运动与胰岛素的敏感性

Exercise and insulin sensitivity

目的:胰岛素敏感性在非胰岛素依赖型糖尿病(non-insulindependentdiabetesmellitus,NIDDM)的发生中起重要作用。为此本文检索了近几年运动对胰岛素敏感性影响的相关研究资料,概述不同运动模式(一次急性运动和长期运动)对不同人群(正常人群和NIDDM人群)胰岛素敏感性的影响。资料来源:应用计算机检索PUBMED1975-01/2005-12的相关文章,检索词为“exercise,insulinsensitivity,NIDDM”,并限定文章语言种类为English。同时计算机检索万方数据库1995-01/2005-12的相关文章,检索词为“运动,胰岛素敏感性,2型糖尿病”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与运动及胰岛素敏感性研究相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到125篇相关文献,22篇文献符合纳入标准,排除的103篇文献为内容陈旧或重复。符合纳入标准的22篇文献中,2篇涉及一次急性运动对健康人胰岛素敏感性的影响,1篇涉及一次急性运动对NIDDM患者胰岛素敏感性的影响,3篇涉及长期运动对健康人胰岛素敏感性的影响,1篇涉及长期运动对NIDDM患者的胰岛素敏感性的影响,15篇涉及运动提高胰岛素敏感性的机制。资料综合:运动是公认的治疗糖尿病的手段之一。目前已知,运动可以在糖尿病发病的各个层面对糖尿病进行正性干预,运动提高胰岛素的敏感性是其中的一个重要机制。运动可通过提高糖原合成相关酶的活性和数量、改善胰岛素受体后的信号转导过程,上调肌肉葡萄糖转运蛋白等机制来提高胰岛素敏感性,这些都有助于控制血糖浓度,改善糖尿病患者的症状。结论:运动提高胰岛素敏感性是运动改善糖尿病症状的重要机制之一,适当的运动可明显改善糖尿病患者的胰岛素抵抗现象,因此运动可以作为治疗和预防NIDDM的重要手段。

OBJECTIVE： Insulin sensitivity plays a very important role in the occurrence of non-insulin dependent diabetes mellitus （NIDDM）. This study aims to retrieve the related articles of the effect of exercise on insulin sensitivity, and overview the different effects of different exercise patterns （acute exercise and long-term exercise） on the insulin sensitivities of different populations （normal people and NIDDM people）. DATA SOURCES： The related articles on exercise and insulin sensitivity published between January 1975 and December 2005 were searched in PUBMED database by computer with the keywords of ＂exercise, insulin sensitivity, NIDDM＂, and the language was limited to English. Meanwhile, the Chinese articles from January 1995 to December 2005 were searched in Wanfang database with the keywords of ＂exercise, insulin sensitivity, NIDDM＂. STUDY SELECTION： All the data were selected firstly, and quotations after each article were looked over. Inclusive criteria： The articles focused on the relationship between exercise and insulin sensitivity. Exclusive criteria： Repetitive research or Meta analysis. DATA EXTRACTION： Totally 125 related literatures on exercise and insulin sensitivity were collected, and 103 were excluded owing to repetitive or outdated contents. Among 22 literatures in accordance with inclusive criteria, there were 2 ones about the effect of acute exercise on insulin sensitivity in healthy people, 1 about the effect of acute exercise on insulin sensitivity in NIDDM patients, 3 ones about the effect of long-term exercise on insulin sensitivity in healthy people, 1 about the effect of long- term exercise on insulin sensitivity in NIDDM patients, and 15 ones about the mechanism of enhanced insulin sensitivity by exercise. DATA SYNTHESIS： Exercise is one of the generally-accepted methods to treat NIDDM. Presently, exercise can affect positively the diabetes through all the course of diabetes episode, one of whose important mechanism is that exercise can enhance the insulin sensitivity. Exercise can increase the activity and amount of glycogen synthase （GS）, improve the insulin signal transduction and elevate the expression of muscle glucose transporter 4 （GLUT4）, which will all contribute to enhancing insulin sensitivity, help to control the blood glucose concentration and improve the symptom of NIDDM patients. CONCLUSION： Up-regulation of insulin sensitivity is one of the important mechanisms of exercise to improve the symptom of diabetes. Proper exercise can improve the insulin resistance of diabetics obviously. So exercise may be the important method of preventing and treating NIDDM.