运动对2型糖尿病绝经妇女血清脂联素与胰岛素抵抗的影响

Effect of Exercise on Serum Adiponectin Level and Insulin Resistance in Postmenopausal Women with Type 2 Diabetes

目的:研究24周规律运动对2型糖尿病绝经后妇女血清脂联素水平的影响,及其与体成分变化和胰岛素抵抗状态改善的关系。方法:将21名受试者(53.67±3.57岁,BMI 26.22±2.89)随机分成运动组及对照组,进行24周运动试验(每周3次,每次70 min)。试验前后测量身体形态指标、空腹血糖、血脂、胰岛素、血清脂联素,并计算体重指数(BMI)、腰臀比(WHR)和胰岛素抵抗指数(HOMA-IR)。结果:运动组体重、BMI、体脂含量、空腹血糖、胰岛素和HOMA-IR水平显著下降,高密度脂蛋白胆固醇(HDL-C)水平显著性升高,血清脂联素升高37.57%(P=0.03);与对照组相比,体重、BMI、体脂含量、空腹血糖、胰岛素、甘油三酯、HDL-C、HOMA-IR及脂联素水平的变化率有显著的组间差异。运动引起的HOMA-IR水平改善与脂联素水平升高呈显著负相关(r=-0.553,P=0.01)。结论:24周每周3次规律运动显著降低了2型糖尿病绝经后妇女空腹血糖和胰岛素水平,改善了胰岛素抵抗状态,并使血清脂联素水平升高。运动改善胰岛素抵抗状态与脂联素的升高密切相关。

Purpose： To assess the effect of 24-week exercise program on serum adiponectin level in postmenopausal women with type 2 diabetes mellitus and discuss whether exercise-induced improvement in insulin resistance could be explained by modifications in changes of body composition and serum adiponeetin level. Methods： Twenty one subjects （aged 53.67±3.57yrs with BMI of 26.22±2.89） were randomly assigned in exercise group （EXE） and control group （CON）. The protocol took 24 weeks （3 times/week, 70 mix per session）. Body weight, body fat mass, fasting blood glucose, lipid profiles, fasting insulin as well as serum adiponectin were measured before and after the last round of exercise. Body mass index （BMI）, waist-to-hip ratio （WHR） and HOMA-IR were calculated. Results： After intervention, significant reduction in body weight, BMI, fat mass, fasting glucose, insulin and HOMA-IR in EXE group was found, and high density lipoprotein cholesterol（HDL-C） increased significantly. Moreover, serum adiponeetin increased 37.57% in EXE group （p= 0.026）. Compared with CON, there were significant differences in percentage changes of body weight, BMI, fat mass, glucose, insulin, triglycerides, HDL-C and HOMA-IR between groups, along with significant difference in percentage change of adiponectin. The reduction in HOMA-IR had significant negative correlation with serum adiponcetin increase （r=-0.55, p=0.01）. Conclusions： A 24-week thrice-weekly exercise training induced a significant decrease in fasting glucose, insulin and HOMA-IR, and a marked increase in plasma adiponectin, which indicates a improvement in insulin resistance resulting from exercise was related to changes in circulating adiponectin.