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| 中强度有氧跑步与分段低强度有氧健走对2型糖尿病合并骨质疏松人群的骨密度、β细胞功能和糖代谢
影响的对比 |
| Comparison of the effects between moderate-intensity aerobic running and segmental low-intensity aerobic walking on bone mineral density, β-cell function, and glucose metabolism in type 2 diabetic patients with osteoporosis |
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| DOI：10.3969/j.issn.1006.7108.2019.09.010 |
| 中文关键词: 跑步 健走 糖尿病性骨质疏松 骨密度 β细胞功能 |
| 英文关键词:run walk DOP bone density β cell function |
| 基金项目:重庆市体育局科研项目（B2017019） |
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| 摘要点击次数: 1386 |
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| 中文摘要: |
| 目的 比较中强度有氧跑步运动和分段低强度有氧健走运动这两种运动对2型糖尿病合并骨质疏松患者β细胞功能、糖代谢和骨密度等指标的影响，为2型糖尿病性骨质疏松患者制订切实可行的运动处方提供具有参考价值的实验依据。方法 本研究招募123名受试者，在实验干预前让受试者佩戴三轴体力活动记录仪，佩戴5 d，每天起床开始佩戴，睡觉前摘下，计算出每天正常生活态的步数。对全部受试者进行前测（包括：身体成分分析、OGTT测试、胰岛β细胞功能评估、骨密度检测、糖脂代谢检测、下肢肌力测试），后进行随机分组：中强度有氧跑步组（medium intensity aerobic running group，MR组，n=41）；低强度有氧健走组（low-intensity aerobic walking，LW组，n=41）；对照组（control group，C组，n=41）。执行12周干预，干预期间MR组和LW组每周干预5 d，MR组，在指定时间以7 km/h的速度进行跑步20 min，后降速度降至6 km/h速度进行20 min的跑步。LW组，在维持原生活形态的基础上，整日累计步数>16 000步。C组，维持原生活形态，不刻意增加活动。12周干预结束后进行后测。利用SPSS软件和student's t test、one-way ANOVA进行干预前、后和组间比较分析。结果 身体成分方面，C组受试者体重、体脂率、腰臀比显著增加（P<0.05），LW组和MR组体重、体脂率、腰臀比显著下降（P <0.05）。骨密度方面，C组受试者股骨颈、Ward三角区、大转子骨密度（BMD）显著下降、LW组和MR显著上升（P <0.05）。骨代谢方面C组受试者尿HOP、尿 DPD、血浆 TRACP显著上升（P <0.05），LW组和MR显著下降（P <0.05）。糖代谢方面，C组受试者FPG、HbA1C、2hPG、HOMA-IR显著上升，而HOMA-β指数显著下降（P <0.05）。LW组和MR受试者FPG、HbA1C、2hPG、HOMA-IR显著下降，而HOMA-β指数显著上升（P <0.05）。下肢肌力方面，C组受试者膝关节屈伸力矩均出现显著下降（P <0.05），LW组和MR受试者膝关节屈伸力矩均出现显著上升（P <0.05），MR组受试者膝关节屈伸力矩均显著高于LW组（P <0.05）。结论 中强度有氧跑步和分段低强度有氧健走两种运动均能够增加2型糖尿病合并骨质疏松患者骨密度、增强β细胞功能和改善糖代谢降低。但增强下肢肌力方面，中强度有氧跑训练显著优于分段低强度有氧健走。 |
| 英文摘要: |
| Objective To compare the effects between moderate-intensity aerobic running and segmental low-intensity aerobic walking exercise on β-cell function, glucose metabolism, and bone mineral density in patients with type 2 diabetes and osteoporosis. It provides an experimental evidence for the development of practical exercise prescription for patients with type 2 diabetic osteoporosis. Methods A total of 123 subjects were recruited in this study. Before the experimental intervention, the subjects were wearing a triaxial body motion recorder for five days, starting from getting up every day and taking off before going to bed. The number of steps was calculated in normal daily life. Pretests were performed on all subjects (including body composition analysis, OGTT test, islet beta cell function assessment, bone mineral density test, glycol-lipid metabolism test, and lower limb muscle strength test). The subjects were then randomly divided to medium-intensity aerobic running group (MR group, n=41), low-intensity aerobic walking (LW group, n=41), and control group (group C, n=41). The intervention was performed for 12 weeks. During the intervention, the MR group and the LW group were intervened for 5 days per week. Patients in the MR group ran at a speed of 7 km/h for 20 min at the specified time, and then reduced to ran at 6 km/h for 20 min. Patients in the LW group walked at the cumulative number of >16,000 steps in the whole day, on the basis of maintaining the original life. Patients in Group C remained in the original life and did not deliberately increase activities. After 12-week intervention, the post-test was performed. Statistical analysis was performed using a SPSS software. Results Body composition, body weight, body fat percentage, and waist-to-hip ratio increased in group C significantly (P<0.05). Body weight, body fat percentage, and waist-to-hip ratio decreased significantly in LW group and MR group (P<0.05). Bone mineral density of the femoral neck, the word triangle, and the greater trochanter decreased significantly in the group C, but increased significantly in the LW and MR group (P<0.05). In terms of bone metabolism, urinary HOP, urinary DPD, and plasma TRACP increased significantly in group C (P<0.05), but decreased significantly in LW and MR group (P<0.05). In terms of glucose metabolism, FPG, HbA1C, 2hPG, and HOMA-IR increased significantly in the C group, while HOMA-β decreased significantly (P<0.05). FPG, HbA1C, 2hPG, and HOMA-IR decreased significantly in the LW group and MR subjects, while HOMA-β increased significantly (P<0.05). In terms of lower limb muscle strength, the knee joint flexion and extension moments showed a significant decrease in group C (P<0.05), and the knee joint flexion and extension moments increased significantly in LW and MR group (P<0.05). The knee flexion and extension moments in MR group were significantly higher than in the LW group (P<0.05). Conclusion Both moderate-intensity aerobic running and segmental low-intensity aerobic walking increase bone mineral density, enhance beta-cell function, and improve glucose metabolism in patients with type 2 diabetes and osteoporosis. However, in terms of lower limb muscle strength, medium-intensity aerobic running training is significantly better than segmental low-intensity aerobic walking. |
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