健步走对糖耐量减低患者脂联素和内皮依赖性血管舒张功能的影响

Effects of Walking on the Serum Adiponectin and Endothelium-dependent Vasodilation in Patients with Impaired Glucose Tolerance

目的:探讨健步走运动锻炼对糖耐量减低(IGT)患者血清脂联素、内皮依赖性血管舒张功能的影响。方法:对41名糖耐量减低患者随机分为健步走组20名、对照组21名,受试者采取24周运动处方的锻炼。运动干预前、后测定身体成分、脂联素(Adiponectin)、空腹血糖、餐后2h血糖和空腹胰岛素,计算胰岛素抵抗指数(HOMA-IR),并采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能(EDD)和硝酸甘油介导的内皮非依赖性血管舒张功能(EID)。结果:1)24周运动干预后,健步走组体脂%、腰围、腰臀围比、餐后2h血糖、空腹胰岛素、HOMA-IR均明显下降,血脂联素水平升高,内皮依赖性血管舒张功能明显改善;2)脂联素变化量的多元逐步回归分析显示出2个预测变量:体脂%、腰围的变化量。结论:对IGT患者进行健步走运动干预可升高血清脂联素水平,改善内皮依赖性血管舒张功能。

The purpose of this study was to explore the effects of walking on the serum adiponectin and endothelium-dependent vasodilation in patients with impaired glucose tolerance （IGT）. Forty-one patients with impaired glucose tolerance were divided randomly into experiment group and control group. The subjects from experiment group took an aerobic exercise prescription （walking） for 24 weeks and the control group without additional exercise than usual. Before and after the experiment, body composition, adiponectin, fasting blood glucose, 2-hour postprandial blood glucose and fasting insulin were examined. Meanwhile,the homeostasis model assessmentinsulin resistant index （HOMA-IR） was calculated,the flow-mediated （endothelium-dependent, EDD） and glycerylnitrate-mediated （endothelium-independent, EID） brachial arterial dilation were measured by the high resolution ultrasound. The result showed that in the experimental group,body fat percentage,waist circumference, waist to hip ratio （WHR）, 2-hour postprandial blood glucose,fasting insulin and HOMA-IR decreased significantly, and the level of serum adiponectin and endothelium-dependent vasodilation were improved. The adiponectin levels in multiple stepwise regression analysis showed two predictor variables of body fat percentage and waist circumference. It concluded that the intervention of walking could improve the serum adiponectin level and endothelium-dependent vasodilation of patients with IGT.