛋白(hs-CRP)和其他炎症标志物的影响。方法与结果:82例患者随机分为4组:久坐对照组(A组);接受进行低强度身体活动的咨询(B);在规定和监督下进行12个月的高强度有氧(C)或有氧+阻力(D)运动(卡路里消耗相同)。在基线和每3个月进行一次休闲时间体力活动评估、身体健康评估、心血管危险因素和炎症生物标志物评估。B-D组体力活动量增加,HbA(1c)降低。VO2max、HOMA-IR指数、hdl -胆固醇、腰围和蛋白尿在C组和D组均有所改善,而力量和柔韧性仅在D组有所改善。所有三个运动组的hs-CRP水平均有所下降,但只有C组和D组降低显著,尤其是D组。C组和d组瘦素、抵抗素和白介素-6降低,脂联素升高。白介素-1 β、肿瘤坏死因子α和干扰素- γ降低,而抗炎白介素-4和10仅在d组升高。结论:2型糖尿病合并代谢综合征患者的体育锻炼与hs-CRP及其他炎症和胰岛素抵抗生物标志物的显著降低相关,与体重减轻无关。长期的高强度(最好是混合)训练,除了白天的身体活动,需要获得显著的抗炎效果。(C) 2009 Elsevier B.V.版权所有
Background and aims: We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome.Methods and results: Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic + resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA(1c) decreased in Groups B-D. VO2max, HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO2max and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1 beta, tumor necrosis factor-alpha and interferon-gamma decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D.Conclusion: Physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect. (C) 2009 Elsevier B.V. All rights reserved.