抗阻运动对糖尿病前期人群代谢控制及转归的影响（基于NMR代谢组学）

Health and financial problems resulted from the various complications of uncontrolled diabetes greatly impact patients' quality of life and lay a great burden on the society. Thus, moving from the prevention of diabetic complications to the prevention of type 2 diabetes has caught global attention. Lifestyle interventions, mainly, medical nutrition treatment and exercise are the effective means to prevent type 2 diabetes. The literature showed that most of exercise interventions involved aerobic exercises, except for two of short term studies on glycemic changes. We were not able to find a single long term study focusing on type 2 diabetes prevention with resistant training and aerobic exercises. It has been known that for those who have already had diabetes, resistant training can reduce insulin resistance and A1c level, improve lipid profile, and decrease blood pressure.We found out that the combination of the resistand training and aerobic excerse was a safe and effective way to reduce A1c level and improve lipid profile in our previous study on type 2 diabetes patients. Based on our previous findings, we will evaluate how the different exercising interventions impact on insulin resistance, metabolic control, and the incidence and prevalence of diabetes in prediabetes population who receive 1 years of either resistant training, aerobic exercises, or combination of resistant training and aerobic exercises intervention. Further more, metabolomics approach will be introdued to detect biological markers,and therfore, to analyze the predictive values of metabolomics on long term outcomes of prediabetes population.

糖尿病控制不良引起的各种并发症及因此带来的健康和经济问题严重影响糖尿病患者的生活质量，并给社会带来沉重的负担。关口前移，预防2型糖尿病的发生已在全球范围内引起重视。生活方式干预，即健康饮食和运动被认为是经济有效的预防2型糖尿病的方法。除了2项短期的研究（分别为24小时和4周），在运动干预中多用有氧运动，未见中长期的抗组运动对预防2型糖尿病的研究。对于糖尿病患者, 抗阻运动能降低胰岛素抵抗，改善血糖血脂代谢，并有轻度降低血压的作用，课题组前期的研究证明抗阻联合有氧运动能有效降低糖尿病患者的糖化血红蛋白，改善血脂代谢。本研究拟在此基础上（已总结出安全有效的运动方案），对糖尿病前期患者进行抗阻、有氧、抗阻联合有氧的为期1年的研究，评价不同运动方式对其代谢控制及转归的影响，并从代谢组学的角度，评价代谢物质及表型的变化，通过监测代谢产物变化找出相关的生物标志物,从而分析其对病情转归的预测意义。

有氧运动被认为是预防糖尿病发生发展的重要方式，抗阻运动也被推荐。本研究对糖尿病前期病人进行为期1年的抗阻、有氧运动，评价不同运动方式对其代谢指标的影响。6个月研究结果发现：1）有氧运动组糖化血红蛋白及餐后2h 血糖（PBG）显著降低；干预后，糖化血红蛋白变化和运动后2h血糖变化三组间比较有统计学意义。干预后，三组餐后血糖比较有统计学意义。2）对照组低密度脂蛋白（LDL）显著增高。总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）三组组间、组内均无统计学意义。3）血压控制前后收缩压差值，组间比较有统计学意义。 4）有氧运动组腰围显著降低，三组内脂前后差值组间比较有统计学意义。5）有氧组、抗阻组和对照组逆转率（糖尿病前期转变为正常糖耐量）分别为30.4%，13%和3%。这些结果提示：有氧运动、抗阻运动均能改善糖尿病前期患者的餐后血糖、糖化血红蛋白，有氧运动优于抗阻运动，这两种运动方式对血脂、血压、肌肉量、人体成分的影响不大。两种运动均能一定程度上逆转糖尿病的发生。