有氧运动和抗阻训练对 2 型糖尿病患者糖化血红蛋白水平的影响：一项随机对照试验。
Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial.
机构信息
Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Rd, Baton Rouge, LA 70808-4124, USA.
出版信息
JAMA. 2010 Nov 24;304(20):2253-62. doi: 10.1001/jama.2010.1710.
CONTEXT
Exercise guidelines for individuals with diabetes include both aerobic and resistance training although few studies have directly examined this exercise combination.
OBJECTIVE
To examine the benefits of aerobic training alone, resistance training alone, and a combination of both on hemoglobin A(1c) (HbA(1c)) in individuals with type 2 diabetes.
DESIGN, SETTING, AND PARTICIPANTS: A randomized controlled trial in which 262 sedentary men and women in Louisiana with type 2 diabetes and HbA(1c) levels of 6.5% or higher were enrolled in the 9-month exercise program between April 2007 and August 2009.
INTERVENTION
Forty-one participants were assigned to the nonexercise control group, 73 to resistance training 3 days a week, 72 to aerobic exercise in which they expended 12 kcal/kg per week; and 76 to combined aerobic and resistance training in which they expended 10 kcal/kg per week and engaged in resistance training twice a week. Main Outcome Change in HbA(1c) level. Secondary outcomes included measures of anthropometry and fitness.
RESULTS
The study included 63.0% women and 47.3% nonwhite participants who were a mean (SD) age of 55.8 years (8.7 years) with a baseline HbA(1c) level of 7.7% (1.0%). Compared with the control group, the absolute mean change in HbA(1c) in the combination training exercise group was -0.34% (95% confidence interval [CI], -0.64% to -0.03%; P = .03). The mean changes in HbA(1c) were not statistically significant in either the resistance training (-0.16%; 95% CI, -0.46% to 0.15%; P = .32) or the aerobic (-0.24%; 95% CI, -0.55% to 0.07%; P = .14) groups compared with the control group. Only the combination exercise group improved maximum oxygen consumption (mean, 1.0 mL/kg per min; 95% CI, 0.5-1.5, P < .05) compared with the control group. All exercise groups reduced waist circumference from -1.9 to -2.8 cm compared with the control group. The resistance training group lost a mean of -1.4 kg fat mass (95% CI, -2.0 to -0.7 kg; P < .05) and combination training group lost a mean of -1.7 (-2.3 to -1.1 kg; P < .05) compared with the control group.
CONCLUSIONS
Among patients with type 2 diabetes mellitus, a combination of aerobic and resistance training compared with the nonexercise control group improved HbA(1c) levels. This was not achieved by aerobic or resistance training alone.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT00458133.
背景
针对糖尿病患者的运动指南包括有氧运动和抗阻训练，尽管很少有研究直接检验这两种运动的联合应用。
目的
观察单纯有氧运动、单纯抗阻运动和两者联合应用对 2 型糖尿病患者糖化血红蛋白（HbA1c）的影响。
设计、地点和参与者：这是一项随机对照试验，2007 年 4 月至 2009 年 8 月，路易斯安那州 262 名 2 型糖尿病且 HbA1c 水平≥6.5%、久坐不动的男性和女性参与者被纳入为期 9 个月的运动项目。
干预措施
41 名参与者被分配到非运动对照组，73 名参与者进行每周 3 天的抗阻训练，72 名参与者进行每周消耗 12 kcal/kg 的有氧运动；76 名参与者进行每周消耗 10 kcal/kg 的有氧和抗阻联合训练，每周进行 2 次抗阻训练。主要观察指标是 HbA1c 水平的变化。次要观察指标包括人体测量和体能。
结果
研究包括 63.0%的女性和 47.3%的非白人参与者，平均（标准差）年龄为 55.8 岁（8.7 岁），基线 HbA1c 水平为 7.7%（1.0%）。与对照组相比，联合训练组的 HbA1c 绝对平均变化为-0.34%（95%置信区间，-0.64%至-0.03%；P=0.03）。与对照组相比，抗阻训练组（-0.16%；95%置信区间，-0.46%至 0.15%；P=0.32）和有氧运动组（-0.24%；95%置信区间，-0.55%至 0.07%；P=0.14）的 HbA1c 变化均无统计学意义。与对照组相比，只有联合运动组的最大耗氧量增加（平均增加 1.0 mL/kg·min；95%置信区间，0.5~1.5，P<0.05）。与对照组相比，所有运动组的腰围均缩小（-1.9 至-2.8 cm）。与对照组相比，抗阻训练组减少了 1.4 kg 脂肪质量（95%置信区间，-2.0 至-0.7 kg；P<0.05），联合训练组减少了 1.7 kg（-2.3 至-1.1 kg；P<0.05）。
结论
在 2 型糖尿病患者中，与不运动对照组相比，有氧运动和抗阻训练的联合应用可改善 HbA1c 水平。这一效果不能通过单纯的有氧运动或抗阻运动来实现。
试验注册
clinicaltrials.gov 标识符：NCT00458133。
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